Transitioning Bryan: The Transition to Adulthood and the Medical Home

Abstract Introduction For the one in five adolescents with a special healthcare need, the transition from pediatric to adult-centered health care can be particularly challenging. In 2011, the American Academy of Pediatrics, American Academy of Family Physicians, and the American College of Physician...

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Main Authors: Holly Gooding, Caitlin O'Reilly, Elissa Weitzman, Pamela Burke, Adrianne Goncalves, Sarah Pitts
Format: Article
Language:English
Published: Association of American Medical Colleges 2015-10-01
Series:MedEdPORTAL
Subjects:
Online Access:http://www.mededportal.org/doi/10.15766/mep_2374-8265.10226
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author Holly Gooding
Caitlin O'Reilly
Elissa Weitzman
Pamela Burke
Adrianne Goncalves
Sarah Pitts
author_facet Holly Gooding
Caitlin O'Reilly
Elissa Weitzman
Pamela Burke
Adrianne Goncalves
Sarah Pitts
author_sort Holly Gooding
collection DOAJ
description Abstract Introduction For the one in five adolescents with a special healthcare need, the transition from pediatric to adult-centered health care can be particularly challenging. In 2011, the American Academy of Pediatrics, American Academy of Family Physicians, and the American College of Physicians published guidelines for the transition of all youth to adult-centered health care and provided additional guidance for youth with special healthcare needs. Key to this process is the frequent and regular assessment of youth's readiness to transition to an adult model of care. This evolving case allows multidisciplinary learners to develop skills in the assessment, treatment, and management of youth transitioning from the pediatric to the adult medical home with an emphasis on the role of the multidisciplinary team. Methods During the administration of this resource, learners review the case of Bryan, a 15-year-old male patient newly diagnosed with Type 1 diabetes. The case is presented over three 75− to 120-minute-long sessions. During this time learners review and discuss the case. Provided probing questions may be used to facilitate discussion. Results Learners reported on standard pre− and postcase 4-point Likert-type scales (1 = not at all confident, 4 = very confident) that the case experience improved their ability to: (1) counsel adolescents transitioning into adulthood (precase M = 3.0, postcase M = 3.6), (2) devise a tailored transition plan (precase M = 2, postcase M = 3.4), and (3) identify age− and developmental stage-appropriate resources (precase M = 2, postcase M = 3.2). Learners also reported that the case experience improved their understanding of the role of a medical doctor, nurse practitioner, nutritionist, psychologist, and social worker in the care of adolescents transitioning into young adulthood. Discussion We find learners are typically surprised that the transition to adulthood is a scholarly field within both medicine and psychology. Learners enjoy reflecting on their personal transition to adulthood (or that of their children, depending on their age), and this brings richness to the case. One element we included in the second year was a question-and-answer session with a young adult with Type 1 diabetes to learn about about her personal experience transitioning to adulthood. If similar patient educators or volunteers are available at the local institution, this could be included at any point in the case.
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spelling doaj.art-ab4b0e7c5a9d432ab6da01dd414002a72022-12-21T19:48:46ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652015-10-011110.15766/mep_2374-8265.10226Transitioning Bryan: The Transition to Adulthood and the Medical HomeHolly Gooding0Caitlin O'Reilly1Elissa Weitzman2Pamela Burke3Adrianne Goncalves4Sarah Pitts51 Boston Children's Hospital2 Boston Children's Hospital3 Boston Children's Hospital4 Boston Children's Hospital5 Boston Children's Hospital6 Boston Children's HospitalAbstract Introduction For the one in five adolescents with a special healthcare need, the transition from pediatric to adult-centered health care can be particularly challenging. In 2011, the American Academy of Pediatrics, American Academy of Family Physicians, and the American College of Physicians published guidelines for the transition of all youth to adult-centered health care and provided additional guidance for youth with special healthcare needs. Key to this process is the frequent and regular assessment of youth's readiness to transition to an adult model of care. This evolving case allows multidisciplinary learners to develop skills in the assessment, treatment, and management of youth transitioning from the pediatric to the adult medical home with an emphasis on the role of the multidisciplinary team. Methods During the administration of this resource, learners review the case of Bryan, a 15-year-old male patient newly diagnosed with Type 1 diabetes. The case is presented over three 75− to 120-minute-long sessions. During this time learners review and discuss the case. Provided probing questions may be used to facilitate discussion. Results Learners reported on standard pre− and postcase 4-point Likert-type scales (1 = not at all confident, 4 = very confident) that the case experience improved their ability to: (1) counsel adolescents transitioning into adulthood (precase M = 3.0, postcase M = 3.6), (2) devise a tailored transition plan (precase M = 2, postcase M = 3.4), and (3) identify age− and developmental stage-appropriate resources (precase M = 2, postcase M = 3.2). Learners also reported that the case experience improved their understanding of the role of a medical doctor, nurse practitioner, nutritionist, psychologist, and social worker in the care of adolescents transitioning into young adulthood. Discussion We find learners are typically surprised that the transition to adulthood is a scholarly field within both medicine and psychology. Learners enjoy reflecting on their personal transition to adulthood (or that of their children, depending on their age), and this brings richness to the case. One element we included in the second year was a question-and-answer session with a young adult with Type 1 diabetes to learn about about her personal experience transitioning to adulthood. If similar patient educators or volunteers are available at the local institution, this could be included at any point in the case.http://www.mededportal.org/doi/10.15766/mep_2374-8265.10226AdolescentMedical HomeInterprofessional CareTransition to AdulthoodYoung Adult
spellingShingle Holly Gooding
Caitlin O'Reilly
Elissa Weitzman
Pamela Burke
Adrianne Goncalves
Sarah Pitts
Transitioning Bryan: The Transition to Adulthood and the Medical Home
MedEdPORTAL
Adolescent
Medical Home
Interprofessional Care
Transition to Adulthood
Young Adult
title Transitioning Bryan: The Transition to Adulthood and the Medical Home
title_full Transitioning Bryan: The Transition to Adulthood and the Medical Home
title_fullStr Transitioning Bryan: The Transition to Adulthood and the Medical Home
title_full_unstemmed Transitioning Bryan: The Transition to Adulthood and the Medical Home
title_short Transitioning Bryan: The Transition to Adulthood and the Medical Home
title_sort transitioning bryan the transition to adulthood and the medical home
topic Adolescent
Medical Home
Interprofessional Care
Transition to Adulthood
Young Adult
url http://www.mededportal.org/doi/10.15766/mep_2374-8265.10226
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