Journal of Education and Health Promotion

The knowledge assessment and reducing the errors of medical certificate of cause of death with sensitization training of physicians: A quality improvement intervention study

Document Type : Original Article

Authors

. Swapnil Prabhakar Akhade
. Shreemanta Kumar Dash 1
. Kiran Swapnil Akhade 2

1 Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India

2 Department of Community Medicine, Raipur Institute of Medical Sciences, Raipur, Chhattisgarh, India

Abstract
BACKGROUND: A Medical Certificate of Cause of Death (MCCD) is a vital document issued by a
doctor and has a prescribed format published by the World Health Organization. It is an essential
tool to obtain scientific and reliable information in terms of the cause of mortality. The aim of this
study is to assess the knowledge about MCCD and to evaluate the impact of sensitization training
on the MCCD among the physicians working in the trauma and emergency department in a Tertiary
Care Centre.
MATERIALS AND METHODS: A quasi‑experimental quality improvement hospital‑based study
executed in Trauma and Emergency Department of Tertiary Care Hospital in Chhattisgarh State,
India. The physicians posted in the Trauma and Emergency Department were participated in the
study and attended the sensitization training session on MCCD. Statistical analysis used; the data
were entered in Microsoft Excel and analyzed with SPSS version 20 statistical software. Mean scores
and standard deviation (SD) were used for pre and posttest data while statistical significance was
tested using the paired t‑test. P < 0.05 was considered as significant. The technical and medical
errors in MCCD forms were depicted in percentages.
RESULTS: A total of 54 physicians completed the study, including 42 junior resident doctors, 6 senior
resident doctors, and 6 faculties. There was a significant difference in the scores before (M = 4.39,
SD = 1.571) and after (M = 7.5, SD = 0.885) the training (t = 17.6, P < 0.0001). The participants
showed substantial improvement by reduction in technical errors from 28% to 14% while the medical
error also slashed down from 42% to 16%.
CONCLUSIONS: Sensitization and educational training should be carried out consistently on regular
intervals to improve the knowledge of physicians regarding the appropriate filling of MCCD and
minimize the errors in MCCD, ultimately this will enhance usability and comparability of mortality
statistics generated from International Classification of Diseases data.
Keywords:
Death certificate, effectiveness of training, errors, medical certification of cause of deathBACKGROUND: A Medical Certificate of Cause of Death (MCCD) is a vital document issued by a
doctor and has a prescribed format published by the World Health Organization. It is an essential
tool to obtain scientific and reliable information in terms of the cause of mortality. The aim of this
study is to assess the knowledge about MCCD and to evaluate the impact of sensitization training
on the MCCD among the physicians working in the trauma and emergency department in a Tertiary
Care Centre.
MATERIALS AND METHODS: A quasi‑experimental quality improvement hospital‑based study
executed in Trauma and Emergency Department of Tertiary Care Hospital in Chhattisgarh State,
India. The physicians posted in the Trauma and Emergency Department were participated in the
study and attended the sensitization training session on MCCD. Statistical analysis used; the data
were entered in Microsoft Excel and analyzed with SPSS version 20 statistical software. Mean scores
and standard deviation (SD) were used for pre and posttest data while statistical significance was
tested using the paired t‑test. P < 0.05 was considered as significant. The technical and medical
errors in MCCD forms were depicted in percentages.
RESULTS: A total of 54 physicians completed the study, including 42 junior resident doctors, 6 senior
resident doctors, and 6 faculties. There was a significant difference in the scores before (M = 4.39,
SD = 1.571) and after (M = 7.5, SD = 0.885) the training (t = 17.6, P < 0.0001). The participants
showed substantial improvement by reduction in technical errors from 28% to 14% while the medical
error also slashed down from 42% to 16%.
CONCLUSIONS: Sensitization and educational training should be carried out consistently on regular
intervals to improve the knowledge of physicians regarding the appropriate filling of MCCD and
minimize the errors in MCCD, ultimately this will enhance usability and comparability of mortality
statistics generated from International Classification of Diseases data.

Keywords

Death certificate
effectiveness of training
errors
medical certification of cause of death
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Journal of Education and Health Promotion
Volume 12, Issue 1
January 2022
Pages 1-7

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