Web-based Education on Primary Care of the Adolescent Patient: Comparison of Internal Medicine and Pediatric Programs Use and Test Scores


      Pediatric training programs are required to include specific training in adolescent medicine. Internal Medicine programs are not, despite a call from the American College of Physicians to enhance internists' capacity to care for adolescents. The Johns Hopkins Physician Education and Assessment Center (PEAC) offers internet based curricula for Pediatric and Internal Medicine (IM) training programs. Residents comprise 85% of registrants to each curriculum. In conjunction with adolescent medicine clinicians, we developed an interactive, case-based teaching module on caring for adolescent patients. Pre and post test questions are included in the module to assess knowledge. The purpose of this study is to compare usage, group pre/post test scores and satisfaction with the module between IM and Pediatric program users. We hypothesized that the IM user group, with less programmed education in adolescent medicine, would have greater pre to post test improvement in knowledge score.


      Data on module use were collected for 3 academic years (2010-2013). Percent correct responses to pre and post-test questions on a) stages of cognitive development, b) limits of confidentiality, c) rationale for confidential services, and d) emancipation were calculated for both programs. User satisfaction data were averaged over three years for each program.


      An average of 1356 learners per year completed the adolescent medicine module on the IM site, 9.5% of registered users. 450 learners per year completed it on the Pediatric site, representing 14.7% of registered Pediatric users. Comparing percent correct responses on pre and post tests shows that both groups showed substantial improvement in percent correct after completion of the internet module. Averaged over 3 years, Pediatric program users had higher pretest scores (average 3.7 percentage points higher than IM) and higher post test scores (average 9.7 percentage points higher than IM). IM users showed greater improvement between pre and post-test than Pediatric users only in the first year the module was available. All those completing the module rated their level of satisfaction with the module. IM users rated it 4.0 on a 1-5 scale (1 = poor, 5 = excellent). Pediatric users rated it 3.7.


      Both IM and Pediatric user groups show knowledge gain from use of an interactive, case-based online module on primary care of the adolescent. Use of internet based curricula such as PEAC is an acceptable and effective method of teaching about adolescent health in residency programs, including those without a specific focus on adolescent medicine. The results from this study demonstrate the potential of an online training module to efficiently target and increase provider knowledge on important adolescent care issues. Additional interventions to increase uptake of this method should be explored.

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