Adolescent depression curriculum for pediatric residents addresses education gaps

Few pediatric medical residents receive experience managing adolescent depression or initiating medication in the continuity clinic, according to results of a prospective, pre-post educational study published in Journal of Adolescent Health. Researchers noted that a case-based, adolescent depression curriculum that simulates patient-provider continuity may increase residents’ self-assessed confidence and knowledge in treating this patient population.

“Early identification and treatment of adolescent depression are critical to improve outcomes,” Michael D. Colburn, MD, MEd, of the Stead Family Department of Pediatrics at the University of Iowa Carver College of Medicine, and colleagues wrote. “Because of the limited number of child and adolescent psychiatrists and the access of pediatricians to adolescents, diagnosis and the management of depression are becoming an expectation for pediatricians. Resident training impacts physician practice for decades and gaps remain in current training.”

To evaluate the novel, case-based adolescent depression curriculum, Colburn and colleagues implemented it within an adolescent medicine rotation. It addressed seven domains “critical for diagnosis and management of adolescent depression,” including the following:

• identification and risk assessment;

• diagnostic criteria for depression;

• safety assessment;

• non-pharmacologic interventions;

• medication initiation;

• medication management; and

• mental health service collaboration.

The researchers recruited residents from the pediatric residency of a single institution and administered a survey that assessed residents’ prior training, demographics and self-assessed knowledge and confidence within each domain using a retrospective pre-post evaluation, they wrote.

Of 51 total residents, 42 (82%) completed the curriculum and survey during their adolescent medicine rotation. A total of 19 residents (45%) reported that within their continuity clinic, they had never initiated medication for depression, and 25 (60%) did not manage depression medications for their adolescent patients. The researchers used the retrospective pre-post survey to compare outcomes before and after participation in the curriculum and found that, for each domain, residents demonstrated increased self-assessed knowledge (P < .001) and confidence (P < .001).

“Utilization of [Accreditation Council for Graduate Medical Education]-required rotations may be a feasible option to expand mental health training,” the researchers wrote. “Although the scope of this project was adolescent depression, the concept could be expanded to additional mental health diagnoses.” – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.