title: Does trainee involvement affect anticipatory guidance in well-child care?
abstract: BACKGROUND
  Studies demonstrate gaps in anticipatory guidance during well-child visits, but none consider academic teaching hospitals where physician trainees also provide counseling. We prospectively assessed parental perception of anticipatory guidance at the outpatient clinic of an academic teaching hospital.
  
  
  METHODS
  Parents of patients newborn to <60 months old completed questionnaires regarding providers seen and anticipatory guidance preferences.
  
  
  RESULTS
  Of 204 parents, 40% saw the child's primary attending alone. There was no association between providers seen and the number of topics covered. Seeing the child's primary attending alone increased the odds that parents' priority topics were covered compared with another attending (odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.11-0.90) or the addition of a resident (OR = 0.35; 95% CI = 0.16-0.77) or medical student (OR = 0.33; 95% CI = 0.12-0.90).
  
  
  CONCLUSIONS
  Priority anticipatory guidance is covered only one third as often when the well-child visit is not conducted by the primary attending. When involving trainees, continuity of care and parental concerns must be emphasized.
authors: 1Pediatrics, Penn State College of Medicine, Hershey, PA, USA.
authors: Nicholas R
authors: NR
authors: Sgrignoli
authors: Erik B
authors: EB
authors: Lehman
authors: Deepa L
authors: DL
authors: Sekhar
mesh_terms: D002662:Child Health Services / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D002675:Child, Preschool; D003266:Continuity of Patient Care; D037001:Directive Counseling / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007396:Internship and Residency; D016015:Logistic Models; D008297:Male; D010044:Outpatient Clinics, Hospital; D010290:Parents; D057240:Patient Preference / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000193:education; D010414:Pennsylvania; D011446:Prospective Studies; D013337:Students, Medical; D011795:Surveys and Questionnaires
keywords: anticipatory guidance; continuity of care; resident; teaching; well-child visits