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Abstract
Background: Internal medicine (IM) physicians report inadequate preparation to care for adolescents and young adults. Purpose: The aim is to (a) improve IM residents’ comfort and confidence caring for adolescents/young adults and (b) increase the percentage of adolescent/young adult patients receiving preventive healthcare. Methods: Fifty-two PGY1 IM residents were assigned to treatment or control groups. Residents in the treatment group interviewed and received feedback from adolescent instructors. We developed a survey to measure residents’ comfort and confidence caring for adolescents/young adults and evaluated their adherence to screening guidelines for patients ages 16 to 26. Results: Significantly more residents in the intervention group felt confident identifying sexually transmitted infections (STIs) and substance abuse and treating STIs, substance abuse, and depression compared to residents in the control group. Residents in the intervention group were no more likely to screen adolescents/young adults for Chlamydia, HIV, alcohol misuse, or depression in the 6 months following the intervention. Conclusions: An educational intervention utilizing adolescent instructors improves resident confidence but does not increase adherence to screening guidelines.
Acknowledgments
This project was funded by the Children's Hospital Boston Aerosmith Fund for Prevention and Treatment of HIV and AIDS. Holly Gooding was supported in part by the Leadership Education in Adolescent Health (LEAH) Training grant #T71MC00009 from the Maternal and Child Health Bureau, Health Resources and Services Administration. We thank Elizabeth Armstrong, PhD, for guidance regarding the study design; Sonja Ziniel, PhD, for assistance with survey development; and Sarah Stelz, Moriah Polanco, and Handan Titz for assistance with data collection and entry. We also thank the Adolescent Instructors Erica Cuevas, Tynaya Fraiser, Emily Gallagher, and Elon Rochbert as well as their program facilitator Adrianne Gonclaves and the session cofacilitator Richard Chung, MD.