Teaching pediatric and adolescent gynecology

Patterns of Pediatric and Adolescent Gynecologic Problems in China: A Hospital-Based Retrospective Study of 97,252 Patients

STUDY OBJECTIVE

To describe the pattern and population characteristics of pediatric and adolescent gynecologic (PAG) problems in China DESIGN: A clinic-based retrospective study of gynecologic patients (aged 0-18 years) over a period of 13 years SETTING: Department of PAG in the Children's Hospital, Zhejiang University School of Medicine PARTICIPANT: The final analyses included 97,252 patients with gynecologic problems.

INTERVENTIONS/METHODS

Descriptive analysis was conducted to evaluate the pattern of PAG problems.

MAIN OUTCOME MEASURES

Spectrum of PAG problems RESULTS AND CONCLUSIONS: The number of first-visit PAG patients increased from 4,582 to 11,876 from 2006 to 2018. Overall, genital inflammation was the most common presentation (57.0%), followed by precocious puberty (18.2%). The disease pattern varied across age groups; the most common problems were genital inflammation for age 0-6 years, genital inflammation and precocious puberty for age 7-9 years, and consultation, genital inflammation, and menstrual disorders for age 10-18 years. Overall, genital inflammation, precocious puberty, consultation, and menstrual disorders were common issues for pediatric and adolescent patients with gynecologic problems in China.

Establishing a Pediatric and Adolescent Gynecology Subinternship for Medical Students

Within the pediatric and adolescent gynecology (PAG) community, an important issue deserving of our attention is expansion of formalized PAG training opportunities for medical students. In addition to those in obstetrics and gynecology, many physicians practicing family medicine, internal medicine, and surgery provide care to young female patients. However, residency programs provide inconsistent training in addressing specific PAG health care needs and communication skills required for delivery of care to pediatric and adolescent patients; opportunities for supervised clinical experience in these areas at the medical school level therefore have great importance because they might not be offered again during some residencies. At the undergraduate medical education level, training opportunities in PAG are currently limited, with only 3 PAG subinternships in North American medical schools. In contrast, other available subinternships include 113 in maternal fetal medicine and 82 in gynecologic oncology. To address this gap in opportunities for medical students, we developed a PAG subinternship and elective for medical students, which we describe in this report. Our 4-week PAG subinternship and 2-week elective expose students to a variety of ambulatory and surgical opportunities, with formal, informal, and self-guided learning activities. In this article, we explain the process of developing the curriculum, gaining alignment from key stakeholders, obtaining formal approval for the course, and advertising the opportunity to medical students. We also provide resources and guidance for medical educators who wish to establish a PAG subinternship or elective course at their institutions.

Using Individualized Learning Plans to Facilitate Learner-Centered Teaching

Individualized learning plans (ILPs) are helpful tools that can facilitate learner-centered education and can be used with all levels of learners. We introduce the concept of ILPs, the rationale for their use in pediatric and adolescent gynecology education, and review the challenges that learners might face in creating ILPs, and describes how educators can support learners during this process.