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Int J Adolesc Med Health. 2018 Jun 28;32(5). doi: 10.1515/ijamh-2017-0212.

An examination of eating disorder education and experience in a 1-month adolescent medicine rotation: what is sufficient to foster adequate self-efficacy?.

International journal of adolescent medicine and health

Tracie L Pasold, Jennifer L Woods, Maria G Portilla, James D Nesmith, Beatrice A Boateng

Affiliations

  1. Marywood University, 2300 Adams Avenue, Scranton, PA 18509, USA, Phone: +570-348-6211, Ext: 2265; Fax: +570-340-6040.
  2. Department of Pediatrics, Children's Hospital Colorado, Aurora Anschutz Outpatient Pavilion, Aurora, CO, USA.
  3. Eating Disorder Clinic, Department Student Health, University of Virginia, Charlottesville, VA, USA.
  4. Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, USA.
  5. Office of Education and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

PMID: 29953405 DOI: 10.1515/ijamh-2017-0212

Abstract

Objective Medical students and professionals report receiving limited education/training related to treating eating disorders. Because medical professionals are the point of initial contact for these patients and are involved necessarily in their treatment, sufficient knowledge on identification and intervention are imperative. This research set out to examine the impact of the eating disorder education and experience offered through a 1-month Adolescent Medicine rotation at a medical university on medical student/resident self-efficacy. Methods The 1-month rotation includes a standardized patient (SP) simulation, 1.5 h of didactic education, and 1 day observing the MD, nutritionist and psychologist within the outpatient Multidisciplinary Child/Adolescent Eating Disorders Clinic. All residents' (n = 132) eating disorder self-efficacy was assessed before (PRE) completing simulation and didactic session and again at the end of the 1-month rotation (END). Self-efficacy was also assessed after simulation and before the didactic session for group 1 (n = 92) and after simulation and didactic session for group 2 (n = 40). Results For group 1, self-efficacy was not significantly impacted PRE to POST. For group 2, self-efficacy significantly improved PRE to POST. POST to END changes were significant for both groups; however, group 2 scored significantly better across all self-efficacy areas at END. Conclusion Resident training in eating disorders requires more than is offered in many residency programs. SP simulation is strengthened as an effective training tool in assessing and promoting resident self-efficacy if it is followed by didactic education. Clinical observation and extended practice that includes ongoing guidance/feedback on performance is recommended in fostering self-efficacy.

Keywords: eating disorders; medical residents; self-efficacy; standardized patient simulation

References

  1. Mehler PS, Krantz MJ, Sachs KV. Treatments of medical complications of anorexia nervosa and bulimia nervosa. J Eat Disord. 2015;3:15. - PubMed
  2. Rojo-Moreno L, Arribas P, Plumed J, Gimeno N, García-Blanco A, Vaz-Leal F, et al. Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up. Psychiatry Res. 2015;227(1):52–7. - PubMed
  3. Crow SJ, Peterson CB, Swanson SA, Raymond NC, Specker S, Eckert ED, et al. Increased mortality in bulimia nervosa and other eating disorders. Am J Psychiatry. 2009;166:1342–6. - PubMed
  4. Rosen D. American academy of pediatrics. clinical report: identification and management of eating disorders in children and adolescents. David S. Rosen and The Committee on Adolescence. Pediatrics. 2010;126(6):1239–53. - PubMed
  5. Son GE, Hoeken D, Furth EF, Donker GA, Hoek HW. Course and outcome of eating disorders in a primary care-based cohort. Int J Eat Disord. 2010;43:130–8. - PubMed
  6. Nasir A, Watanabe-Galloway S, DiRenzo-Coffey G. Health services for behavioral problems in pediatric primary care. J Behav Health Serv Res. 2014;43(3):396–401. - PubMed
  7. Stein RE, Horwitz SM, Storfer-Isser A, Heneghan A, Olson L, Hoagwood KE. Do pediatricians think they are responsible for identification and management of child mental health problems? Results of the AAP periodic survey. Ambul Pediatr. 2008;8(1):11–7. - PubMed
  8. Mahr F, Farahmand P, Bixler EO, Domen RE, Moser EM, Nadeem T, et al. A national survey of eating disorder training. Int J Eat Disord. 2015;48(4):443–5. - PubMed
  9. Davis DW, Honaker SM, Jones VF, Williams PG, Stocker F, Martin E. Identification and management of behavioral/mental health problems in primary care pediatrics: perceived strengths, challenges, and new delivery models. Clin Pediatr. 2012;10:978–82. - PubMed
  10. Fox HB, McManus MA, Diaz A, Elster AB, Felice ME, Kaplan DW, et al. Advancing medical education training in adolescent health. Pediatrics. 2008;121(5):1043–5. - PubMed
  11. Linville D, Brown T, O’Neil M. Medical providers’ self-perceived knowledge and skills for working with eating disorders: a national survey. Eat Disord: J Treat Prevent. 2012;20(1):1–13. - PubMed
  12. Robinson AL, Boachie A, Lafrance GA. Assessment and treatment of pediatric eating disorders: a survey of physicians and psychologists. J Can Acad Child Adolesc Psychiatry. 2012;21(1):45–52. - PubMed
  13. Williams M, Leichner P. More training needed in eating disorders: a time cohort comparison study of canadian psychiatry residents. Eat Disord: J Treat Prevent. 2006;14(4):323–34. - PubMed
  14. Lee H, Stewart D, Mallios R. Mental health and psychiatry training in primary care residency programs: part ii. what skills and diagnoses are taught, how adequate, and what affects training directors’ satisfaction? Gen Hosp Psychiatry. 2006;28(3):195–204. - PubMed
  15. Cabana MD, Rand CS, Becher OJ, Rubin HR. Reasons for pediatrician nonadherence to asthma guidelines. Arch Pediatr Adolesc Med. 2001;155:1057–62. - PubMed
  16. Cabana MD, Rand C, Slish K, Nan B, Davis MD, Clark N. Smoking pediatrician self-efficacy for counseling parents of asthmatic children to quit smoking. Pediatrics. 2004;113:78–81. - PubMed
  17. Cheng TL, DeWitt TG, Savageau JA, O’Connor KG. Determinants of counseling in primary care pediatric practice: physician attitudes about time, money, and health issues. Arch Pediatr Adolesc Med. 1999;153:629–35. - PubMed
  18. Bandura A. Self-efficacy: the exercise of control. New York: W.H. Freeman; 1997. - PubMed
  19. Ozer EM, Bandura A. Mechanisms governing empowerment effects: a self-efficacy analysis. J Pers Soc Psychol. 1990;58:472–86. - PubMed
  20. Ozer EM, Adams SH, Gardner LR, Mailloux DE, Wibbelsman CJ, Irwin CE. Provider self-efficacy and the screening of adolescents for risky health behaviors. J Adolesc Health. 2004;35(2):101–7. - PubMed
  21. Djuricich AM, Ciccarelli M, Swigonski N. A Continuous quality improvement curriculum for residents: addressing core competency, improving systems. Acad Med. 2004;79(10 Suppl):S65–7. - PubMed
  22. Hillenbrand KM, Larsen PG. Effect of an educational intervention about breastfeeding on the knowledge, confidence, and behaviors of pediatric resident physicians. Pediatrics. 2002;110(5):1–7. - PubMed
  23. Buckelew SM, Adams SH, Irwin CE, Gee S, Ozer EM. Increasing clinician self-efficacy for screening and counseling adolescents for risky health behaviors: results of an intervention. J Adolesc Health. 2008;43:198–200. - PubMed
  24. Cox ED, Koscik RL, Olson CA, Behrmann AT, McIntosh GC, Kokotailo PK. Clinical skills and self-efficacy after a curriculum on care for the underserved. Am J Prev Med. 2008;34(5):442–8. - PubMed
  25. Ozuah PO, Reznik M. Using unannounced standardized patients to assess residents’ competency in asthma severity classification. Ambul Pediatr. 2008;8(2):139–42. - PubMed
  26. Brown R, Doonan S, Schellenberger S. Using children as simulated patients in communication training for residents and medical students: a pilot program. Acad Med. 2005;80(12):1114–20. - PubMed
  27. Woods JL, Pasold TL, Boateng BA. Adolescent medicine and the trainee: evaluating self-efficacy, knowledge and communication through the utilization of standardized patient simulations. MedEdPORTAL. 2012. Available at: www.mededportal.org/publication/9137. - PubMed
  28. Hampton E, Richardson JE, Bostwick S, Ward MJ, Green C. The current and ideal state of mental health training: Pediatric resident perspectives. Teach Learn Med. 2015;27(2):147–54. - PubMed
  29. Blake K, Mann KV, Kaufman DM, Kappelman M. Learning adolescent psychosocial interviewing using simulated patients. Acad Med. 2000;75(10):S56–8. - PubMed
  30. Epstein RM, Levenkron JC, Frarey L, Thompson J, Anderson K, Franks P. Improving Physicians’ HIV risk-assessment skills using announced and unannounced standardized patients. J Gen Intern Med. 2001;16:176–80. - PubMed
  31. Chen W, Liao SC, Tsai CH, Huang CC, Lin CC, Tsai CH. Clinical skills in final-year medical students: the relationship between self-reported confidence and direct observation by faculty or residents. Ann Acad Med Singapore. 2008;37(1):3–8. - PubMed
  32. Linville D, Aoyama T, Knoble NB, Gau J. The effectiveness of a brief eating disorder training programme in medical settings. J Res Nurs. 2013;18(6):544–58. - PubMed

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