148: Is Paediatric Resident Knowledge and Comfort with Pubertal Exams Adequate? Performance of a Needs Assessment and Development of a Learning Module
Notice bibliographique
Résumé
It is important that paediatric residents (our future paediatricians) know how to perform pubertal examinations. Without appropriate training, there is a risk that exams are done inaccurately, patients experience unnecessary discomfort and physicians avoid warranted exams. To conduct a learning needs assessment (LNA) of paediatric residents to determine their knowledge of and comfort in performing a Tanner Staging pubertal examination and to develop a learning module (LM), informed by the LNA, to address deficits identified in the LNA. The LNA questionnaire was developed to assess residents' previous education, experience, confidence, and knowledge related to Tanner Staging. The questionnaire underwent content and face validity testing. The LNA was administered to residents in four Canadian paediatric training programs that varied in geography and size to sample residents across Canada. The results of the LNA were analyzed using quantitative and qualitative methods to identify themes regarding knowledge and comfort. Sixty-four PGY-1 to PGY-4 residents responded. Half (51.6%) reported discomfort introducing the puberty exam to patients, and 50% reported lack of confidence in their ability to perform a puberty exam. Over half (56.3%) reported having avoided a warranted puberty exam. Of concern, avoidance rates were not statistically different between junior (PGY-1 and PGY-2) and senior (PGY-3 and PGY-4) residents (P=0.69). Over a third (39.1%) did not correctly identify the numeric scale used for Tanner Staging, and 15.6% erroneously identified Tanner Stage 0 as a component of the system. Based on provided pictures, 57.6% assigned the incorrect Tanner Stage for breast development and 67.2% assigned the incorrect Tanner Stage for pubic hair. There were no differences in performance on the knowledge based questions between senior and junior residents, or between residents who had completed an endocrine rotation (54.7%) and those who had not. Quantitative and qualitative analyses identified barriers and enabling factors for exam performance. Together all results were used to develop a case-based, web-based LM that addressed education gaps. This study demonstrated the importance of evaluating paediatric residents' experiences with Tanner Staging. Residents report being uncomfortable with Tanner Staging and avoiding the puberty exam, and they have significant knowledge gaps. To address these issues, we have developed a case-based, web-based LM to help residents learn to perform accurate and compassionate pubertal exams. An important next step will be to examine the utility and effectiveness of the LM.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».