Medical Students' Acquisition of Adolescent Interview Skills after Coached Role Play

Turning HEADSS: Utilizing Coached Role-Play to Increase Student Self-Efficacy with Adolescent Interviewing Skills

INTRODUCTION

Adolescent patients make up a significant number of the primary care population, yet medical training specific to adolescents is inadequate and challenging. 2 Medical trainees report feeling less competent caring for adolescents compared to caring for infants and children. 3 Framed after an adolescent HEADSS (Home, Education/employment, peer group Activities, Drugs, Sexuality and Suicide/depression) interview role-play activity for pediatric clerkship students, 1,2 this study sought to investigate the impact that facilitated role-play would have on physician assistant (PA) students' self-perceived knowledge, skills, and comfort in interviewing adolescents.

METHODS

A coached role-play focused on skills used during a HEADSS interview was used to demonstrate the communication skills inherently important to adolescent encounters. Pre- and postintervention surveys were administered.

RESULTS

Data from 2 sequential cohorts (n = 88) showed statistically significant improvement in pre- versus postsession self-perception of knowledge ( p ≤ 0.0001) and skills ( p ≤ 0.0001), but not in comfort ( p = 0.1610).

DISCUSSION

Teaching PA students how best to engage with adolescents can be done effectively via coached role-play.

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.