Chastain D O, Sanders J M, DuRant R H
Department of Pediatrics, Fitzsimons Army Medical Center, Aurora, Colorado.
Pediatrics. 1988 Sep;82(3 Pt 2):469-76.
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.
为了调查儿科教育特别工作组发布的建议在住院医师培训期间对加强青少年医学重视程度方面的实施情况，研究人员评估了儿科医生对其为青少年提供医疗保健的技能和能力的看法。随机抽取的558名儿科医生和美国儿科学会青少年健康分会（SAH）的385名成员完成了一份包含41个项目的问卷。分析了医生在十个领域的自我认知技能水平，同时评估了SAH成员身份、医学院毕业年份、性别以及用于青少年患者的执业时间百分比对每个问题的影响。正如预期的那样，在所有调查领域中，SAH成员对自己技能水平的排名显著高于其他儿科医生。然而，相当比例的SAH儿科医生表示，他们的技能是通过住院医师后的进修培训获得的。在过去几十年里，所有儿科医生在为青少年提供医疗保健方面的自我认知技能水平都呈上升趋势，但自特别工作组发布建议以来，这种自我认知技能水平并没有明显提高。事实上，1976年之前十年毕业的非SAH成员儿科医生对自己技能的排名高于过去十年毕业的非SAH成员儿科医生。这些数据得出的结论是，儿科教育特别工作组的建议没有得到充分实施。
