title: Beliefs and practices of pediatric emergency physicians and nurses regarding counseling alcohol-using adolescents: can counseling practice be predicted?
abstract: OBJECTIVE
  The objectives of the study were to investigate the attitudes and practices of pediatric emergency department (PED) physicians (MDs), MD extenders (MD's assistants [PAs], nurse practitioners [NPs]), and nurses (RNs) regarding their counseling of alcohol-using adolescent PED patients and to determine which, if any, PED clinician characteristics predict current counseling practice.
  
  
  METHODS
  An Internet-based survey of PED clinicians (MDs, PAs, NPs, and RNs) from 11 academic US PEDs was conducted. Respondents were asked about their counseling training, current counseling practices, confidence in their counseling skills, importance of counseling, attitudes and beliefs about counseling, and demographic information. Univariate and multivariate analyses were performed to determine the relationship between clinician characteristics and counseling practice.
  
  
  RESULTS
  Counseling practice was strongly associated with one's profession; PED MDs/PAs/NPs reported significantly higher rates of counseling alcohol-using adolescents than PED RNs. These 2 groups differed significantly in terms of counseling training and experience. Counseling training and experience remained significant predictors of counseling practice, even after controlling for profession and other covariates. Both groups had similar views on the importance of counseling, confidence in their ability to counsel, and counseling substance-using adolescent PED patients.
  
  
  CONCLUSIONS
  Pediatric ED MDs/PAs/NPs differ significantly from PED RNs in their counseling training, experience, and practice. These findings have important implications for the training and support necessary to successfully implement PED counseling. Specifically, formal training in counseling during professional schooling and garnering counseling experience after completing training may be critical factors in promoting PED counseling.
authors: Department of Emergency Medicine, Center for Alcohol and Addiction Studies, The Alpert Medical School of Brown University, Providence, RI, USA. Thomas_Chun@brown.edu
authors: Thomas H
authors: TH
authors: Chun
authors: Anthony
authors: A
authors: Spirito
authors: William
authors: W
authors: Rakowski
authors: Gail
authors: G
authors: D'Onofrio
authors: Robert H
authors: RH
authors: Woolard
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking; D001291:Attitude of Health Personnel; D003469:Culture; D003625:Data Collection; D037001:Directive Counseling / Q000458:organization & administration; D004635:Emergency Medicine / Q000193:education; D004636:Emergency Service, Hospital; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008297:Male; D024802:Nurse's Role; D009726:Nurses / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000458:organization & administration; D010371:Pediatric Nursing / Q000193:education; D010372:Pediatrics / Q000193:education; D010819:Physician's Role; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States