157. Educating Medical Students about Transition from Pediatric to Adult Care: Student Perspectives

Increasing numbers of adolescents with chronic medical conditions are surviving into adulthood. However, despite research demonstrating effective transition of care models for pediatric to adult care, undergraduate medical education regarding this transition is lacking. In light of this discrepancy, we sought to evaluate student perceptions on transition of care training. We surveyed 130 fourth-year medical students at a Mid-Atlantic medical school. Questions asked about current understanding of transition of care, interest in transition of care education, and perceptions on when it was, and should be, taught. Students were also asked to state their intended specialty, which allowed respondents to be stratified into either primary care (internal medicine, internal medicine/pediatrics, pediatrics, family medicine, or obstetrics and gynecology) or specialty care (all other specialties). Chi-squared values were calculated to determine significance defined as a p-value <0.05. A total of 130 medical students were surveyed, and 112 students completed the questionnaire for a response rate of 86%. Of those surveyed, 42% intend to pursue primary care while 53% intend to pursue a specialty; 5% were undecided. The majority of students (73%) wished they had learned more about pediatric to adult transition of care regardless of whether they are pursing primary care or specialty care. Students pursuing primary care were significantly more interested in transition of care education vs. specialty care (86% vs. 66%, p=0.021). Among students who stated they understood the meaning of transition of care, as provided on the survey, 57% noted that they did not feel they had been taught this concept during medical school (p<0.001). Those who did not understand what was meant by “transition of care” also did not feel they had been educated on this concept (86%, p<0.001). Of the 73% of students who stated they wished they would have learned more about pediatric to adult transition of care, 89% felt that this education should begin in medical school (p<0.001). In this cohort of fourth-year medical students, three in four participants wished their undergraduate medical education included transition of care training, and nearly as many felt that this education should begin in medical school. Despite this interest, few if any educational opportunities exist at the undergraduate medical education level. These findings suggest that medical schools should consider including transition of care education in their curriculum.