Rosen Monica W, Alaniz Veronica I, Kobernik Emily K, Booms Stephanie, Smith Yolanda R, Quint Elisabeth H
University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, Michigan.
University of Michigan, Department of Obstetrics and Gynecology, Ann Arbor, Michigan.
J Pediatr Adolesc Gynecol. 2018 Feb;31(1):7-12. doi: 10.1016/j.jpag.2017.09.002. Epub 2017 Sep 14.
To assess pediatric resident training in diagnosing and managing prepubertal gynecologic conditions.
Voluntary 32-question survey e-mailed to participants.
E-mail contact through the American Academy of Pediatrics listserv.
Seven thousand seventy-five US pediatrics and combined internal medicine-pediatric residents.
Descriptive analysis including χ tests was performed on survey results.
Residents' training experiences and comfort, confidence, and knowledge in evaluating pediatric gynecologic concerns.
In the 866 of 7075 (12%) completed surveys, a greater proportion of residents reported they were "very" or "extremely" comfortable talking to parents about general pediatric topics compared with gynecologic topics (88.5% vs 30.4%; P < .001). Similarly, they reported being "very" or "extremely" confident diagnosing general pediatric conditions compared with prepubertal gynecologic conditions (87.6% vs 32.8%; P < .001). These differences were also observed according to residency year (comfort: first year, 10.2% vs third/fourth year, 39.9%; P < .001; confidence: first year, 22.5% vs third/fourth year, 37.6%; P < .001). Residents learned about vulvovaginal concerns from attendings in clinic (79.8%), residency-specific didactics (34.7%), and conferences, meetings, and workshops (24.1%). Confidence examining, diagnosing, and treating vulvovaginitis was associated with participation in any learning activity and exposure to more than 5 patients with this concern. Additional education or training in prepubertal vulvovaginal conditions was requested by 97% of residents.
Our findings suggest that pediatric residents are lacking in comfort, confidence, and knowledge of prepubertal vulvovaginal conditions, especially compared with general pediatric topics. Although this improves during training, it remains low, and more education is indicated and desired by residents.
评估儿科住院医师在诊断和处理青春期前妇科疾病方面的培训情况。
通过电子邮件向参与者发送一份包含32个问题的自愿调查问卷。
通过美国儿科学会邮件列表进行电子邮件联系。
7075名美国儿科及内科-儿科联合住院医师。
对调查结果进行包括χ检验在内的描述性分析。
住院医师在评估儿科妇科问题方面的培训经历、舒适度、信心和知识。
在7075名参与者中有866人（12%）完成了调查，与妇科话题相比，更多的住院医师表示他们在与家长谈论一般儿科话题时“非常”或“极其”自在（88.5%对30.4%；P <.001）。同样，与青春期前妇科疾病相比，他们表示在诊断一般儿科疾病时“非常”或“极其”自信（87.6%对32.8%；P <.001）。根据住院年限也观察到了这些差异（舒适度：第一年为10.2%，第三/四年为39.9%；P <.001；信心：第一年为22.5%，第三/四年为37.6%；P <.001）。住院医师从临床带教老师（79.8%）、特定住院医师培训课程（34.7%）以及会议和研讨会（24.1%）中了解到外阴阴道问题。检查、诊断和治疗外阴阴道炎的信心与参与任何学习活动以及接触超过5例此类问题患者有关。97%的住院医师要求提供青春期前外阴阴道疾病的额外教育或培训。
我们的研究结果表明，儿科住院医师在青春期前外阴阴道疾病方面缺乏舒适度、信心和知识，尤其是与一般儿科话题相比。尽管在培训过程中这种情况有所改善，但仍然较低，住院医师表示需要更多的教育。
