Preparing for Transition from Pediatric to Adult Care

Hess, Janet; Straub, Diane M.; Mateus, Julián; Pelaez-Velez, Cristina

doi:10.1016/j.yapd.2015.04.003

Cited by 10 publications

(5 citation statements)

References 24 publications

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“…Competency-based medical education (CBME) centers on education and training using standard practices across training programs. Up to this point, many med-peds residency programs have created and implemented their own curriculum to teach HCT utilizing various teaching modalities including didactics, online modules, electronic health record tools, small group discussions, case studies, pediatric and internal medicine dyads, or direct patient care activities [17][18][19]. However, there is a lack of standardization of educational content and assessment in teaching HCT to residents.…”

Section: Discussionmentioning

confidence: 99%

A Multi-Institutional Collaborative To Assess the Knowledge and Skills of Medicine-Pediatrics Residents in Health Care Transition

Feeney¹,

Hotez²,

Wan³

et al. 2021

Cureus

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BackgroundPediatric to adult health care transition (HCT) is an essential process in the care of youth with special health care needs (YSHCN). Many internal medicine-pediatrics (med-peds) residency programs have developed curricula to teach transition knowledge and skills for the care of YSHCN. ObjectiveUsing a national med-peds program director quality improvement collaborative to improve transition curriculum, we aim to identify curricular content areas of improvement by describing baseline trainee knowledge and skills taught through existing transition curricula in med-peds programs. MethodsWe analyzed data collected during the 2018-2019 national med-peds program director quality improvement collaborative to improve transition curriculum. Program directors assessed their programs, and trainees assessed themselves on five transition goals by completing a Likert-scale questionnaire. In addition, trainees received an objective assessment of their knowledge through a multiple-choice questionnaire (MCQ). ResultsAll 19 programs in the collaborative, and 193 of 316 trainees from these programs, completed the questionnaires. Most programs were based at academic centers (68%) and provided transition training via didactics (63%) and/or subspecialty rotations (58%). More programs had high confidence (95%) than trainees (58%) in goal 1 (knowledge and skills of the issues around transition), whereas more trainees had high confidence (60%) than programs (47%) in goal 2 (understanding the developmental and psychosocial aspects of transition). Programs and trainees self-assessed lower in goals related to health insurance, educational and vocational needs, and application of health care system knowledge to the practice environment (goals 3, 4, and 5, respectively). ConclusionsUsing the assessments of the program directors and resident trainees, we identified subject areas for improvement of transition curricula, including health insurance and the application of health care system knowledge to the practice environment.

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Section: Discussionmentioning

confidence: 99%

A Multi-Institutional Collaborative To Assess the Knowledge and Skills of Medicine-Pediatrics Residents in Health Care Transition

Feeney¹,

Hotez²,

Wan³

et al. 2021

Cureus

View full text Add to dashboard Cite

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“…Experiential and multimodal approaches to health care transition training have resulted in improvement of resident comfort and abilities. 11 We will incorporate learning methods specifically identified in our survey as preferred approaches to health care transition training. The qualitative responses suggest that our residents appreciate the structure and familiarity of didactics, the flexibility and independence afforded by online resources, and the practical learning stimulated by clinical experiences.…”

Section: Discussionmentioning

confidence: 99%

“…The questionnaire was adapted from previously validated instruments developed at the University of Kansas School of Medicine and the University of South Florida Morsani College of Medicine formulated to appraise resident training in health care transition. 11 We included epilepsy-specific knowledge questions and qualitative items that allowed a more focused and detailed assessment of resident exposure at providing health care transition to youth with chronic epilepsy.…”

Section: Methodsmentioning

confidence: 99%

Resident Training in Transitioning Youth With Epilepsy Into Adult Care

Tirol

Kumar

2020

J Child Neurol

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Objective: To appraise the current training of Neurology (N), Pediatric (P), and Med-Peds (MP) residents at MedStar Georgetown University Hospital (MGUH) in providing care to patients with epilepsy who are transitioning from pediatric to adult care. Methods: Through an online questionnaire, we surveyed Neurology, Pediatric, and Med-Peds residents to assess their knowledge, confidence, and experience at transitioning youth with epilepsy to adult-oriented health care. Results: N, P, and MP residents generally rated their knowledge and confidence at providing transition care to youth with epilepsy to be poor; however, P and MP residents rated higher in limited measures of knowledge and experience. Conclusion: Our appraisal of resident training in transitions care for youth with epilepsy has highlighted training elements in our institution that require attention for both adult and pediatric providers, leading to the formulation of an educational intervention that will promote experiential and multimodal approaches in this area.

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“…The literature is beginning to include pilot curricula for trainees [22,23], including creative ways for pediatric and internal medicine trainees to learn from each other's' expertise [22]. There are also many tools and resources offered on the National Center for Healthcare Transition's website, GotTransition.org [24], and training on the use of these tools would itself constitute a curriculum in clinically-relevant transition and transfer skills.…”

Section: Discussionmentioning

confidence: 99%

Lost in transition: resident and fellow training and experience caring for young adults with chronic conditions in a large United States’ academic medical center

Sadun

Chung

Pollock

et al. 2019

Medical Education Online

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Background: The transition from pediatric to adult healthcare is a vulnerable time for adolescents and young adults (AYA), especially those with chronic conditions. Successful transition requires communication and coordination amongst providers, patients, and families. Unfortunately, multiple studies have demonstrated that the majority of practicing providers do not feel prepared to help AYA patients through health care transition, but little is known about the transition/transfer aptitudes of physician trainees. Objectives: The purpose of this study was to establish the transition/transfer training that residents and fellows from different fields receiveand determine what training factors are associated with increased confidence in core transition/transfer skills. Design: A 20-item electronic survey regarding experiences caring for AYA patients was sent to all 2014-2015 graduate medical education (GME) trainees at our institution. Results: Forty-nine percent (479/985) of trainees responded: 60 pediatric, 387 non-pediatric, and 32 'combined' (e.g., Medicine/Pediatrics or Family Medicine). Trainees from all three categories of programs reported similar exposure to AYA patients with chronic conditions, with a median of 1-3 encounters per month. A quarter of trainees rated themselves as 'not at all prepared' to speak with a counterpart provider about a transferring patient, while nearly half of trainees considered themselves 'not at all prepared' to speak with a patient and family about transition. Trainee confidence in performing these two skills was strongly predicted by three factors: increased exposure to AYA with chronic conditions, education (training or role modeling) in transition skills, and experience practicing transition skills. Of these, the strongest association with trainee confidence was experience practicing the skills of communicating with other providers (OR = 13.0) or with patients/families (OR = 14.5). Conclusion: Despite at least monthly encounters with AYA with chronic conditions, most residents and fellows have very little experience communicating across the pediatric-to-adult healthcare divide, highlighting training opportunities in graduate medical education.

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Preparing for Transition from Pediatric to Adult Care

Cited by 10 publications

References 24 publications

A Multi-Institutional Collaborative To Assess the Knowledge and Skills of Medicine-Pediatrics Residents in Health Care Transition

A Multi-Institutional Collaborative To Assess the Knowledge and Skills of Medicine-Pediatrics Residents in Health Care Transition

Resident Training in Transitioning Youth With Epilepsy Into Adult Care

Lost in transition: resident and fellow training and experience caring for young adults with chronic conditions in a large United States’ academic medical center

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