Brandi Shah1, Serena H Chan2, Lisa Perriera3, Melanie A Gold4, Aletha Y Akers5. 1. Division of Adolescent Medicine, Department of Pediatrics, University of Washington/Seattle Children's Hospital, Seattle, Washington. 2. Division of Pediatric and Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinatti, Ohio. 3. Department of Obstetrics and Gynecology, Case Western Reserve University School of Medicine, Cleveland, Ohio. 4. Center for Community Health and Education, New York, New York. 5. Department of Pediatrics, Obstetrics and Gynecology, The Craig Dalsimer Division of Adolescent Medicine, Philadelphia, Pennsylvania. Electronic address: akersa@email.chop.edu.
Abstract
STUDY OBJECTIVE: Delivery of reproductive services to adolescents varies according to specialty and has been linked to differences in clinical training. Few studies have explored how different specialties' graduate medical education (GME) programs prepare providers to deliver adolescent reproductive services. We explored the perceptions of resident physicians regarding their training in delivering adolescent reproductive health services. DESIGN: Between November 2008 and February 2009, 9 focus groups were conducted with graduate medical trainees in 3 specialties that routinely care for adolescents. The semistructured discussions were audio-recorded, transcribed, and analyzed using an inductive approach to content analysis. SETTING: Large, urban academic medical center in Pittsburgh, Pennsylvania. PARTICIPANTS: Fifty-four resident trainees in pediatrics, family medicine, and obstetrics/gynecology. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Trainees' perspectives regarding the didactic teaching and clinical training in providing adolescent reproductive services. RESULTS: Five themes emerged, reflecting trainees' beliefs regarding the best practices in which GME programs can engage to ensure that trainees graduate with the belief that they are competent and will be comfortable delivering adolescent reproductive services. Trainees believed programs need to: (1) provide didactic lectures and diverse inpatient and outpatient clinical experiences; (2) have faculty preceptors skilled in providing and supervising adolescent reproductive services; (3) teach skills for engaging adolescents in clinical assessments and decision-making; (4) train providers to navigate confidentiality issues with adolescents and caregivers; and (5) provide infrastructure and resources for delivering adolescent reproductive services. CONCLUSION: The 3 specialties differed in how well each of the 5 best practices were reportedly addressed during GME training. Policy recommendations are provided.
STUDY OBJECTIVE: Delivery of reproductive services to adolescents varies according to specialty and has been linked to differences in clinical training. Few studies have explored how different specialties' graduate medical education (GME) programs prepare providers to deliver adolescent reproductive services. We explored the perceptions of resident physicians regarding their training in delivering adolescent reproductive health services. DESIGN: Between November 2008 and February 2009, 9 focus groups were conducted with graduate medical trainees in 3 specialties that routinely care for adolescents. The semistructured discussions were audio-recorded, transcribed, and analyzed using an inductive approach to content analysis. SETTING: Large, urban academic medical center in Pittsburgh, Pennsylvania. PARTICIPANTS: Fifty-four resident trainees in pediatrics, family medicine, and obstetrics/gynecology. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Trainees' perspectives regarding the didactic teaching and clinical training in providing adolescent reproductive services. RESULTS: Five themes emerged, reflecting trainees' beliefs regarding the best practices in which GME programs can engage to ensure that trainees graduate with the belief that they are competent and will be comfortable delivering adolescent reproductive services. Trainees believed programs need to: (1) provide didactic lectures and diverse inpatient and outpatient clinical experiences; (2) have faculty preceptors skilled in providing and supervising adolescent reproductive services; (3) teach skills for engaging adolescents in clinical assessments and decision-making; (4) train providers to navigate confidentiality issues with adolescents and caregivers; and (5) provide infrastructure and resources for delivering adolescent reproductive services. CONCLUSION: The 3 specialties differed in how well each of the 5 best practices were reportedly addressed during GME training. Policy recommendations are provided.
Authors: Amy Lewis Gilbert; Allison L McCord; Fangqian Ouyang; Dillon J Etter; Rebekah L Williams; James A Hall; Wanzhu Tu; Stephen M Downs; Matthew C Aalsma Journal: J Pediatr Date: 2018-04-06 Impact factor: 4.406