RESUMO
PURPOSE: The publicly available Society for Adolescent Health and Medicine (SAHM) Resident Curriculum provides resources for blended learning. This report presents a formal evaluation of this blended learning curriculum. METHODS: We adapted the SAHM curriculum for a required four-week rotation for pediatricians in training. We selected webinars, videos, articles, and Web sites from the SAHM curriculum to complement the local clinical context. We evaluated the effectiveness of our curriculum using resident pre- and post-self-assessments, weekly knowledge quizzes, and a standardized patient encounter. RESULTS: Resident self-assessment improved in all domains except managing urologic conditions. Residents scored 85% or higher on knowledge quizzes. Standardized patients rated residents a mean of 90.2 out of 100 on adolescent communication and 89.0 out of 100 on parent communication. CONCLUSIONS: A blended learning curriculum consisting of SAHM online materials and local clinical experiences improved resident self-assessment, knowledge, and communication skills.
Assuntos
Medicina do Adolescente , Internato e Residência , Adolescente , Saúde do Adolescente , Competência Clínica , Comunicação , Currículo , HumanosRESUMO
A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
Assuntos
Aleitamento Materno , Lactação , Minorias Sexuais e de Gênero , Pessoas Transgênero , Protocolos Clínicos , Feminino , Humanos , Lactente , Saúde das Minorias , Sociedades MédicasRESUMO
Crisis pregnancy centers (CPCs) attempt to dissuade pregnant people from considering abortion, often using misinformation and unethical practices. While mimicking health care clinics, CPCs provide biased, limited, and inaccurate health information, including incomplete pregnancy options counseling and unscientific sexual and reproductive health information. The centers do not provide or refer for abortion or contraception but often advertise in ways that give the appearance that they do provide these services without disclosing the biased nature and marked limitations of their services. Although individuals working in CPCs in the United States have First Amendment rights to free speech, their provision of misinformation might be harmful to young people and adults. The Society for Adolescent Health and Medicine and North American Society for Pediatric and Adolescent Gynecology support the following positions: (1) CPCs pose risk by failing to adhere to medical and ethical practice standards; (2) governments should only support health programs that provide accurate, comprehensive information; (3) CPCs and individuals who provide CPC services should be held to established standards of ethics and medical care; (4) schools should not outsource sexual education to CPCs or other entities that do not provide accurate and complete health information; (5) search engines and digital platforms should enforce policies against misleading advertising by CPCs; and (6) health professionals should educate themselves, and young people about CPCs and help young people identify safe, quality sources of sexual and reproductive health information and care.
Assuntos
Saúde do Adolescente/normas , Intervenção em Crise/normas , Fidelidade a Diretrizes , Ginecologia/normas , Guias de Prática Clínica como Assunto , Aborto Induzido/psicologia , Adolescente , Criança , Comunicação , Aconselhamento , Feminino , Humanos , Gravidez , Estados UnidosRESUMO
STUDY OBJECTIVE: To contextualize young women's knowledge and attitudes regarding contraception at the outset of an intervention promoting long-acting reversible contraceptive (LARC) use for teen pregnancy prevention. DESIGN AND SETTING: Our intervention was on the basis of diffusion of innovation theory, and at the outset we were interested in likely early adopters' existing knowledge and attitudes toward contraception. This mixed methods study consisted of focus groups within positive youth development programs in Rochester, New York; we discussed young women's knowledge and sources of information for all US Food and Drug Administration-approved contraceptive methods. PARTICIPANTS: Seven focus groups and 24 female adolescent participants aged 15-19 years. INTERVENTIONS AND MAIN OUTCOME MEASURES: Quantitative ranking of all contraceptive methods; qualitative themes from focus group discussions. RESULTS: Our findings showed a high level of knowledge about a select group of methods, which included LARC methods, and that participants received contraceptive information from peers and family. Participants had more concerns than positive impressions regarding the effectiveness, safety, practicality, and partner reception of the contraceptive methods, with the exception of the condom. Quantitatively, the condom received the highest average rating. CONCLUSION: The importance of personal anecdotes in our findings supports the use of outreach and information campaigns; providing medically accurate information and spreading positive personal anecdotes will be key to improving young women's impressions of the safety and acceptability of LARC use. This snapshot of contraceptive knowledge indicates that young women can be mature, informed consumers of sexual and reproductive health care, and through diffusion of innovation could be key players in promoting the most effective means of pregnancy prevention.
Assuntos
Comportamento Contraceptivo , Anticoncepcionais Femininos/uso terapêutico , Grupos Focais/métodos , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Anticoncepção/métodos , Feminino , Humanos , New York , Gravidez , População Urbana , Adulto JovemRESUMO
PURPOSE: Adolescent Medicine (AM) educators in pediatric residency programs are seeking new ways to engage learners in adolescent health. This mixed-methods study presents a novel self-reflection tool and addresses whether self-reflection enhanced residents' perception of the value of an adolescent rotation, in particular, its relevance to their future practice. METHODS: The self-reflection tool included 17 Likert scale items on residents' comfort with the essential tasks of adolescent care and open-ended questions that promoted self-reflection and goal setting. Semi-structured, postrotation interviews encouraged residents to discuss their experiences. Likert scale data were analyzed using descriptive statistics, and interview notes and written comments on the self-reflection tool were combined for qualitative data analysis. RESULTS: Residents' pre-to post-self-evaluations showed statistically significant increases in comfort with most of the adolescent health care tasks. Four major themes emerged from our qualitative analysis: (1) the value of observing skilled attendings as role models; (2) the comfort gained through broad and frequent adolescent care experiences; (3) the career relevance of AM; and (4) the ability to set personally meaningful goals for the rotation. CONCLUSIONS: Residents used the self-reflection tool to mindfully set goals and found their AM education valuable and relevant to their future careers. Our tool helped make explicit to residents the norms, values, and beliefs of the hidden curriculum applied to the care of adolescents and helped them to improve the self-assessed quality of their rapport and communications with adolescents. We conclude that a structured self-reflection exercise can enhance residents' experiences on an AM rotation.
Assuntos
Medicina do Adolescente/educação , Atitude do Pessoal de Saúde , Internato e Residência/métodos , Autoavaliação (Psicologia) , Adolescente , Adulto , Escolha da Profissão , Feminino , Humanos , Entrevistas como Assunto , Masculino , Inquéritos e Questionários , Adulto JovemRESUMO
PURPOSE: To identify provider and practice characteristics associated with long-acting reversible contraception (LARC, either progesterone contraceptive implants or intrauterine devices [IUDs]) provision among adolescent health care providers. METHODS: We used data from a previously conducted survey of US providers on reproductive health to predict provision of any form of LARC as well as progesterone contraceptive implants or IUDs specifically using Chi-square and multivariate logistic regressions. RESULTS: One third of providers reported any LARC provision. In logistic regressions, residency training in obstetrics/gynecology or family medicine (rather than internal medicine/pediatrics) was the strongest predictor of LARC provision, particularly for IUDs. CONCLUSIONS: A minority of providers reported offering IUDs or contraceptive implants, most of whom had received procedural women's health training. Increasing the number of providers offering this type of contraception may help to prevent adolescent pregnancies and may be most easily accomplished via training in contraceptive implant provision.