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Susan M. Sawyer - One of the best experts on this subject based on the ideXlab platform.
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somatic symptom disorders in Adolescent inpatients
Journal of Adolescent Health, 2018Co-Authors: Phillipa Mcswiney, Andrew Court, Aaron Wiggins, Susan M. SawyerAbstract:Abstract Purpose There are only a few reports of Adolescents with somatic disorders (SDs) whose symptoms are sufficiently severe to require hospital admission. The aim of this study was to describe the symptom profile, health service utilization, and outcome of Adolescents with SDs admitted to a tertiary children's hospital. Methods A retrospective cohort study of all Adolescents admitted to the Adolescent Medicine Unit of a tertiary children's hospital was undertaken from July 2013 to June 2014. In a two-stage process, medical records were examined to identify patients who met the diagnostic criteria for SD. Evidence of functional recovery was obtained for the period from 18 to 30 months after discharge and rated as completely recovered, partially recovered, or functionally disabled. Results A total of 60 admissions (53 patients, 79% female) were identified with SD, accounting for 12% of the unit's admissions and 2% of hospital admissions over 12 years old. Nearly half (45%) the presenting symptoms were neurological and 39% involved pain. In total, 20% of admissions were for complex symptoms involving multiple body systems. The majority (81%) of Adolescents with follow-up documentation (n = 37) demonstrated complete or partial recovery. Patients whose families fully accepted the diagnosis were more likely to accept counseling following discharge (p Conclusions Hospitalized Adolescents with SD utilize substantial resources due to the requirement for comprehensive assessment, including multidisciplinary communication. Recovery can be anticipated for the majority, especially if supported by parents.
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somatic symptom disorders in Adolescent inpatients
Journal of Adolescent Health, 2018Co-Authors: Phillipa Mcswiney, Andrew Court, Aaron Wiggins, Susan M. SawyerAbstract:Abstract Purpose There are only a few reports of Adolescents with somatic disorders (SDs) whose symptoms are sufficiently severe to require hospital admission. The aim of this study was to describe the symptom profile, health service utilization, and outcome of Adolescents with SDs admitted to a tertiary children's hospital. Methods A retrospective cohort study of all Adolescents admitted to the Adolescent Medicine Unit of a tertiary children's hospital was undertaken from July 2013 to June 2014. In a two-stage process, medical records were examined to identify patients who met the diagnostic criteria for SD. Evidence of functional recovery was obtained for the period from 18 to 30 months after discharge and rated as completely recovered, partially recovered, or functionally disabled. Results A total of 60 admissions (53 patients, 79% female) were identified with SD, accounting for 12% of the unit's admissions and 2% of hospital admissions over 12 years old. Nearly half (45%) the presenting symptoms were neurological and 39% involved pain. In total, 20% of admissions were for complex symptoms involving multiple body systems. The majority (81%) of Adolescents with follow-up documentation (n = 37) demonstrated complete or partial recovery. Patients whose families fully accepted the diagnosis were more likely to accept counseling following discharge (p Conclusions Hospitalized Adolescents with SD utilize substantial resources due to the requirement for comprehensive assessment, including multidisciplinary communication. Recovery can be anticipated for the majority, especially if supported by parents.
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confidentiality with Adolescents in the medical setting what do parents think
Journal of Adolescent Health, 2011Co-Authors: Rony E Duncan, Susan M. Sawyer, Moya Vandeleur, Anouk DerksAbstract:Abstract Purpose When confidential health care is provided to Adolescents they are more likely to seek care, disclose sensitive information, and return for future visits. Guidelines for health professionals recommend seeing young people alone to facilitate confidential care. We sought to document parental views regarding confidentiality with Adolescents, aiming to identify topics that parents believe they should be informed about despite an assurance of confidentiality between their child and the doctor. We also aimed to document harms and benefits that parents associate with Adolescents seeing doctors alone. Methods A sample of 86 parents attending an Adolescent Medicine clinic with their son/daughter was surveyed using a brief, anonymous questionnaire. Results Parents identified several benefits associated with confidential care, yet also believed they should be informed about a wide range of topics, even if their children did not want them to know. Parents' primary concern about confidentiality was a fear of not being informed about important information. Conclusions Parental views concerning confidentiality are complex and conflicting and differ from current guidance provided to health professionals. Ensuring that parents accurately understand the limits to confidentiality and support the notion of confidential care for their children is a challenging yet vital task for health professionals.
Elizabeth Goodman - One of the best experts on this subject based on the ideXlab platform.
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reliability of the problem oriented screening instrument for teenagers posit in Adolescent medical practice
Journal of Adolescent Health, 2001Co-Authors: Robert H Durant, John R Knight, Elizabeth Goodman, Todd PulerwitzAbstract:Abstract Purpose: To determine the internal consistency and 1-week test–retest reliability of the Problem Oriented Screening Instrument for Teenagers (POSIT) among Adolescent medical patients. Methods: A research assistant administered the POSIT to a consecutive sample of 15- to 18-year-old patients arriving for routine medical care at a hospital-based Adolescent medical practice. Each subject returned for a retest 1 week later. Internal consistency for each scale on test and retest was calculated using Cronbach alpha, and 1-week test–retest reliability by the intraclass correlation coefficient (r) and the kappa coefficient (κ). Results: The Substance Use/Abuse, Mental Health Status, Educational Status, and Aggressive Behavior/Delinquency scales had favorable alpha scores (> .70). Others, including Physical Health Status, had lower alpha scores. High intraclass correlation coefficients were found for all 10 POSIT scales (r = .72 to .88), although (r) was lower for males on two of the scales. Kappa coefficients for all scales indicated good reproducibility beyond chance (κ = .42 to .73). Conclusions: This study provided supportive evidence for the reliability of the POSIT in primary care medical settings, although some POSIT scales could likely be improved. The 20- to 30-min administration time is most practical in settings that are dedicated to Adolescent Medicine, and computerized administration and scoring are needed.
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development of a bright futures curriculum for pediatric residents
Ambulatory Pediatrics, 2001Co-Authors: John R Knight, Terrill Bravender, Carolyn Frazer, Elizabeth Goodman, Gregory S Blaschke, Jean S EmansAbstract:Objective.—To develop a standardized case-based curriculum for pediatric residents on child growth, development, behavior, and Adolescent Medicine that incorporates the Bright Futures health supervision guidelines. Design.—This project included a needs assessment, development of a list of important topics, writing and revising of standardized cases, formative evaluation of cases, and efficacy pilot testing of 2 cases. Setting.—A large pediatric teaching hospital continuity clinic. Participants.—Pediatric residents, fellows, and faculty. Interventions.—Preparation of standardized cases, facilitator training, and resident-led teaching conferences. Outcome Measures.—Learner and facilitator evaluation forms and two 10-item diagnostic skills assessments. Results.—During the project, faculty-fellow teams wrote 29 case-teaching modules. All participants gave high ratings to cases, and resident facilitators reported increased comfort with the case discussion method. Resident learners' ability to accurately interpret developmental screening tests and growth charts improved following sessions on those topics. Conclusions.—Further evaluation is required, but these standardized cases appear promising for teaching pediatric residents. The curriculum is now freely available to faculty nationwide.
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Adolescent Medicine training in pediatric residency programs are we doing a good job
Pediatrics, 1998Co-Authors: S J Emans, Terrill Bravender, John R Knight, Carolyn Frazer, Maria Luoni, Carol D Berkowitz, Ehrin J Armstrong, Elizabeth GoodmanAbstract:Objectives To determine how pediatric residency programs are responding to the new challenges of teaching Adolescent Medicine (AM) to residents by assessing whether manpower is adequate for training, whether AM curricula and skills are adequately covered by training programs, what types of teaching methodologies are used to train residents in AM, and the needs for new curricular materials to teach AM. Design A 3-part 92-item survey mailed to all US pediatric residency training programs. Setting Pediatric residency programs. Participants Residency program directors and directors of AM training. Main outcome measures AM divisional structure, clinical sites of training, presence of a block rotation, and faculty of pediatric training programs; training materials used and desired in AM; perceived adequacy of coverage of various AM topics; competency of residents in performing pelvic examinations in sexually active teens; and manpower needs. Results A total of 155/211 (73.5%) of programs completed the program director and the AM parts of the survey. Ninety-six percent of programs (size range, 5-120 residents) had an AM block rotation and 90% required the AM block; those without a block rotation were more likely to be larger programs. Only 39% of programs felt that the number of AM faculty was adequate for teaching residents. Almost half of the programs reported lack of time, faculty, and curricula to teach content in substance abuse. Besides physicians, AM teachers included nurse practitioners (28%), psychologists (25%), and social workers (19%). Topics most often cited as adequately covered included sexually transmitted diseases (81.9%), confidentiality (79.4%), puberty (77.0%), contraception (76.1%), and menstrual problems (73.5%). Topics least often cited as adequately covered included psychological testing (16.1%), violence in relationships (20.0%), violence and weapon-carrying (29.7%), and sports Medicine (29.7%). Fifty-eight percent of 137 respondents thought that all or nearly all of their residents were competent in performing pelvic examinations by the end of training; there was no difference between perceived competence and the residents' use of procedure books. Seventy-four percent used a specific curriculum for teaching AM; materials included chapters/articles (85%), lecture outlines (76.1%), slides (41.9%), videos (35.5%), written case studies (24.5%), computerized cases (6.5%), and CD-ROMs (3.2%). Fifty-two percent used Bright Futures, 48% used the Guidelines for Adolescent Preventive Services, and 14% used the Guide to Clinical Preventive Services for teaching clinical preventive services. Programs that used Bright Futures were more likely to feel that preventive services were adequately covered in their programs than those who did not (78% vs 57%). A majority of programs desired more learner-centered materials. Conclusions Although almost all pediatric programs are now providing AM rotations, there is significant variability in adequacy of training across multiple topics important for resident education. Programs desire more learner-centered materials and more faculty to provide comprehensive resident education in AM.
John R Knight - One of the best experts on this subject based on the ideXlab platform.
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reliability of the problem oriented screening instrument for teenagers posit in Adolescent medical practice
Journal of Adolescent Health, 2001Co-Authors: Robert H Durant, John R Knight, Elizabeth Goodman, Todd PulerwitzAbstract:Abstract Purpose: To determine the internal consistency and 1-week test–retest reliability of the Problem Oriented Screening Instrument for Teenagers (POSIT) among Adolescent medical patients. Methods: A research assistant administered the POSIT to a consecutive sample of 15- to 18-year-old patients arriving for routine medical care at a hospital-based Adolescent medical practice. Each subject returned for a retest 1 week later. Internal consistency for each scale on test and retest was calculated using Cronbach alpha, and 1-week test–retest reliability by the intraclass correlation coefficient (r) and the kappa coefficient (κ). Results: The Substance Use/Abuse, Mental Health Status, Educational Status, and Aggressive Behavior/Delinquency scales had favorable alpha scores (> .70). Others, including Physical Health Status, had lower alpha scores. High intraclass correlation coefficients were found for all 10 POSIT scales (r = .72 to .88), although (r) was lower for males on two of the scales. Kappa coefficients for all scales indicated good reproducibility beyond chance (κ = .42 to .73). Conclusions: This study provided supportive evidence for the reliability of the POSIT in primary care medical settings, although some POSIT scales could likely be improved. The 20- to 30-min administration time is most practical in settings that are dedicated to Adolescent Medicine, and computerized administration and scoring are needed.
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development of a bright futures curriculum for pediatric residents
Ambulatory Pediatrics, 2001Co-Authors: John R Knight, Terrill Bravender, Carolyn Frazer, Elizabeth Goodman, Gregory S Blaschke, Jean S EmansAbstract:Objective.—To develop a standardized case-based curriculum for pediatric residents on child growth, development, behavior, and Adolescent Medicine that incorporates the Bright Futures health supervision guidelines. Design.—This project included a needs assessment, development of a list of important topics, writing and revising of standardized cases, formative evaluation of cases, and efficacy pilot testing of 2 cases. Setting.—A large pediatric teaching hospital continuity clinic. Participants.—Pediatric residents, fellows, and faculty. Interventions.—Preparation of standardized cases, facilitator training, and resident-led teaching conferences. Outcome Measures.—Learner and facilitator evaluation forms and two 10-item diagnostic skills assessments. Results.—During the project, faculty-fellow teams wrote 29 case-teaching modules. All participants gave high ratings to cases, and resident facilitators reported increased comfort with the case discussion method. Resident learners' ability to accurately interpret developmental screening tests and growth charts improved following sessions on those topics. Conclusions.—Further evaluation is required, but these standardized cases appear promising for teaching pediatric residents. The curriculum is now freely available to faculty nationwide.
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Adolescent Medicine training in pediatric residency programs are we doing a good job
Pediatrics, 1998Co-Authors: S J Emans, Terrill Bravender, John R Knight, Carolyn Frazer, Maria Luoni, Carol D Berkowitz, Ehrin J Armstrong, Elizabeth GoodmanAbstract:Objectives To determine how pediatric residency programs are responding to the new challenges of teaching Adolescent Medicine (AM) to residents by assessing whether manpower is adequate for training, whether AM curricula and skills are adequately covered by training programs, what types of teaching methodologies are used to train residents in AM, and the needs for new curricular materials to teach AM. Design A 3-part 92-item survey mailed to all US pediatric residency training programs. Setting Pediatric residency programs. Participants Residency program directors and directors of AM training. Main outcome measures AM divisional structure, clinical sites of training, presence of a block rotation, and faculty of pediatric training programs; training materials used and desired in AM; perceived adequacy of coverage of various AM topics; competency of residents in performing pelvic examinations in sexually active teens; and manpower needs. Results A total of 155/211 (73.5%) of programs completed the program director and the AM parts of the survey. Ninety-six percent of programs (size range, 5-120 residents) had an AM block rotation and 90% required the AM block; those without a block rotation were more likely to be larger programs. Only 39% of programs felt that the number of AM faculty was adequate for teaching residents. Almost half of the programs reported lack of time, faculty, and curricula to teach content in substance abuse. Besides physicians, AM teachers included nurse practitioners (28%), psychologists (25%), and social workers (19%). Topics most often cited as adequately covered included sexually transmitted diseases (81.9%), confidentiality (79.4%), puberty (77.0%), contraception (76.1%), and menstrual problems (73.5%). Topics least often cited as adequately covered included psychological testing (16.1%), violence in relationships (20.0%), violence and weapon-carrying (29.7%), and sports Medicine (29.7%). Fifty-eight percent of 137 respondents thought that all or nearly all of their residents were competent in performing pelvic examinations by the end of training; there was no difference between perceived competence and the residents' use of procedure books. Seventy-four percent used a specific curriculum for teaching AM; materials included chapters/articles (85%), lecture outlines (76.1%), slides (41.9%), videos (35.5%), written case studies (24.5%), computerized cases (6.5%), and CD-ROMs (3.2%). Fifty-two percent used Bright Futures, 48% used the Guidelines for Adolescent Preventive Services, and 14% used the Guide to Clinical Preventive Services for teaching clinical preventive services. Programs that used Bright Futures were more likely to feel that preventive services were adequately covered in their programs than those who did not (78% vs 57%). A majority of programs desired more learner-centered materials. Conclusions Although almost all pediatric programs are now providing AM rotations, there is significant variability in adequacy of training across multiple topics important for resident education. Programs desire more learner-centered materials and more faculty to provide comprehensive resident education in AM.
John S. Santelli - One of the best experts on this subject based on the ideXlab platform.
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abstinence and abstinence only education a review of u s policies and programs
Journal of Adolescent Health, 2006Co-Authors: John S. Santelli, Maureen E Lyon, Jennifer Rogers, Daniel Summers, Rebecca SchleiferAbstract:Abstinence from sexual intercourse is an important behavioral strategy for preventing human immunodeficiency virus (HIV), other sexually transmitted infections (STIs), and pregnancy among Adolescents. Many Adolescents, including most younger Adolescents, have not initiated sexual intercourse and many sexually experienced Adolescents and young adults are abstinent for varying periods of time. There is broad support for abstinence as a necessary and appropriate part of sexuality education. Controversy arises when abstinence is provided to Adolescents as a sole choice and where health information on other choices is restricted or misrepresented. Although abstinence is theoretically fully effective, in actual practice abstinence often fails to protect against pregnancy and STIs. Few Americans remain abstinent until marriage; many do not or cannot marry, and most initiate sexual intercourse and other sexual behaviors as Adolescents. Although abstinence is a healthy behavioral option for teens, abstinence as a sole option for Adolescents is scientifically and ethically problematic. A recent emphasis on abstinence-only programs and policies appears to be undermining more comprehensive sexuality education and other government-sponsored programs. We believe that abstinence-only education programs, as defined by federal funding requirements, are morally problematic, by withholding information and promoting questionable and inaccurate opinions. Abstinence-only programs threaten fundamental human rights to health, information, and life. © 2006 Society for Adolescent Medicine. All rights reserved.
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abstinence only education policies and programs a position paper of the society for Adolescent Medicine
Journal of Adolescent Health, 2006Co-Authors: John S. Santelli, Maureen E Lyon, Jennifer Rogers, Daniel SummersAbstract:Abstinence from sexual intercourse represents a healthy choice for teenagers as teenagers face considerable risk to their reproductive health from unintended pregnancy and sexually transmitted infections (STIs) including infection with the human immunodeficiency virus (HIV). Remaining abstinent at least through high school is strongly supported by parents and even by Adolescents themselves. However few Americans remain abstinent until marriage many do not or cannot marry and most initiate sexual intercourse and other sexual behaviors as Adolescents. Abstinence as a behavioral goal is not the same as abstinence-only education programs. Abstinence from sexual intercourse while theoretically fully protective often fails to protect against pregnancy and disease in actual practice because abstinence is not maintained. (excerpt)
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guidelines for Adolescent health research a position paper of the society for Adolescent Medicine
Journal of Adolescent Health, 2003Co-Authors: John S. Santelli, Walter D Rosenfeld, Robert H Durant, Nancy Dubler, Madlyn C Morreale, Abigail English, Audrey Smith RogersAbstract:Their ambiguous legal and ethical status has become a barrier to Adolescents' appropriate involvement in research from which they may benefit and which is needed to improve Adolescent health care and to inform health policy. Involvement of Adolescents in research should be based on a scientific and empathetic understanding of their developing capabilities and a careful assessment of risks and benefits. The important role of parents and communities as protectors of Adolescents should be respected and enhanced as we acknowledge and respect developing Adolescent autonomy. These guidelines provide a framework to interpret the federal regulations for protection of human subjects in light of the unique legal, ethical, developmental, contextual, and racial issues that affect Adolescents. The guidelines are designed to protect individual Adolescent research subjects and to facilitate important youth research that would promote the health of Adolescents.
Terrill Bravender - One of the best experts on this subject based on the ideXlab platform.
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Predictors of Outcome at 1 Year in Adolescents With DSM-5 Restrictive Eating Disorders: Report of the National Eating Disorders Quality Improvement Collaborative
The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2014Co-Authors: Sara F. Forman, Cynthia J. Kapphahn, Rebecca Hehn, Kathleen A. Mammel, Nicole M. Mckenzie, Maria C. Monge, S. Todd Callahan, Eric Sigel, Terrill Bravender, Mary RomanoAbstract:Abstract Purpose The National Eating Disorders Quality Improvement Collaborative evaluated data of patients with restrictive eating disorders to analyze demographics of diagnostic categories and predictors of weight restoration at 1 year. Methods Fourteen Adolescent Medicine eating disorder programs participated in a retrospective review of 700 Adolescents aged 9–21 years with three visits, with DSM-5 categories of restrictive eating disorders including anorexia nervosa (AN), atypical AN, and avoidant/restrictive food intake disorder (ARFID). Data including demographics, weight and height at intake and follow-up, treatment before intake, and treatment during the year of follow-up were analyzed. Results At intake, 53.6% met criteria for AN, 33.9% for atypical AN, and 12.4% for ARFID. Adolescents with ARFID were more likely to be male, younger, and had a longer duration of illness before presentation. All sites had a positive change in mean percentage median body mass index (%MBMI) for their population at 1-year follow-up. Controlling for age, gender, duration of illness, diagnosis, and prior higher level of care, only %MBMI at intake was a significant predictor of weight recovery. In the model, there was a 12.7% change in %MBMI (interquartile range, 6.5–19.3). Type of treatment was not predictive, and there were no significant differences between programs in terms of weight restoration. Conclusions The National Eating Disorders Quality Improvement Collaborative provides a description of the patient population presenting to a national cross-section of 14 Adolescent Medicine eating disorder programs and categorized by DSM-5. Treatment modalities need to be further evaluated to assess for more global aspects of recovery.
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an eleven site national quality improvement evaluation of Adolescent Medicine based eating disorder programs predictors of weight outcomes at one year and risk adjustment analyses
Journal of Adolescent Health, 2011Co-Authors: Sara F. Forman, Cynthia J. Kapphahn, Dionne A. Graham, Eric Sigel, Terrill Bravender, Leah Grodin, Cara J Sylvester, David S Rosen, Todd S Callahan, Rebecka PeeblesAbstract:Abstract Purpose This quality improvement project collected and analyzed short-term weight gain data for patients with restrictive eating disorders (EDs) treated in outpatient Adolescent Medicine-based ED programs nationally. Methods Data on presentation and treatment of low-weight ED patients aged 9–21 years presenting in 2006 were retrospectively collected from 11 independent ED programs at intake and at 1-year follow-up. Low-weight was defined as Results The sites contained 6–51 patients per site (total N=267); the mean age was 14.1–17.1 years; duration of illness before intake was 5.7–18.6 months; % MBW at intake was 77.5–83.0; and % MBW at follow-up was 88.8–93.8. In general, 40%–63% of low weight ED subjects reached ≥90% MBW at 1-year follow-up. At intake, patients with higher % MBW ( p = .0002) and shorter duration of illness ( p = .01) were more likely to be ≥90% MBW at follow-up. Risk-adjusted odds ratios controlled for % MBW and duration of illness were .8 (.5, 1.4)–1.3 (.3, 3.8), with no significant differences among sites. Conclusion A total of 11 ED programs successfully compared quality improvement data. Shorter duration of illness before intake and higher % MBW predicted improved weight outcomes at 1 year. After adjusting for risk factors, program outcomes did not differ significantly. All Adolescent Medicine-based ED programs were effective in assisting patients to gain weight.
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development of a bright futures curriculum for pediatric residents
Ambulatory Pediatrics, 2001Co-Authors: John R Knight, Terrill Bravender, Carolyn Frazer, Elizabeth Goodman, Gregory S Blaschke, Jean S EmansAbstract:Objective.—To develop a standardized case-based curriculum for pediatric residents on child growth, development, behavior, and Adolescent Medicine that incorporates the Bright Futures health supervision guidelines. Design.—This project included a needs assessment, development of a list of important topics, writing and revising of standardized cases, formative evaluation of cases, and efficacy pilot testing of 2 cases. Setting.—A large pediatric teaching hospital continuity clinic. Participants.—Pediatric residents, fellows, and faculty. Interventions.—Preparation of standardized cases, facilitator training, and resident-led teaching conferences. Outcome Measures.—Learner and facilitator evaluation forms and two 10-item diagnostic skills assessments. Results.—During the project, faculty-fellow teams wrote 29 case-teaching modules. All participants gave high ratings to cases, and resident facilitators reported increased comfort with the case discussion method. Resident learners' ability to accurately interpret developmental screening tests and growth charts improved following sessions on those topics. Conclusions.—Further evaluation is required, but these standardized cases appear promising for teaching pediatric residents. The curriculum is now freely available to faculty nationwide.
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Adolescent Medicine training in pediatric residency programs are we doing a good job
Pediatrics, 1998Co-Authors: S J Emans, Terrill Bravender, John R Knight, Carolyn Frazer, Maria Luoni, Carol D Berkowitz, Ehrin J Armstrong, Elizabeth GoodmanAbstract:Objectives To determine how pediatric residency programs are responding to the new challenges of teaching Adolescent Medicine (AM) to residents by assessing whether manpower is adequate for training, whether AM curricula and skills are adequately covered by training programs, what types of teaching methodologies are used to train residents in AM, and the needs for new curricular materials to teach AM. Design A 3-part 92-item survey mailed to all US pediatric residency training programs. Setting Pediatric residency programs. Participants Residency program directors and directors of AM training. Main outcome measures AM divisional structure, clinical sites of training, presence of a block rotation, and faculty of pediatric training programs; training materials used and desired in AM; perceived adequacy of coverage of various AM topics; competency of residents in performing pelvic examinations in sexually active teens; and manpower needs. Results A total of 155/211 (73.5%) of programs completed the program director and the AM parts of the survey. Ninety-six percent of programs (size range, 5-120 residents) had an AM block rotation and 90% required the AM block; those without a block rotation were more likely to be larger programs. Only 39% of programs felt that the number of AM faculty was adequate for teaching residents. Almost half of the programs reported lack of time, faculty, and curricula to teach content in substance abuse. Besides physicians, AM teachers included nurse practitioners (28%), psychologists (25%), and social workers (19%). Topics most often cited as adequately covered included sexually transmitted diseases (81.9%), confidentiality (79.4%), puberty (77.0%), contraception (76.1%), and menstrual problems (73.5%). Topics least often cited as adequately covered included psychological testing (16.1%), violence in relationships (20.0%), violence and weapon-carrying (29.7%), and sports Medicine (29.7%). Fifty-eight percent of 137 respondents thought that all or nearly all of their residents were competent in performing pelvic examinations by the end of training; there was no difference between perceived competence and the residents' use of procedure books. Seventy-four percent used a specific curriculum for teaching AM; materials included chapters/articles (85%), lecture outlines (76.1%), slides (41.9%), videos (35.5%), written case studies (24.5%), computerized cases (6.5%), and CD-ROMs (3.2%). Fifty-two percent used Bright Futures, 48% used the Guidelines for Adolescent Preventive Services, and 14% used the Guide to Clinical Preventive Services for teaching clinical preventive services. Programs that used Bright Futures were more likely to feel that preventive services were adequately covered in their programs than those who did not (78% vs 57%). A majority of programs desired more learner-centered materials. Conclusions Although almost all pediatric programs are now providing AM rotations, there is significant variability in adequacy of training across multiple topics important for resident education. Programs desire more learner-centered materials and more faculty to provide comprehensive resident education in AM.