title: Development of an Online Learning Module to Improve Pediatric Residents' Confidence and Knowledge of the Pubertal Examination.
abstract: OBJECTIVE
  Pediatric residents must know how to perform pubertal examinations. The initial objective of this study was to evaluate pediatric resident knowledge and comfort related to the pubertal examination and to determine whether and why these examinations are avoided. The subsequent objective was to develop and assess a learning module (LM) addressing identified education gaps.
  
  
  METHODS
  A learning needs assessment (LNA) was administered to residents in four Canadian pediatric training programs. Identified themes and knowledge gaps were used to develop an online, case-based LM. A randomized assessment of the LM was conducted among residents from nine training programs across Canada.
  
  
  RESULTS
  Sixty-four residents completed the LNA. About 52% reported discomfort introducing the pubertal examination, 50% reported a lack of confidence related to the examination, and 56% reported having avoided a warranted examination. Ninety-seven residents participated in the LM assessment. The baseline results were similar to those from the LNA in terms of discomfort, lack of confidence, and avoidance related to pubertal examinations. However, the intervention group showed improvement on a knowledge assessment compared with control group (p < .001). Confidence levels also improved in the intervention group LM (p < .01). Most residents (95%) stated they found the LM to be useful.
  
  
  CONCLUSIONS
  Residents report being uncomfortable with and avoiding the pubertal examination and have significant knowledge gaps. The online, case-based LM used in this study improved the knowledge and confidence related to this aspect of pediatric care and may be an effective adjunct to pediatric training.
authors.affiliation: Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, Toronto, Canada; Department of Leadership, Higher and Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada; Department of Pediatrics, Markham Stouffville Hospital, Markham, Canada. Electronic address: aens@msh.on.ca.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ens
authors.affiliation: Department of Leadership, Higher and Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada.
authors.forename: Katharine
authors.initials: K
authors.lastname: Janzen
authors.affiliation: Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, Toronto, Canada; Department of Physiology, University of Toronto, Toronto, Canada.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Palmert
mesh_terms: D000328:Adult; D002170:Canada; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003479:Curriculum; D020375:Education, Distance / Q000379:methods*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D010372:Pediatrics / Q000193:education*; D010808:Physical Examination / Q000379:methods*; D011627:Puberty; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Medical education; Puberty examination; Tanner staging