244 - Design and impact of an interactive case-based workshop to improve adolescent sexual health history taking among pediatric residents

Publication Number: 3236.244

Sydney Hartman-Munick, UMass Memorial Children's Medical Center, Worcester, MA, United States; Suzanne Allen, UMass Memorial Children's Medical Center, Worcester, MA, United States; Jessalyn Shaw, UMass Memorial Children's Medical Center, Worcester, MA, United States; Sasha S. Svendsen, UMass Memorial Children's Medical Center, Worcester, MA, United States; Nisha Fahey, University of Massachusetts Medical School, Worcester, MA, United States

Background: Proficiency in obtaining an adolescent sexual health history, including navigating confidentiality and assessing safety, is an integral skill for pediatrics residents. Interactive learning around this topic is beneficial for knowledge retention; however, significant gaps in medical education curriculum exist.

Objective: To develop a highly interactive case-based workshop focused on obtaining a sexual health history and to assess impact on pediatric resident confidence, knowledge, and attitudes.

Design/Methods: This study received an IRB exemption. Residents participated in a 3-hour workshop designed by adolescent and child abuse medicine providers. It consisted first of a didactic portion highlighting background information and practical knowledge. Participants were then split into triads to role play three challenging, real-life clinical case scenarios and rotated roles of patient, provider, and observer. Participants completed pre- and post-surveys that used the Kirkpatrick Model to assess impact of the workshop. Assessments were rated on a five-point Likert scale and were grouped into reaction, confidence, knowledge, attitudes, and anticipated behavior change domains. Baseline distribution was summarized as counts and percentages. Domain scores were calculated as the mean of the numeric items within each domain. Changes from pre to post were evaluated using paired Wilcoxon signed rank tests for each item and domain. Statistical analysis was performed using Python.

Results: Twenty pediatric and four medicine/pediatric residents participated and completed surveys with near equal representation across PGY 1 to 3. More than half (58.3%) had already completed their adolescent medicine rotation and most (91.7%) had taken an adolescent sexual health history in the past. Baseline confidence and knowledge mean scores were 3.54 and 3.5, respectively. Attitudes about the importance of sexual health conversations had a mean score of 4.79. Significant improvements were observed for all confidence and knowledge items (p values < 0.01), with mean increases of about one point (Table 1, Figure 1). Attitude items showed little change. All participants indicated that the workshop would change their future practice and would recommend this workshop to their peers. Patient care (95.8%) and communication skills (91.7%) were the most commonly self-reported improvements in ACGME competency areas (Figure 2).

Conclusion(s): Interactive case-based workshops focused on obtaining a sexual health history are effective in improving resident confidence and knowledge on this topic and are highly valued by learners.

Table 1
Pre and Post Confidence, Knowledge, and Attitudes by Survey Item

Figure 1
Pre and Post Confidence, Knowledge, and Attitudes by Domain

Figure 2
Self-Reported Improvement in ACGME Core Competency