Leadership in adolescent health: developing the next generation of maternal child health leaders through mentorship.

Leadership development is a core value of Maternal Child Health Bureau training programs. Mentorship, an MCH Leadership Competency, has been shown to positively affect career advancement and research productivity. Improving mentorship opportunities for junior faculty and trainees may increase pursuit of careers in areas such as adolescent health research and facilitate the development of new leaders in the field. Using a framework of Developmental Networks, a group of MCH Leadership Education in Adolescent Health training program faculty developed a pilot mentoring program offered at the Society for Adolescent Health and Medicine Annual Meeting (2011-2013). The program matched ten interdisciplinary adolescent health fellows and junior faculty with senior mentors at other institutions with expertise in the mentee's content area of study in 2011. Participants were surveyed over 2 years. Respondents indicated they were "very satisfied" with their mentor match, and all agreed or strongly agreed that the mentoring process in the session was helpful, and that the mentoring relationships resulted in several ongoing collaborations and expanded their Developmental Networks. These results demonstrate that MCH programs can apply innovative strategies to disseminate the MCH Leadership Competencies to groups beyond MCH-funded training programs through programs at scientific meetings. Such innovations may enhance the structure of mentoring, further the development of new leaders in the field, and expand developmental networks to provide support for MCH professionals transitioning to leadership roles.

Teen Advisory Committee: lessons learned by adolescents, facilitators, and hospital staff.

The Teen Advisory Committee (TAC), Boston Children's Hospital (BCH), began in 2002 and has been meeting monthly since that time. The top lessons learned by adolescents, committee facilitators, and hospital staff incorporate principles of adolescent development, joint decision-making, and a respect and commitment to patient and family-centered care. The program addresses the unique needs of teens with chronic illness from their perspective through special projects that have led to the development of hospital policies, procedures, and quality improvement initiatives. The discussion of the framework of the TAC and lessons learned are intended to support youth-driven initiatives and models for improvement at children's hospitals nationally.

Lesbian, Gay, Bisexual, and Transgender Adolescent Health: An Interprofessional Case Discussion.

INTRODUCTION: Lesbian, gay, bisexual, and transgender (LGBT) adolescents frequently endure considerable adversity as they encounter identity-related stigma. As a result, LGBT adolescents are often at disproportionate risk for experiencing negative social and health outcomes. METHODS: This four-module curriculum allows learners to explore challenges common to the clinical care of LGBT adolescents while also providing exposure to current trends and evidence in LGBT health. Through a combination of reflective exercises, didactic lectures, foundational readings, facilitated case discussion, and debate, the curriculum introduces learners to issues of assessment, treatment, and support as they relate to LGBT youth. The curriculum was written for use with learners in an interprofessional training program representing the disciplines of medicine, nursing, nutrition, social work, and psychology. RESULTS: Four years of evaluation data indicate that the curriculum is particularly useful for exposing learners to the complexities of serving and supporting LGBT youth and identifying personal skills that may require additional development. Learners emerge with greater confidence in identifying local and national LGBT resources. DISCUSSION: Incorporating cultural humility is key to fostering a commitment to lifelong learning and maintaining learners' confidence when working with marginalized populations. Optimal discussion occurs when learners in all disciplines contribute, yet instructors can teach modules separately or modify them when learners from all disciplines are not present. In addition, learners emerge with greater confidence in connecting with outside resources, which assists both referrals for patients and self-directed learning.

Case-Based Teaching for Interprofessional Postgraduate Trainees in Adolescent Health.

PURPOSE: Adolescent health providers increasingly work in interprofessional environments. There is a lack of evidence regarding best educational practices for preparing the adolescent health care workforce of the future. We developed, implemented, and evaluated an interprofessional longitudinal case-based curriculum for postgraduate trainees in adolescent health. METHODS: Faculty in an academic adolescent medicine division worked collaboratively with recent trainees to develop six teaching cases illustrative of interprofessional care of adolescents. During the 2013-2014 academic year, seven trainees (two social workers, two physicians, one nurse practitioner, one psychologist, and one dietician) completed the six month-long case modules while simultaneously working together in an interprofessional clinic. Trainees completed four-item pre- and post-case questionnaires that assessed confidence with assessment and diagnosis, comfort with counseling skills, ability to devise a treatment plan, and understanding of their colleagues' role for each of the six cases. Participants completed the 19-item Readiness for Interprofessional Learning Scale and the 12-item Interdisciplinary Education Perception Scale at three time points during the academic year and a 15-minute interview after their final session. RESULTS: Confidence with assessment/diagnosis, comfort counseling adolescents, and the ability to devise treatment plans increased for most case topics, as did understanding of the role of others on the interprofessional team. Mean Readiness for Interprofessional Learning Scale and Interdisciplinary Education Perception Scale scores were high at baseline and similar at all three time points. Interviews highlighted the value of role clarity, communication, and learning within interprofessional teams along with modeling from interprofessional faculty. CONCLUSIONS: Case-based learning in conjunction with collaborative practice provided a successful teaching strategy for interprofessionals in adolescent health.

Direct Versus Remote Clinical Observation: Assessing Learners' Milestones While Addressing Adolescent Patients' Needs.

BACKGROUND: Direct clinical observation is an essential component of medical trainee assessment, particularly in the era of milestone-based competencies. However, the adolescent patient's perspective on this practice is missing from the literature. Quality health care is patient centered, yet we did not know if our educational practices align with this clinical goal. OBJECTIVE: We sought to better understand our adolescent/young adult patients' perspectives of the direct observation of our medical trainees in the outpatient clinical setting. METHODS: As a quality improvement initiative, we surveyed adolescent/young adult patients, medical trainees, and physician observers in our outpatient clinical practice regarding their experience following a direct observation encounter. We performed descriptive analyses of the data. RESULTS: During a 1-year period, responses were received from 23 adolescent/young adult patients, 8 family members, 14 trainees, and 6 faculty observers. Nearly all adolescent/young adult patients (n=22) and all surveyed family members (n=8) expressed comfort with direct observation, and all respondents felt the care they received was the same or better. All patient/family respondents preferred direct observation to the idea of remote observation, and most, but not all, trainees and faculty observers expressed similar opinions. CONCLUSIONS: Adolescent/young adult patients and their family members found direct observation of their trainee providers to be comfortable and beneficial. Despite adolescent and young adults' facility and comfort with modern technologies, there was an expressed preference for direct versus remote observation.