The Role of Internal Medicine-Pediatric Programs and Transition Champions in Graduate Medical Trainee Health Care Transition Development

Objective: Transition to adult health care for adolescents and young adults (AYAs), especially those with chronic conditions, is a critical time. Medical trainees lack competency in providing transition care, but little is known about the factors contributing to the development of health care transition (HCT) knowledge, attitudes, and practice. This study examines how Internal Medicine-Pediatrics (Med-Peds) programs and institutional HCT champions influence trainee HCT knowledge, atti-tudes, and practices.Study Design: A 78-item electronic survey regarding the knowledge, attitudes, and practices of caring for AYA patients was sent to trainees from 11 graduate medical institutions.Results: A total of 149 responses were analyzed, including 83 from institutions with Med-Peds programs and 63 from institutions without Med-Peds programs. Trainees with an institutional Med-Peds Program were more likely to identify an institutional HCT champion (odds ratio, 10.67; 95% confidence interval, 2.40-47.44; p 1/4 .002). The mean HCT knowledge scores and use of a routine, standardized HCT tools were higher in trainees with an institutional HCT champion. Trainees without an institutional Med-Peds program experienced more barriers to HCT education. Trainees with institutional HCT champions or Med-Peds programs reported greater comfort in providing transition education and using validated, standardized transition tools.Discussion: The presence of a Med-Peds residency program was associated with a greater likeli-hood of a visible institutional HCT champion. Both factors were associated with increased HCT knowledge, positive attitudes, and HCT practices. Both clinical champions and adoption of Med-Peds program curricula will enhance HCT training within graduate medical education.& COPY; 2023 Society for Adolescent Health and Medicine. All rights reserved.

Automated summary

This study examines the influence of Internal Medicine-Pediatrics programs and institutional health care transition (HCT) champions on trainee HCT knowledge, atti-tudes, and practices. The results show that trainees with an institutional Med-Peds program are more likely to identify an institutional HCT champion, resulting in higher knowledge scores and use of standardized HCT tools. Trainees without an institutional Med-Peds program experience more barriers to HCT education.