Development of an Online Learning Module to Improve Pediatric Residents' Confidence and Knowledge of the Pubertal Examination

Ens, Andrea; Janzen, Katharine; Palmert, Mark R.

doi:10.1016/j.jadohealth.2016.10.006

Cited by 18 publications

(22 citation statements)

References 24 publications

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“…Lastly, a Canadian study evaluated the effects of an online module designed to improve knowledge levels and comfort regarding pubertal examinations among pediatric residents (Ens, Janzen, & Palmert, ). According to a needs assessment, about half of the sample reported discomfort about introducing the pubertal exam, a lack of confidence concerning the exam, and attempts to avoid giving the exam.…”

Section: Sources Of Puberty Informationmentioning

confidence: 99%

Puberty Education in a Global Context: Knowledge Gaps, Opportunities, and Implications for Policy

Crockett

Deardorff

Johnson

et al. 2019

J of Research on Adolesc

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Youth programs and policies provide opportunities for institutions and societies to support healthy adolescent development. Puberty education programs are universally important, as they provide crucial knowledge and skills to help youth and their caregivers navigate the physical, emotional, and interpersonal changes of puberty with positive outcomes. However, few puberty programs have been rigorously evaluated, resulting in a lack of evidence-based knowledge and practice in this area. This review examines the status of research on puberty education and related programs and draws on the broader intervention literature and recent research findings on adolescence to identify program features that might improve program effectiveness. Implications for policy are also discussed. The need for rigorous program evaluation is emphasized throughout.

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Section: Sources Of Puberty Informationmentioning

confidence: 99%

Puberty Education in a Global Context: Knowledge Gaps, Opportunities, and Implications for Policy

Crockett

Deardorff

Johnson

et al. 2019

J of Research on Adolesc

View full text Add to dashboard Cite

show abstract

“…The current study also used one physician per sex, thereby avoiding inter-rater variability, thus eliminating potential bias due to the rater. Additionally, physicians underwent periodic retraining and evaluation using the online assessment module [20,21]. It is possible that low school attendance and low literacy rates among participants in the current study could have contributed to a lack of knowledge around sexual development and negatively impacted the ability of the participants to self-assess pubertal development, although this seems to have been largely mitigated by the study design including puberty education before the PDS puberty assessments.…”

Section: Discussionmentioning

confidence: 99%

“…It included hands-on training conducted by a pediatric endocrinologist (K.N.H.) and an online module with an evaluation component designed at the Hospital for Sick Children proven to improve accuracy, confidence, and comfort in pubertal examinations [20,21]. Owing to the limited capacity of this study, the physical Tanner stage assessment was carried out by the same physician who administered the PDS.…”

Section: Physician Assessment Of Pubertal Milestonesmentioning

confidence: 99%

Self-assessed puberty is reliable in a low-income setting in rural Pakistan

Campisi

Humayun

Wasan

et al. 2020

Journal of Pediatric Endocrinology and Metabolism

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ObjectivesStaging sexual maturation is an integral component of adolescent research. The Pubertal Development Scale (PDS) is commonly used as a puberty self-assessment tool because it avoids the use of images. Among the youth living in rural Pakistan, we determined the accuracy of self-reported pubertal assessments using a modified PDS compared to the ‘gold standard’ of physically assessed Tanner stages by a physician.MethodsThe strength of agreement between self-assessed puberty using a modified PDS and the ‘gold’ standard of physician-assessed Tanner stages was reported using weighted kappa (κw) for girls (n = 723) of 9.0–14.9 years of age or boys (n = 662) of 10.0–15.9 years of age living in the rural District of Matiari.ResultsAgreement between the gold standard and self-assessment for puberty was substantial, with a κw of 0.73 (95% confidence interval [CI]: 0.67; 0.79) for girls and a κw of 0.61 (95% CI: 0.55; 0.66) for boys. Substantial agreement was observed for both boys and girls classified as thinness but only for girls with a normal body mass index. Those who were classified as severely thin had moderate agreement. The prevalence of overestimation was 18.5% (95% CI: 15.9–21.5) for girls and 2.7% (95% CI: 1.7–4.3) for boys, while the prevalence of underestimation estimation was 8.0% (95% CI: 6.2–10.2) for girls and 29.0% (95% CI: 25.8–32.6) for boys.ConclusionsMost girls and boys assessed their pubertal development with substantial agreement with physician assessment. Girls were better able to assess their puberty, but they were more likely to overestimate. Agreement for boys was also substantial, but they were more likely to underestimate their pubertal development. In this rural Pakistan population, the PDS seems to be a promising tool for self-assessed puberty.

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“…Given local cultural norms, Tanner Stage for female breast, male genital and pubic hair development were determined by sex-matched study physicians (one physician per sex). Physicians completed online Tanner Stage training (Ens, Janzen, & Palmert, 2017; "Puberty Assessment Learning Module,") and one-on-one training by a pediatric endocrinologist (KNH) before the study start and at regular intervals during the study.…”

Section: Methodsmentioning

confidence: 99%

The relationship between pubertal timing and under‐nutrition in rural Pakistan

Campisi

Humayun

Wasan

et al. 2021

Journal of Adolescence

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Introduction Sexual development in females and males are routinely measured according to the Tanner Stages. Sparse data exist on the timing of pubertal milestones in Pakistan. To fill this gap, the age of attainment of pubertal milestones and their relationship with nutritional status was explored among children and adolescents living in the rural district of Matiari, Pakistan. Methods Anthropometry, nutrition biomarkers and Tanner Stage were assessed among girls aged 9.0–14.9 years (n = 723) and boys aged 10.0–15.9 years (n = 662) who were free from known disease in the rural District of Matiari, Pakistan. Median age was calculated for all Tanner Stages and menarche. Multivariable linear regressions were undertaken to determine covariates associated with the timing (age) of pubertal milestones. Results Among participants living in this rural community, the median age of puberty onset for girls was 11.9 years (95%CI:10.9; 12.5) and boys was 12.3 years (95%CI:11.5; 12.9). Age at first menarche was 12.9 years (95%CI:12.1; 13.3). Undernutrition was widespread among adolescents in this community. Thirty‐seven percent of females and 27.0% of males were stunted while 20.5% of females and 31.3% of males were thin. Only 8% (n = 58) of females and 12% (n = 78) of males were free from any nutrient deficiency with most adolescents having two or three nutrient deficiencies. Conclusions Undernutrition (stunting or thinness) was associated with relatively older ages for early puberty stages but not puberty completion. This may decrease the duration of the pubertal growth spurt and curtail potential catch‐up growth that may occur during puberty. Efforts to decrease nutrient deficiencies, stunting and thinness beyond childhood should be made in rural Pakistan.

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Development of an Online Learning Module to Improve Pediatric Residents' Confidence and Knowledge of the Pubertal Examination

Cited by 18 publications

References 24 publications

Puberty Education in a Global Context: Knowledge Gaps, Opportunities, and Implications for Policy

Puberty Education in a Global Context: Knowledge Gaps, Opportunities, and Implications for Policy

Self-assessed puberty is reliable in a low-income setting in rural Pakistan

The relationship between pubertal timing and under‐nutrition in rural Pakistan

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