Adolescent Medicine Training in Pediatric Residency Programs

National Alliance to Advance Adolescent Health, Washington, DC 20006, USA.
PEDIATRICS (Impact Factor: 5.47). 12/2009; 125(1):165-72. DOI: 10.1542/peds.2008-3740
Source: PubMed


The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine.
We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience.
Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training.
Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.

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    • "Some studies in the literature have examined pediatric residents' and other trainees' clinical skills and/or knowledge of adolescent health care [3-8]. Others have assessed pediatric residency training programs for the adolescent medicine training provided to their residents [9], and some have even looked at physicians' personal adolescent experiences or values and their subsequent effects on the delivery of health care to adolescent patients [10,11]. However, no studies to date have explored the experiences and perceptions of residents themselves during their postgraduate training in Adolescent Medicine and how such clinical experiences and exposure to different patient populations and patient-provider interactions may differ from the rest of their training in pediatrics. "
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    ABSTRACT: Although Adolescent Medicine is a pediatric subspecialty, it addresses many issues that differ from other aspects of pediatrics clinical training. The aim of this study was to explore the general experiences of pediatric residents during their rotations in Adolescent Medicine. Qualitative methods were applied. Semi-structured individual interviews were conducted with pediatric residents who had completed a rotation in Adolescent Medicine. Emergent themes were identified. Three key themes emerged: gaining exposure, taking on a professional role, and achieving self-awareness. Subcategories were also identified. There was particular emphasis on the multidisciplinary team and the biopsychosocial approach to adolescent health care. The experiences in Adolescent Medicine reflected residents' learning, notably gains in the "non-expert" as well as "medical expert" physician competencies. Future studies should explore how the interprofessional nature of an Adolescent Medicine team and the patient populations themselves contribute to this learning.
    BMC Medical Education 12/2010; 10(1):88. DOI:10.1186/1472-6920-10-88 · 1.22 Impact Factor
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