Kirkpatrick Laura, Bell Lauren A, Borcky Theresa, Boutros-Khoury Hannah, Hooven-Davis Jayde, Rankine Jacquelin, Robbins Cynthia, Syed Tahniat, Szoko Nicholas, Allison Bianca A
Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee.
J Adolesc Health. 2025 Mar;76(3):475-481. doi: 10.1016/j.jadohealth.2024.11.003. Epub 2024 Dec 15.
To evaluate an adolescent-centered pregnancy options counseling curriculum for pediatric residents.
In 2022, we assessed the curriculum in one residency by randomizing half the residents to a pretraining or posttraining Observed Structured Clinical Exam (OSCE). We scored the OSCE by 15-item rubric and analyzed results by Wilcoxon Rank-Sum tests. From 2022 to 2023, we implemented the curriculum across 3 residencies. Surveys assessed knowledge and self-rated abilities before, immediately after, and 6-month posttraining. Two residencies also surveyed controls. We analyzed results using mixed-effects and ordinal logistic regression.
2022: 25 residents participated in the OSCE (13 pregroup, 12 post-group). Median score increased from 9/15 (interquartile range 8/15, 10/15) pretraining to 13/15 (13/15, 14/15) posttraining (p < .05). 2022-2023: Residents in the training arm completed presurveys (n = 79), immediate postsurveys (n = 65), and 6-month postsurveys (n = 40). Median baseline knowledge score was 57% (24%, 83%), which improved immediately posttraining [90% (81%, 95%), p < .05] and was sustained at 6 months [86% (57%, 90%), p < .05]. Median baseline self-rated ability to discuss pregnancy options was 8/12 (7/12, 9/12) and increased immediately posttraining [12/12 (10/12, 12/12), p < .05] with sustained improvement at 6 months [9/12 (8/12, 11/12), p < .05]. Median baseline self-rated ability to provide pregnancy-related referrals was 6/12 (5/12, 8/12) which improved posttraining [10/12 (9/12, 12/12), p < .05)] with sustained improvement at 6 months [8/12 (6/12, 9/12), p < .05]. Control residents completed presurveys (n = 140) and 6month postsurveys (n = 94). Trained residents performed better at 6 months on all measures (p < .05).
Pregnancy options counseling training for pediatrics residents led to improved knowledge, abilities, and behavior.
评估以青少年为中心的针对儿科住院医师的妊娠选择咨询课程。
2022年，我们在一个住院医师培训项目中评估该课程，将一半住院医师随机分配到培训前或培训后的客观结构化临床考试（OSCE）。我们根据15项评分标准对OSCE进行评分，并通过Wilcoxon秩和检验分析结果。从2022年到2023年，我们在3个住院医师培训项目中实施了该课程。通过调查评估培训前、培训后即刻以及培训后6个月的知识和自我评估能力。两个住院医师培训项目也对对照组进行了调查。我们使用混合效应和有序逻辑回归分析结果。
2022年：25名住院医师参加了OSCE（13名培训前组，12名培训后组）。中位数得分从培训前的9/15（四分位间距8/15，10/15）提高到培训后的13/15（13/15，14/15）（p <.05）。2022 - 2023年：培训组的住院医师完成了培训前调查（n = 79）、培训后即刻调查（n = 65）和培训后6个月调查（n = 40）。基线知识得分中位数为57%（24%，83%），培训后即刻有所提高[90%（81%，95%），p <.05]，并在6个月时保持[86%（57%，90%），p <.05]。讨论妊娠选择的自我评估能力基线中位数为8/12（7/12，9/12），培训后即刻增加[12/12（10/12，12/12），p <.05]，6个月时持续改善[9/12（8/12，11/12），p <.05]。提供妊娠相关转诊的自我评估能力基线中位数为6/12（5/12，8/12），培训后有所改善[10/12（9/12，12/12），p <.05]，6个月时持续改善[8/12（6/12，9/12），p <.05]。对照住院医师完成了培训前调查（n = 140）和6个月后调查（n = 94）。经过培训的住院医师在6个月时在所有指标上表现更好（p <.05）。
针对儿科住院医师的妊娠选择咨询培训导致知识、能力和行为得到改善。
