title: Perceived preparedness to provide preventive counseling: reports of graduating primary care residents at academic health centers.
abstract: OBJECTIVE
  To assess the perceived preparedness of residents in adult primary care specialties to counsel patients about preventive care and psychosocial issues.
  
  
  METHODS
  Cross-sectional national mail survey of residents (63% response rate).
  
  
  METHODS
  Nine hundred twenty-eight final-year primary care residents in Internal Medicine (IM), family practice (FP), and Obstetrics/Gynecology (OB/GYN) at 162 U.S. academic health centers.
  
  
  METHODS
  Residents self-rated preparedness to counsel patients about smoking, diet and exercise, substance abuse, domestic violence, and depression.
  
  
  RESULTS
  Residents felt better prepared to counsel about smoking (62%) and diet and exercise (53%) than about depression (37%), substance abuse (36%), or domestic violence (21%). In most areas, females felt better prepared than males. Rates of counseling preparedness varied significantly by specialty after adjustment for gender, race, medical school location, and percent of training spent in ambulatory settings. FP residents felt better prepared than OB/GYN residents to counsel about smoking, diet and exercise, and depression, while OB/GYN residents felt better prepared to address domestic violence than IM or FP residents. IM residents' perceptions of preparedness were between the other 2 specialties. Proportion of training spent in ambulatory settings was not associated with residents' perceived preparedness.
  
  
  CONCLUSIONS
  Physicians completing residencies in adult primary care did not feel very well prepared to counsel patients about preventive and psychosocial issues. Significant differences exist among specialties, even after adjusting for differences in time spent in ambulatory settings. Increasing residency time in ambulatory settings may not alone be sufficient to ensure that residents emerge with adequate counseling skills.
authors.affiliation: Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA. epark@partners.org <epark@partners.org>
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.forename: Taida J
authors.initials: TJ
authors.lastname: Wolfe
authors.forename: Manjusha
authors.initials: M
authors.lastname: Gokhale
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Winickoff
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003376:Counseling; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000193:education; D005260:Female; D006176:Gynecology / Q000193:education; D019538:Health Care Surveys; D006293:Health Promotion; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D015999:Multivariate Analysis; D009774:Obstetrics / Q000193:education; D011320:Primary Health Care / Q000592:standards*; D012655:Self-Evaluation Programs; D014481:United States