Anisha A. Abraham, MD, MPH, Georgetown; Kirsten B. Hawkins, MD, MPH, Georgetown University, Georgetown University, Washington, DC
Background: Health professionals play a crucial role in assessing adolescents for high-risk behaviors. However, there is a lack of targeted education for medical students regarding effective communication and psychosocial screening of teens. Objective: The objective of this study is to evaluate the effects of an educational intervention involving standardized patients on medical students’ comfort level and skills in the identification of adolescent high-risk behaviors. Methods: This study uses trained teen actors as simulated patients in the outpatient setting. Previous studies in other settings have shown that the use of standardized teen patients improves the comfort and skills of trainees in interviewing adolescents. This control comparison study involved 3rd year medical students assigned to the pediatric clerkship. Students in the intervention received a lecture on the adolescent psychosocial interview approach before an encounter with a standardized patient, while students in the control group received the didactic lecture alone. The pediatric and medicine-pediatric residents rotating through the adolescent clinic helped facilitate the intervention session. Medical students were asked to complete pre- and post-rotation questionnaires assessing self-reported screening practices and perceived importance and confidence in high-risk behavior screening. Results: There were 85 participants in the control group and 73 in the intervention group. Independent sample t-test was used to compare the post questionnaire scores for the control and intervention. Participants in the intervention group showed a statistically significant improvement in how often they asked about sexual history (p<.04), violence at home, school and neighborhood (p<.001), depression (p<.004) and family functioning (p<.01). In addition, subjects in the intervention group were more likely to counsel patients on drug use (p<.01), sexual activity (p<.005), and violence risks (p< .0001). Finally, intervention subjects were more confident in providing guidance on violence (p<.001), depression and family functioning (p<.01) than subjects in the control group. Conclusion: A workshop involving teen actors as standardized patients can improve trainees’ confidence and screening practices regarding certain adolescent health risks.