Of 350 physicians who met the study criteria, 141 completed the survey. No statistically significant differences were noted in responses between the 2 conferences after analysis and P value adjustment. Therefore, both groups were combined for analysis.
The 141 respondents reported specialties as follows: 101 (72.1%), primary care (including family medicine, general practice, geriatrics, pediatrics, emergency medicine, and urgent care medicine); 19 (13.5%), internal medicine; 5 (3.5%), surgery; 5 (3.5%), psychiatry; 4 (2.8%), obstetrics and gynecology; 1 (0.7%), anesthesiology; and 1 (0.7%), radiology. For statistical purposes, the specialties of surgery, psychiatry, obstetrics and gynecology, anesthesiology, and radiology were combined to form an “Other” category. Five respondents did not report their specialty and were thus excluded from final analysis. One respondent who indicated pediatrics as a specialty reported “not applicable” or “0” for all responses and was excluded from final analysis.
The 135 remaining physicians’ responses were compared and analyzed.
Figure 1 shows that overall, physicians reported feeling moderately comfortable with military terminology and uncomfortable understanding the diagnosis and management of TBI. More than half of the physicians indicated that they were not comfortable discussing health-related exposures and associated risks that veterans might experience, and half reported that they were unfamiliar with referral and consultation services for veterans. Overall, the data collected with the survey displayed a high degree of reliability (Cronbach α=0.88).
A matrix of correlations was visualized as a network of items (
Figure 2). Because the new results from the correlation analysis and EFA were identical (ie,
rdifference<0.02), the results based on the more popular Pearson correlation are shown.
Respondents’ self-perception of knowledge about or familiarity with veterans’ medical conditions, military terminology, and military health risks were more strongly related to each other than other items. Furthermore, the network (
Figure 2) suggests a strong correlation between items about respondents’ understanding of the diagnosis and management of TBI and PTSD and between items about respondents’ familiarity with military culture and lifestyle of active veterans and reservists. Lastly, although the items about referral and consultation were correlated with many other items, the item about respondents’ perceived need for training was negatively correlated with the item about referral and consultation.
The EFA indicated that a model with 4 factors fit the data best (log likelihood-ratio tests,
P<.01), accounting for 66% of the variances across the 9 items (
Table). Consistent with the patterns of correlations depicted in the network (
Figure 2), factor 1 loaded highly onto the items about veterans’ medical conditions, military terminology, and military health risks, and factor 2 loaded highly onto the items about military culture and lifestyle of active veterans and reservists. Factor 3 loaded onto the items about understanding the diagnosis and management of TBI and PTSD. Finally, factor 4 loaded highly onto the item about referral and consultation and negatively onto the item about perceived need for training.
We compared whether the 3 specialty groupings (ie, primary care, internal medicine, and other) differed in any of the 4 factors. In factor 1 (ie, veterans’ medical conditions, military terminology, and military health risks), respondents of both primary care and internal medicine scored statistically significantly higher than the other respondents (P<.05), although these 2 groups scored similarly (P>.05). On the other hand, the 3 specialties did not differ in any other factors (P>.05). These results suggest that primary care and internal medicine physicians were more experienced with these specific general military topics than the other physicians, but they may not differ in other military-related domains.