Wednesday, November 29, 2017

Effectiveness of the Adolescent Medicine Rotation in Improving Pediatric Residents Skill and Confidence Caring for Youth

Emily Ruedinger
University of Minnesota
 Purpose: Practicing and resident pediatricians report inadequate skill in caring for adolescents, despite adolescents comprising roughly one-quarter of most general and sub-specialty practices. This study examined the effectiveness of participation in an Adolescent Medicine rotation at improving pediatric residents’ self-perceived skills and confidence across nine key adolescent health domains. We also evaluated the impact of didactic instruction during the rotation.

Methods: Resident and recent-graduate participants (n=52) completed milestone-based self-assessment of their skill and confidence caring for adolescent patients in nine key adolescent health related domains. This study employed a post- then retrospective-pre test design, whereby participants rate their skill and confidence at the end of the rotation (post test) and then retrospectively rate their pre-rotation skill (retrospective pre-test). A subset of participants also completed a true pre-test. Additionally, differences in gains between those who did and did not participate in didactic instruction were evaluated.

Results: There was no difference between pre- and retrospective-pre-test ratings. Participants demonstrated a significant increase in self-perceived skill levels for all assessed domains after the rotation as compared to before the rotation, whether or not they received didactic instruction. Participation in didactic instruction yielded significant additional benefit for only one assessed domain: transition to adult healthcare.

Conclusions: Participation in an Adolescent Medicine rotation is of value to pediatric resident trainees and leads to increased self-assessed skill and confidence in caring for youth.

Implications and Contributions
Exposure to adolescents is limited during pediatric residency training. Pediatricians generally lack adequate skill and confidence when caring for adolescents. This study demonstrates that participation in the required Adolescent Medicine rotation, designed to help close these gaps, measurably improves residents’ self-assessed skills and confidence in caring for youth.