Residents' self-assessed skills in providing sexuality-related care to teenagers
M. D. Wilson, S. Manoff and A. Joffe
Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, Md., USA.
OBJECTIVES: To assess pediatric residents' self-reported skills and
satisfaction with providing sexuality-related health care to teenagers and
to examine differences by resident and patient gender. DESIGN:
Cross-sectional survey. PARTICIPANTS: Forty second-year (PGY2) and 17
third-year (PGY3) pediatric residents at one training program who completed
a self-administered questionnaire. MAIN OUTCOME MEASURES: Residents rated
their skills with taking a history from, performing a physical examination
on, developing a diagnosis for, and counseling both male and female
teenagers. Skills with providing health care to male and female teenagers
were assessed separately. Scales were constructed for skills with
performing a physical examination and providing a diagnosis and counseling.
Residents also rated their satisfaction with providing health care to male
and female teenagers. Skills and satisfaction with providing health care to
male vs female teenagers were analyzed. RESULTS: Female residents rated
their skills with providing health care to male teenagers significantly
lower than their skills with providing health care to female teenagers as
follows: taking a history of pubertal development (PGY2, P = .001; PGY3, P
= .02), taking a sexual history (PGY2, P = .004), asking about sexual
preference (PGY2, P = .02), examination and diagnosis scale (PGY2, P <
.001; PGY3, P = .008), and counseling scale (PGY2, P = .003). For male
residents, there were no significant differences in skills with providing
health care to male vs female teenagers. Second-year, but not third-year,
female residents reported significantly lower (P < .005) satisfaction
with providing health care to male vs female teenagers. CONCLUSIONS: Among
female residents, discrepancies were found when comparing self-assessed
competencies and, for PGY2 residents, level of satisfaction with providing
health care to male vs female patients. If other research confirms these
findings, educational interventions related to sexuality-related health
care for teenagers should be designed with consideration to gender-specific
learner needs.
