Diagnosis and Lifestyle Modification Counseling for Adolescents With PCOS: An Assessment of Learning Needs in OBGYN, Pediatrics, and Family Medicine Residents

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Abstract

OBJECTIVE:

To assess the knowledge gaps in residents of three disciplines to both accurately diagnose polycystic ovary syndrome (PCOS) and use lifestyle modification counseling with adolescents who have PCOS.

METHODS:

A 21-question survey was administered several months before and then 2 weeks after an interactive didactic session with resident physicians in Pediatrics, Family Medicine, and OBGYN at Erlanger Health System, to assess knowledge of disease mechanism, knowledge of treatment options, focus of counseling, adequacy of resources, and potential barriers to counseling. Basic descriptive and frequency analyses were conducted on all items.

EVALUATION:

Most residents, regardless of specialty, did not feel confident diagnosing PCOS in adolescents and this confidence decreased after the didactic session, presumably with increased knowledge of the complexity of PCOS. Although more than two thirds of residents acknowledged lifestyle modification as first-line management, most spent 5 minutes or less counseling on lifestyle changes. This trended consistently toward spending more time in the second survey. Most did not understand that 5% weight loss often restores menses. Residents felt barriers to counseling could be addressed via quick text links for the EHR media resources, patient didactic sessions on eating and exercise, and educational pamphlets. They expressed an interest in having such resources provided. The overall interest in lifestyle counseling increased statistically after the intervention.

DISSEMINATION:

A motivational interviewing curriculum will be developed, implemented and evaluated to address the learning needs identified by the survey, followed by repeat collection of survey data. Patient resources will be part of this. It will be submitted to the MedEd Portal.

REFLECTIVE CRITIQUE:

This needs assessment was conducted in residency programs at one institution including the three types of specialists who treat teens with PCOS. It demonstrated a need to educate these residents and equip them to better educate their adolescent patients with PCOS.

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