57. Pilot Study: Impact of a Pediatric and Adolescent Gynecology Rotation on Confidence in Provision of Adolescent Sexual and Reproductive Health Services Among Pediatric Residents

Adolescence is a major life transition filled with many changes including physical, psychosocial, and cognitive changes which impact sexual and reproductive health (SRH). Pediatricians play a major role in providing SRH education and services that mitigate adverse outcomes from high-risk SRH behaviors. However, there is an insufficient amount of data assessing SRH training among pediatric residents. This study aimed to assess pediatric residents confidence in providing SRH education and services to adolescent patients before and after a pediatric adolescent gynecology (PAG) rotation. We hypothesize that a rotation in PAG will enhance pediatric residents’ confidence in providing SRH education and services to adolescent patients. Pediatric and combined medicine-pediatric residents (PGY 2-4) completed an online Qualtrics surveys before and after completing 1-2 PAG clinic sessions. The 21-question survey assessed confidence in providing SRH education and services around eight topics including: contraception, pregnancy, physical examination, focused interview, anticipatory guidance, gender and sexual identity, mental health, and sexually transmitted infections. Level of confidence was assessed through a 4-point Likert scale, “highly confident” =4 to “not confident” =1, and responses were summed to create a total confidence score that could range from 21-84. We used paired t-tests to compare pre and post rotation scores. A total of 19 respondents completed the pre and post surveys. The response rate was 56.8 % (25/44). The highest possible confidence score was 84 and the lowest was 21. The mean total confidence score increased between the pre- and post-rotation surveys (from 57.3 to 62; p-value 0.01). Similarly, the mean total number of items marked “highly confident” or “confident” increased from 12.7 to 14.6 (p-value 0.048). Our pilot data shows an increase in trainee’s confidence in providing SRH education and services after a PAG rotation, as measured by total confidence score. Limitations include small sample size, limited exposure to PAG clinics, use of a non-validated survey, and lack of assessment of prior SRH training. Our future direction with this data is to modify the adolescent medicine rotation to improve confidence in residents' skills, and thus, improve sexual and reproductive health patient care for patients.