Teaching Trainees to Deliver Adolescent Reproductive Health Services

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• 作者：Brandi Shah ; MD ; MPH¹ ; Serena H. Chan ; MD² ; Lisa Perriera ; MD MPH³ ; Melanie A. Gold ; DO ; DABMA⁴ ; Aletha Y. Akers ; MD ; MPH FACOG⁵ ; ^{akersa@email.chop.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Adolescents ; Reproductive health services ; Graduate medical education ; Focus groups ; Qualitative research
• 刊名：Journal of Pediatric and Adolescent Gynecology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：29
• 期：1
• 页码：53-61
• 全文大小：731 K

文摘

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.