Recommended changes in pediatric education: the impact on pediatrician involvement in health care delivery to adolescents.

In an attempt to examine the extent of implementation of the recommendations issued by the Task Force on Pediatric Education for increased emphasis on adolescent medicine during residency training, pediatricians' perceptions of their skills and abilities to provide health care to adolescents were evaluated. A sample of 558 pediatricians selected at random and 385 members of the American Academy of Pediatrics' Section on Adolescent Health (SAH) completed a 41-item questionnaire. The physicians' perceived levels of skill in ten areas were analyzed while simultaneously assessing the impact of SAH membership, year of graduation from medical school, gender, and percentage of practice time devoted to adolescents on each issue. SAH members, as expected, ranked their levels of skill significantly higher than did the other pediatricians in all areas surveyed. A significant percentage of the SAH pediatricians, however, indicated that their skills were acquired through postresidency fellowship training. There was an increasing trend among all pediatricians in their perceived levels of skill to deliver health care to adolescents during the past several decades, but there has been no appreciable increase in such perceived skill levels since the task force issued its recommendations. In fact, pediatricians graduating from medical school in the decade prior to 1976 who are not SAH members ranked their skills higher than did non-SAH pediatricians who graduated in the past 10 years. These data lead to the conclusion that the recommendations of the Task Force on Pediatric Education have not been adequately implemented.