National Alliance to Advance Adolescent Health, Washington, DC 20006, USA.
Pediatrics. 2010 Jan;125(1):165-72. doi: 10.1542/peds.2008-3740. Epub 2009 Dec 7.
The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine.
We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience.
Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training.
Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.
本研究旨在评估儿科住院医师培训中的青少年医学课程。
我们进行了两项全国性调查：一项针对儿科住院医师项目主任，另一项针对负责儿科住院医师青少年医学轮科的教师，以收集有关住院医师在青少年医学中的门诊护理培训经验的性质以及影响经验的劳动力问题的描述性和定性信息。
涵盖得很好的青少年医学必修主题涉及正常发育、访谈和性问题。涉及暴力、机动车安全、运动医学和慢性病等问题的内容则涉及得最少。青少年医学专家、成瘾咨询师、精神科医生和其他了解青少年的卫生专业人员短缺，经常限制了儿科住院医师在青少年医学方面的培训。强制性青少年医学轮科的时间、用于门诊护理培训的诊所地点以及主要培训地点提供的服务范围存在相当大的差异。此外，住院医师的连续性诊所经验通常不包括青少年患者；因此，儿科住院医师没有机会随着时间的推移与青少年建立持续的治疗关系。项目和轮科主任对青少年医学培训有类似的看法。
全美儿科住院医师培训项目中的青少年医学门诊护理培训存在显著差异和差距。为了解决许多项目中的不足之处，应提高轮科的质量，并努力在连续性、普通儿科和专科诊所中教授青少年医学。此外，应重新关注阐述照顾青少年所需的核心能力。
