277 - Evaluation of Adolescent Anxiety Curriculum for Pediatric Residents

Poster Number: 277
Publication Number: 277.420

Chelsea A. Garnett, UCSF Benioff Children's Hospital San Francisco, San Bruno, CA, United States; Amanda Downey, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Ellen Laves, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Sara M. Buckelew, UCSF Benioff Children's Hospital San Francisco, San Francisco, CA, United States

Background: Due to the rise of mental health disorders among adolescents and the national shortage of mental health providers, the AAP has issued a policy statement emphasizing the need for general pediatricians to address mental health concerns. Pediatric care providers report insufficient training in this area. A needs assessment conducted prior to this study demonstrated that pediatric residents at our large academic institution lack confidence and training in the identification and management (particularly pharmacological management) of pediatric and adolescent mental health concerns, including anxiety disorders.

Objective:
To create, implement, and evaluate a curriculum for pediatric residents on identification and management of anxiety in adolescent patients.

Design/Methods:
The curriculum created was comprised of a didactic lecture followed by case-based, small-group discussions and was presented to second and third year pediatric residents at a large urban academic institution via Zoom. Pre- and post- surveys utilizing unique identifiers were administered to assess confidence (Likert scale of agreement 1-5) and knowledge (6 multiple choice questions) related to identification and management of adolescent anxiety disorders. Confidence and knowledge scores were compared pre- and post-curriculum delivery using paired t-tests. Chi-square analysis was used to compare the proportion of participants who answered each knowledge question correctly before and after participating in the curriculum.

Results:
28 participants completed both the pre and post survey. On a scale of 1 to 5 (with 1 = strongly agree and 5 = strongly disagree, thus lower numbers implying higher agreement), the mean level of agreement with statements regarding confidence improved in screening (2.1  1.4, p< .001), non-pharmacologic management (2.5  1.5, p< .001), and medication initiation (3.5  1.9, p< .001) after the curriculum intervention. Mean score on the 6-item knowledge-based section improved from 2.9 to 4.6 (p < .001). The number of participants who answered correctly increased for all 6 knowledge questions and was statistically significant for 5 out of 6 questions.
Conclusion(s):
Implementation of a didactic and case-based curriculum for pediatric residents was associated with improved self-efficacy and content knowledge in the care of adolescents with anxiety, particularly regarding initiation of pharmacotherapy. Further directions include the development of curriculum targeting other adolescent mental health concerns such as depression, suicidality, and non-suicidal self-harm.

Table 1: Resident Agreement with Statements of Confidence in Identification and Management of Adolescent Anxiety
Table 2: Resident Knowledge Related to Identification and Management of Adolescent Anxiety