- Email: [email protected]
81. Building Adolescent Medicine Skills Among Medical Students: Individualized Learning Goals
Poster Abstracts / 56 (2015) S36eS84
interactions with AYA over the past 6 months and how often they discussed adolescent health issues including sexual health, mental health and substance use. Nurses’ perception of their comfort discussing these topics with AYAs with cancer was also assessed via Likert scale. Then, nurses participated in a one-hour interactive in-service providing information on confidentiality, consent, body image, sexuality, mental health, risk taking behavior and transition to adulthood. Finally, a follow-up survey was obtained 3-6 months after in-service completion to assess changes in knowledge and comfort. Results: In the initial survey, 109 nurses who had been working in pediatric oncology for an average of 6.5 years in both inpatient and outpatient settings, participated. Few nurses reported that they had had conversations with AYA patients about sexual health (17%), mental health (53%) or risk taking behavior such as substance use (21%) over the prior 6 month period, though the majority of nurses (77%) felt that nursing should have a role in discussing adolescent health issues with AYA patients with cancer. Fewer than half of nurses stated that they were comfortable discussing sexual health (26%), mental health (48%) or substance use (43%) with their AYA patients. More nurses were comfortable discussing body image (61%). Regarding sexual health, 36% of nurses acknowledged they are more likely to discuss sexual health with female patients and 84% stated they were most likely to discuss AYA issues with patients over 18 years in contrast to teenagers thirteen to eighteen. For the follow up survey, based on the responses of 47 nurses, a higher proportion of nurses reported feeling comfortable discussing sexual health (40%), mental health (72%), substance use (64%) and body image (77%). In addition, 89% of nurses who completed the follow up survey were familiar with the institutional policy for pregnancy testing for female cancer patients as compared to 60% before the intervention. Conclusions: Pediatric oncology nurses may not feel comfortable addressing routine adolescent health care issues with AYA patients with cancer. This study demonstrates the feasibility of educational in-services for subspecialty nurses to disseminate information on routine adolescent care and improve interactions with AYA. Future directions include development of educational programming for AYA cancer patients on general adolescent health issues. Sources of Support: n/a
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skills for performing a HEADS interview. Developing individualized learning goals (ILG) may facilitate learning during skills building sessions. We hypothesized that medical students would be able to achieve their ILGs after a short HEADS learning session, as assessed by their own focused self-reflection. Methods: Third year medical students at the University of Colorado School of Medicine were asked to read an article on the HEADS framework and attend an AM Learning Session. The students each identified an ILG pertaining to HEADS and practiced this interview technique using coached role play with peers. Feedback on interview skills was provided by peers and the preceptor. After the session, the students were surveyed to evaluate whether or not they met their ILG. Frequencies and chi square tests were used to describe the study population. Data were analyzed using SPSS version 21.0. Results: 89% (308/346) of students created an ILG. Among those students with ILG, over two thirds (69.5%) reported that they achieved their ILG, while 19.2% were unsure and 11.4% believed they did not achieve their ILG. Of those students who responded that they had or had not achieved their ILG (249) were included for analysis, over 4/5 (85.9%) reported that they had achieved their ILG. Sex was the most common ILG focus area (27.5%) among the students. The other areas addressed among the HEADS topics were drugs (10.4%), safety (7%), home (6.8%), suicidality (5.8%), eating (3.9%) education (2.6%), and activity (1.0%). Students also wrote ILGs related to general communication (20.4%), nonspecific mastery of the HEADS framework (11.7%), and interactions with parents (3.2%). The most common areas where students achieved their ILG were safety (94.4%), drugs (92.3%) and sex (90.1%). The most frequent areas in which students believed they did not achieving their ILG were activities (50%), interaction with parents (25%) and HEADS framework (24.1%). Analysis revealed that there was no significant difference between the different HEADS subgroups regarding the percentage of students who did or did not achieve their ILGs. Limitations of this study include it was conducted at a single institution and does not take into consideration previous clinical experiences of students. Conclusions: Over four fifths of 3rd year medical students successfully met their ILG following a short learning session in AM. Sexual health was the most common area addressed in their ILG. Sources of Support: None. 82.
81. BUILDING ADOLESCENT MEDICINE SKILLS AMONG MEDICAL STUDENTS: INDIVIDUALIZED LEARNING GOALS Justin Lockwood, MD, Marissa Peters, MPH, Janice Hanson, PhD, Alexandria Forte, BA, Paritosh Kaul, MD, FSAHM.
INCREASING RESIDENT EXPOSURE TO ADOLESCENTS IN THEIR CLINIC HOME (REACH) Lisa A. Cao, MS 1, Laura S. Price, MD 2, Mary A. Ott, MD 2. 1 University of California, Los Angeles; 2Indiana University School of Medicine.
University of Colorado School of Medicine.
Purpose: While there is little research exploring adolescent medicine (AM) training in undergraduate medical education (UGME), available evidence suggests that medical training provides inadequate preparation of health care providers to serve the adolescent population. One UGME study showed medical student performance on an AM case was poor compared to performance in other clinical areas. The HEADS (Home, Education, Activity, Drugs, Sex and Suicidality) interview framework is an important aspect of AM training and provides an approach to adolescent interviewing that starts with non-threatening topics and progresses to more personal questions. A short learning session may provide essential
Purpose: Pediatric residents have limited exposure to adolescents in continuity clinic. As part of an educational QI initiative, a subset of residents participated in the Adolescent Continuity Clinic Program (AACP) to increase their exposure to adolescent primary care patients. We describe predictors of number of adolescent patients seen, comfort in caring for adolescent patients, and knowledge of adolescent primary care topics among the participants in the ACCP compared to nonparticipants. Methods: A volunteer subset of second and third year residents from a large children’s hospital participated in the AACP. Once a month for six months, participants attended an adolescent continuity clinic co-located on-site, rather than their regular pediatric
interactions with AYA over the past 6 months and how often they discussed adolescent health issues including sexual health, mental health and substance use. Nurses’ perception of their comfort discussing these topics with AYAs with cancer was also assessed via Likert scale. Then, nurses participated in a one-hour interactive in-service providing information on confidentiality, consent, body image, sexuality, mental health, risk taking behavior and transition to adulthood. Finally, a follow-up survey was obtained 3-6 months after in-service completion to assess changes in knowledge and comfort. Results: In the initial survey, 109 nurses who had been working in pediatric oncology for an average of 6.5 years in both inpatient and outpatient settings, participated. Few nurses reported that they had had conversations with AYA patients about sexual health (17%), mental health (53%) or risk taking behavior such as substance use (21%) over the prior 6 month period, though the majority of nurses (77%) felt that nursing should have a role in discussing adolescent health issues with AYA patients with cancer. Fewer than half of nurses stated that they were comfortable discussing sexual health (26%), mental health (48%) or substance use (43%) with their AYA patients. More nurses were comfortable discussing body image (61%). Regarding sexual health, 36% of nurses acknowledged they are more likely to discuss sexual health with female patients and 84% stated they were most likely to discuss AYA issues with patients over 18 years in contrast to teenagers thirteen to eighteen. For the follow up survey, based on the responses of 47 nurses, a higher proportion of nurses reported feeling comfortable discussing sexual health (40%), mental health (72%), substance use (64%) and body image (77%). In addition, 89% of nurses who completed the follow up survey were familiar with the institutional policy for pregnancy testing for female cancer patients as compared to 60% before the intervention. Conclusions: Pediatric oncology nurses may not feel comfortable addressing routine adolescent health care issues with AYA patients with cancer. This study demonstrates the feasibility of educational in-services for subspecialty nurses to disseminate information on routine adolescent care and improve interactions with AYA. Future directions include development of educational programming for AYA cancer patients on general adolescent health issues. Sources of Support: n/a
S43
skills for performing a HEADS interview. Developing individualized learning goals (ILG) may facilitate learning during skills building sessions. We hypothesized that medical students would be able to achieve their ILGs after a short HEADS learning session, as assessed by their own focused self-reflection. Methods: Third year medical students at the University of Colorado School of Medicine were asked to read an article on the HEADS framework and attend an AM Learning Session. The students each identified an ILG pertaining to HEADS and practiced this interview technique using coached role play with peers. Feedback on interview skills was provided by peers and the preceptor. After the session, the students were surveyed to evaluate whether or not they met their ILG. Frequencies and chi square tests were used to describe the study population. Data were analyzed using SPSS version 21.0. Results: 89% (308/346) of students created an ILG. Among those students with ILG, over two thirds (69.5%) reported that they achieved their ILG, while 19.2% were unsure and 11.4% believed they did not achieve their ILG. Of those students who responded that they had or had not achieved their ILG (249) were included for analysis, over 4/5 (85.9%) reported that they had achieved their ILG. Sex was the most common ILG focus area (27.5%) among the students. The other areas addressed among the HEADS topics were drugs (10.4%), safety (7%), home (6.8%), suicidality (5.8%), eating (3.9%) education (2.6%), and activity (1.0%). Students also wrote ILGs related to general communication (20.4%), nonspecific mastery of the HEADS framework (11.7%), and interactions with parents (3.2%). The most common areas where students achieved their ILG were safety (94.4%), drugs (92.3%) and sex (90.1%). The most frequent areas in which students believed they did not achieving their ILG were activities (50%), interaction with parents (25%) and HEADS framework (24.1%). Analysis revealed that there was no significant difference between the different HEADS subgroups regarding the percentage of students who did or did not achieve their ILGs. Limitations of this study include it was conducted at a single institution and does not take into consideration previous clinical experiences of students. Conclusions: Over four fifths of 3rd year medical students successfully met their ILG following a short learning session in AM. Sexual health was the most common area addressed in their ILG. Sources of Support: None. 82.
81. BUILDING ADOLESCENT MEDICINE SKILLS AMONG MEDICAL STUDENTS: INDIVIDUALIZED LEARNING GOALS Justin Lockwood, MD, Marissa Peters, MPH, Janice Hanson, PhD, Alexandria Forte, BA, Paritosh Kaul, MD, FSAHM.
INCREASING RESIDENT EXPOSURE TO ADOLESCENTS IN THEIR CLINIC HOME (REACH) Lisa A. Cao, MS 1, Laura S. Price, MD 2, Mary A. Ott, MD 2. 1 University of California, Los Angeles; 2Indiana University School of Medicine.
University of Colorado School of Medicine.
Purpose: While there is little research exploring adolescent medicine (AM) training in undergraduate medical education (UGME), available evidence suggests that medical training provides inadequate preparation of health care providers to serve the adolescent population. One UGME study showed medical student performance on an AM case was poor compared to performance in other clinical areas. The HEADS (Home, Education, Activity, Drugs, Sex and Suicidality) interview framework is an important aspect of AM training and provides an approach to adolescent interviewing that starts with non-threatening topics and progresses to more personal questions. A short learning session may provide essential
Purpose: Pediatric residents have limited exposure to adolescents in continuity clinic. As part of an educational QI initiative, a subset of residents participated in the Adolescent Continuity Clinic Program (AACP) to increase their exposure to adolescent primary care patients. We describe predictors of number of adolescent patients seen, comfort in caring for adolescent patients, and knowledge of adolescent primary care topics among the participants in the ACCP compared to nonparticipants. Methods: A volunteer subset of second and third year residents from a large children’s hospital participated in the AACP. Once a month for six months, participants attended an adolescent continuity clinic co-located on-site, rather than their regular pediatric