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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel


CiteScore 2018: 0.79

SCImago Journal Rank (SJR) 2018: 0.350
Source Normalized Impact per Paper (SNIP) 2018: 0.476

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2191-0278
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Pubertal assessment: targeted educational intervention for pediatric trainees

Aditi Khokhar
  • Corresponding author
  • Division of Pediatric Endocrinology, Department of Pediatrics, State University of New York Downstate Medical Center and Kings County Hospital Center, Brooklyn, NY, USA, Phone: 315-464-5726, Fax: 315-464-3532
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Sairaman Nagarajan
  • Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn, NY, USA
  • Kings County Hospital Center, Brooklyn, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Yagnaram Ravichandran
  • Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn, NY, USA
  • Kings County Hospital Center, Brooklyn, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Sheila Perez-Colon
  • Division of Pediatric Endocrinology, Department of Pediatrics, State University of New York Downstate Medical Center and Kings County Hospital Center, Brooklyn, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-08-18 | DOI: https://doi.org/10.1515/ijamh-2017-0064

Abstract

Background

Timely and periodic pubertal assessment in children is vital to identify puberty related disorders. Pediatricians need to have working knowledge of puberty time and tempo. Pediatric residency is an important platform to acquire physical examination skills including pubertal assessment.

Objective

An educational intervention for teaching pubertal assessment was piloted on pediatric residents at our institution.

Methods

The intervention comprised of interactive lecture series, ID badge size Tanner stage cards and Tanner posters placed in residents’ continuity clinics. Pre-intervention, post-intervention and 3 months post-intervention surveys for participating trainees were administered to determine the effectiveness of the intervention. Attitudes, practices, knowledge scores, and barriers to Tanner staging conduct were analyzed.

Results

Forty-three residents participated in the intervention. Knowledge scores of PGY1 (5.95 ± 1.6 vs. 7.47 ± 1.4, p < 0.01) improved right after the intervention, as did self-reported clinical practices of all trainees 3 months post- intervention with regards to conducting external genital examination and performing pubertal assessment. Confidence levels of pediatric trainees in conducting pubertal assessment and comfort levels in assessing the need for endocrine referral based on abnormal Tanner staging improved after the intervention, although the effect was not statistically significant.

Conclusion

Our intervention is a worthwhile technique for teaching pubertal assessment to residents as it is simple to conduct, easily reproducible, provides baseline knowledge needed for recognition of normal pubertal development and puberty related conditions, and instills confidence in residents.

This article offers supplementary material which is provided at the end of the article.

Keywords: educational intervention; pediatrics; puberty; residents; Tanner staging

References

  • [1]

    Fuqua JS. Treatment and outcomes of precocious puberty: an update. J Clin Endocrinol Metab. 2013;98:2198–207.Web of ScienceCrossrefGoogle Scholar

  • [2]

    Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44:291–303.CrossrefGoogle Scholar

  • [3]

    Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970;45:13–23.CrossrefGoogle Scholar

  • [4]

    Khokhar A, Ravichandran Y, Stefanov D, Perez-Colon S. Pubertal assessment: a national survey of attitudes, knowledge and practices of the US pediatric trainees. Int J Adolesc Med Health 2017. DOI: .CrossrefGoogle Scholar

  • [5]

    Taylor SJ, Whincup PH, Hindmarsh PC, Lampe F, Odoki K, Cook DG. Performance of a new pubertal self-assessment questionnaire: a preliminary study. Paediatr Perinat Epidemiol. 2001;15:88–94.CrossrefGoogle Scholar

  • [6]

    Rabbani A, Noorian S, Fallah JS, Setoudeh A, Sayarifard F, Abbasi F. Reliability of pubertal self assessment method: an Iranian study. Iran J Pediatr. 2013;23:327–32.Google Scholar

  • [7]

    Sun Y, Tao FB, Su PY. China Puberty Research C. Self-assessment of pubertal Tanner stage by realistic colour images in representative Chinese obese and non-obese children and adolescents. Acta Paediatr. 2012;101:e163–6.CrossrefGoogle Scholar

  • [8]

    Rasmussen AR, Wohlfahrt-Veje C, Tefre de Renzy-Martin K, Hagen CP, Tinggaard J, Mouritsen A, et al. Validity of self-assessment of pubertal maturation. Pediatrics. 2015;135:86–93.CrossrefWeb of ScienceGoogle Scholar

  • [9]

    Afsari A, Mirghafourvand M, Valizadeh S, Abbasnezhadeh M, Galshi M, Fatahi S. The effects of educating mothers and girls on the girls’ attitudes toward puberty health: a randomized controlled trial. Int J Adolesc Med Health. 2017;29(2):151–156.CrossrefGoogle Scholar

  • [10]

    Saghi S, Mirghafourvand M, Alizadeh Charandabi SM, Nabighadim A, Seidi S, Rahmani A. Knowledge and attitude about pubertal health and their socio-demographic predictors in Iranian adolescents. Int J Adolesc Med Health. 2016;28(4):397–405.CrossrefGoogle Scholar

  • [11]

    Wilson MD, Manoff S, Joffe A. Residents’ self-assessed skills in providing sexuality-related care to teenagers. Arch Pediatr Adolesc Med. 1997;151:418–22.CrossrefGoogle Scholar

  • [12]

    Mookherjee S, Pheatt L, Ranji SR, Chou CL. Physical examination education in graduate medical education—a systematic review of the literature. J Gen Intern Med. 2013;28:1090–9.Web of ScienceCrossrefGoogle Scholar

  • [13]

    Roter D, Lipkin M, Korsgaard A. Sex differences in patients’ and physicians’ communication during primary care medical visits. Med Care. 1991;29:1083–93.CrossrefGoogle Scholar

  • [14]

    Leder MR, French GM. Precepting genital exams: challenges in implementing a complex educational intervention in the continuity clinic. Ambul Pediatr. 2005;5:112–6.CrossrefGoogle Scholar

About the article

Received: 2017-04-13

Accepted: 2017-05-26

Published Online: 2017-08-18


Support: No funding was sought or obtained for this study, and the authors had no conflict of interest or personal gain during its completion.

Financial Disclosure: None.

Conflicts of Interest: None


Citation Information: International Journal of Adolescent Medicine and Health, 20170064, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2017-0064.

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