Exploring residents' and fellows' confidence in sexually transmitted infection management and confidential care for adolescents.

Abstract

Background In the United States, many residents and fellows lack confidence in their ability to confidentially counsel adolescents regarding sexual health topics. Little is known about how personal and professional experiences may affect medical residents' and fellows' confidence in counselling adolescents about sexual health services. Methods We invited 361 residents and fellows (trainees) from paediatric, obstetrics and gynaecology, as well as family medicine programs at an academic medical centre in Texas to complete a survey about confidence in counselling about sexual health services. We describe respondents' demographics, medical training, personal sexual healthcare experiences, and confidence in confidential care and STI management measured on a four-point Likert scale. We calculated average confidence scores, dichotomised responses into confident (≥3 points) and not-so-confident ( Results Among 228 trainees (63% response rate), 54% were confident in confidential care and 81% were confident in STI management. Those who received training in aspects of confidential care and STI management reported significantly greater confidence in many of these areas. Respondents who recalled private discussions with their personal healthcare provider as an adolescent reported confidence in STI management (P =0.02) compared to those who did not have that experience. Conclusions Medical training should focus on communication training to address gaps in confidence, particularly regarding adolescent confidentiality. Clinicians' personal experiences may impact aspects of confidence, highlighting the importance of encouraging trainees to reflect on how their background might influence their clinical practice.