Adolescent Medicine Training in Postgraduate Family Medicine Education: A Scoping Review

Abstract

Adolescence is a critical period of physical, psychological, and social development. Family physicians play a crucial role in providing comprehensive healthcare to adolescents. However, the adequacy of adolescent medicine training within postgraduate family medicine education programs remains a subject of ongoing debate. This scoping review aims to systematically examine the current state of adolescent medicine training within family medicine residency programs, identify key curricular elements, assess the effectiveness of existing training approaches, and explore strategies for improvement.

Introduction

Adolescence is a period of significant physical, psychological, and social change. During this critical developmental stage, adolescents face a unique range of health challenges, including mental health issues, substance use disorders, sexual and reproductive health concerns, chronic diseases, and social and emotional difficulties.

Family physicians are uniquely positioned to provide comprehensive and continuous healthcare for adolescents. However, effectively addressing the complex needs of this population requires specialized knowledge, skills, and attitudes. This scoping review aims to systematically examine the current state of adolescent medicine training within postgraduate family medicine education programs, identify key curricular elements, assess the effectiveness of existing training approaches, and explore strategies for improvement.

Methods

This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. 

• Search Strategy:

  • A comprehensive search was conducted in electronic databases, including PubMed, Scopus, ERIC, and Google Scholar, using a combination of keywords related to adolescent medicine, family medicine residency, curriculum, education, and training.

  • Search terms included: "adolescent medicine," "family medicine residency," "curriculum," "training," "education," "competencies," "outcomes," "needs assessment."

• Inclusion Criteria:

  • Studies that specifically addressed adolescent medicine training within postgraduate family medicine residency programs.

  • Articles published in English.

• Exclusion Criteria:

  • Studies focusing solely on undergraduate medical education or other specialties.

  • Reviews, editorials, and opinion pieces without original data.

• Data Extraction:

  • Data were extracted from included studies by two independent reviewers using a standardized data extraction form.

  • Extracted data included study characteristics (e.g., study design, sample size, setting), curricular elements (e.g., didactic sessions, clinical rotations, simulation-based training), assessment methods, and outcomes.

• Data Analysis:

  • The extracted data were analyzed qualitatively to identify key themes and trends in adolescent medicine training within family medicine residency programs.

  • Descriptive statistics were used to summarize the characteristics of included studies.

Results

[This section will present the findings of the literature search and data analysis. It should include:

• Number of studies included:

• Characteristics of included studies:

  • Study design (e.g., surveys, program descriptions, qualitative studies)

  • Setting (e.g., academic, community-based)

  • Sample size (if applicable)

• Key curricular elements:

  • Didactic sessions:

    • Topics covered (e.g., adolescent development, sexual and reproductive health, mental health, substance use disorders, chronic diseases)

    • Teaching methods (e.g., lectures, small group discussions, case-based learning)

  • Clinical rotations:

    • Rotations in adolescent medicine clinics, school-based health centers, community health centers, and other relevant settings.

    • Opportunities for supervised clinical encounters with adolescent patients.

  • Simulation-based training:

    • Use of standardized patients, simulated patients, and other simulation modalities to enhance clinical skills.

  • Interprofessional education:

    • Opportunities for collaboration with other healthcare professionals, such as nurses, social workers, and psychologists.

• Assessment methods:

  • Methods used to assess resident knowledge, skills, and attitudes related to adolescent medicine (e.g., examinations, clinical performance evaluations, surveys)

• Training outcomes:

  • Reported outcomes of adolescent medicine training programs (e.g., resident knowledge, skills, confidence, attitudes)

• Gaps in current training:

  • Identified gaps in current training programs, such as inadequate coverage of specific topics, limited access to clinical experiences, and lack of standardized assessment methods.]

Discussion

[This section will discuss the findings of the review and their implications for improving adolescent medicine training in family medicine residency programs. It should address the following:

• Key strengths of current training programs:

  • Identify successful training approaches and best practices.

• Areas for improvement:

  • Address identified gaps in current training, such as:

    • Inadequate coverage of specific topics (e.g., gender identity, LGBTQ+ health, cultural competence)

    • Limited access to diverse patient populations and clinical settings

    • Lack of standardized assessment methods and feedback mechanisms

    • Insufficient emphasis on cultural competency and health equity

    • Limited integration of technology and telehealth

• Recommendations for improvement:

  • Develop and implement standardized curricula for adolescent medicine training in family medicine residency programs.

  • Increase the availability of clinical rotations in adolescent-focused settings.

  • Utilize innovative teaching methods, such as simulation-based training, technology-enhanced learning, and interprofessional education.

  • Develop and implement robust assessment methods to evaluate resident competency in adolescent medicine.

  • Foster a culture of lifelong learning and continuous professional development in adolescent health.

• The role of accreditation bodies:

  • The role of accrediting bodies (e.g., the Accreditation Council for Graduate Medical Education [ACGME]) in setting and enforcing standards for adolescent medicine training in family medicine residency programs.

• The importance of faculty development:

  • The need for ongoing training and education for faculty members in adolescent medicine to ensure high-quality teaching and mentorship.

Conclusion

Adolescent medicine training is a critical component of postgraduate family medicine education. This scoping review highlights the importance of comprehensive and high-quality training to equip family physicians with the knowledge, skills, and attitudes necessary to effectively care for adolescent patients.

Limitations

• Search limitations:

  • The search strategy may not have captured all relevant studies.

• Data extraction limitations:

  • Potential for bias in data extraction and interpretation.

• Heterogeneity of studies:

  • Variability in study design, methodology, and reported outcomes may limit the ability to draw generalizable conclusions.

Future Directions

• Conduct further research:

  • Conduct more rigorous studies, such as randomized controlled trials, to evaluate the effectiveness of different training interventions.

  • Investigate the long-term impact of adolescent medicine training on resident knowledge, skills, and patient care outcomes.

  • Explore the use of technology and innovative teaching methods to enhance adolescent medicine training.