Browsing by Author "Robbins, Cynthia"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Adolescent Interview With a Medical Interpreter: A Standardized Patient Encounter for Pediatric Residents
    (Springer Nature, 2023-10-18) Hudson, Tristin; Hecht, Shaina M.; Robbins, Cynthia; McHenry, Megan S.; Byrne, Bobbi; Pediatrics, School of Medicine
    Background: Pediatricians can cultivate a more trusting relationship with their non-English speaking patients by emphasizing the importance of upholding patient confidentiality in the presence of an interpreter. We designed a case for pediatric residents to increase comfort when conducting an adolescent interview using a medical interpreter, emphasizing the importance of upholding patient confidentiality, specifically when discussing sensitive health topics. Methods: We developed a standardized patient encounter (SPE) for pediatric residents at a large academic institution that focused on exploring sensitive health topics with an adolescent, non-English speaking female patient using an interpreter. A validated survey was administered upon completion of the case, prompting participants to reflect on their comfort and skills with specific activities before and after the case, and was analyzed using paired t-tests. Results: Eighty-nine residents participated; 66 were interns and 23 were in their second year of residency. The mean scores of all paired survey items significantly increased after the case (p<0.01), indicating perceived personal growth in all educational objective categories. The majority of the participants (97%, N=86) agreed that they built skills in understanding cultural humility and caring for future patients (mean Likert scores: 4.91 and 5.10, respectively). Conclusions: Upon completion of the case, residents reported increased comfort and skills using a medical interpreter for non-English speaking patients within the context of patient-centered care, discussing various sensitive health topics, emphasizing the importance of upholding patient confidentiality, and demonstrating skills in adolescent interviewing. Both medical confidentiality and cultural humility education can be integrated into simulation-based medical education to improve the quality of care for diverse patient populations.
  • Thumbnail Image
    Item
    Impact of COVID-19 on Post Graduate Medical Education and Training
    (BMC, 2021-08-13) Enujioke, Sharon; McBrayer, Kimberly; Soe, Katherine; Imburgia, Teresa; Robbins, Cynthia; School of Social Work
    Purpose: The novel Coronavirus Disease 19 (COVID-19) has had a significant impact worldwide that led to changes in healthcare.&nbsp;The purpose of this study was to evaluate the effect of the COVID-19 pandemic on trainee’s mental health and educational preparedness.Methods: Trainees at the Indiana University School of Medicine were surveyed regarding the impact of the COVID-19 pandemic on their training. Using a Likert scale, participants were asked questions pertaining to educational preparedness, mental health, and clinical work during the pandemic.&nbsp;Data was analyzed using SPSS version 27.&nbsp;The study was approved as exempt by the Institutional review Board (IRB). Results: 324 of the 1204 trainees responded to the survey.&nbsp;The respondents were 76% white with an equal distribution of males and females.&nbsp;A majority of the respondents were first year residents with an equal distribution of second, third, and fourth year residents.&nbsp;Twenty-three percent of respondents were in a procedural residency or fellowship program. Better perceived educational preparedness was associated with an improved home-work balance during COVID-19 (β=0.506, p&lt;0.0001) and having a department that advocated/supported focus on mental health during COVID-19 (β=0.177, p&lt;0.0001). Worse perceived educational preparedness was associated with being in procedural vs. non-procedural dominant training program (β=-0.122, p=0.01). Conclusion: COVID-19 has had a significant impact on the training experience of residents and fellows.&nbsp;Departmental support increased mental well-being and perceived education preparedness in trainees. &nbsp;Trainees that felt they had a better home-work life balance had better educational preparedness compared to their peers. Also, trainees in procedural programs had less educational preparedness compared to their peers in non-procedural programs. This study highlights the importance for programs to find avenues to increase educational preparedness in their trainees while being attuned to the mental health of their trainees.
  • Thumbnail Image
    Item
    IUD Use in Adolescents With Disabilities
    (AAP, 2020-08) Robbins, Cynthia; Ott, Mary A.; Pediatrics, School of Medicine
    Intrauterine devices (IUDs) are safe, highly effective, and recommended by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists as a first-line contraceptive option for adolescents.1,2 In this month’s Pediatrics, Schwartz et al3 examine the use of IUDs among adolescents with disabilities, providing further evidence that IUDs are safe for menstrual management and contraception in this population. In their work, Schwartz et al3 raise 3 important issues in IUD use and contraceptive decisions among adolescents with disabilities: recognition of the adolescent’s sexuality and rights to sexual and reproductive health; the need to incorporate quality of life into risk/benefit decisions; and the use of shared and supported decision-making approaches to maximize autonomy and dignity.
  • Thumbnail Image
    Item
    Pregnancy Options Counseling for Pediatric Residents and Fellows: Effectiveness, Acceptability, and Appropriateness
    (2023-04-28) Bell, Lauren A; Kirkpatrick, Laura; Robbins, Cynthia
    BACKGROUND: Pediatricians are likely to encounter a pregnant adolescent in their lifetime of practice, yet many do not obtain clinical experience in pregnancy options counseling during residency. OBJECTIVE: To assess the effectiveness and perceived acceptability and appropriateness of a 2-hour interactive training in pregnancy options counseling including role-play simulation. METHODS: Pediatric residents on their adolescent medicine rotation participated in a required training in options counseling for adolescents each month between July-December 2022. Pediatric fellows were invited to participate if desired. Participants completed anonymous surveys on Redcap before and after training. We utilized 4-option Likert-scale measures ranging from “1= not at all important” or “1= strongly disagree” to “4 = very important” or “4 = strongly agree” looking at knowledge and attitudes related to pregnancy options counseling. The post-training survey also included the Acceptability of Intervention Measure (AIM) and Intervention Appropriateness Measure (IAM) which each utilize a mean of 4 different questions with 5-option Likert scale responses ranging from “1=completely disagree” to “5=completely agree.” This study was deemed exempt by the Indiana University Institutional Review Board. We used IBM SPSS (28.0) to perform descriptive statistics and Wilcoxon sign tests to analyze baseline and post-training data. RESULTS: 145 individuals completed the baseline survey. Of 33 participants who completed the training, 75% (n=25) filled out the post-participation survey. These were 3 pediatric fellows, 13 categorical pediatric residents, 8 combined pediatric residents, and 1 who did not disclose. Baseline demographics did not differ significantly between those who did or did not complete the post-test. Only 60% (n=15) of post-test completers correctly selected “parenting, adoption, abortion” as the three options to discuss during options counseling pre-training, but 92% (n=23) selected the correct answer after the training. Only 52% of participants (n=13) knew about judicial bypass requirements compared to 76% (n=19) post- training. Median AIM-Acceptability and IAM-Appropriateness scores post-intervention were high at 5.00 (IQR 1.00) and 4.75 (IQR 1.00). 85% (n=22) of participants endorsed the 2-hour training period as having “just the right amount of time. 81% (n=21) strongly agreed with the training’s value to their medical education. There were statistically significant improvements in attitudinal measures: participants’ perceived ability to discuss parenting (p<.001), adoption (p=.002), and abortion (p<.001); feeling knowledgeable about pregnancy-related resources (p<.001); and confidence making prenatal referrals for prenatal services (p<.001), abortion services (p=.002), and adoption services (p<.001). Participants rated some measures highly at baseline, with no significant change between pre-test and post-test: the importance of pregnancy options counseling training for pediatric residents, discussing all options as consistent with professional medical practice, and endorsement of referring to another colleague if they could not discuss all options. These measures all had a median of 4.00 and a mean of 3.88 on the pre-test. CONCLUSIONS: Pediatric residents showed gains in knowledge in and confidence around pregnancy options counseling for adolescents after completing a 2-hour interactive training. This format of training was rated highly in value to medical education, acceptability, and appropriateness by participating pediatric residents.