Effectiveness of a Curriculum for Pediatric Residents to Address Adolescent Nonsuicidal Self-Injury

• Published in: Academic psychiatry Vol. 47; no. 1; pp. 18 - 24
• Main Authors: Westers, Nicholas J., Needham, Heather E., Walsh, Jennifer B.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-02-2023; Springer Nature B.V
• Subjects: Adolescent; Adolescents; Adult Programs; Child; Child & adolescent mental health; Clinical Competence; Collaboration; Curricula; Curriculum; Didacticism; Educational Measurement; Empirical Report; Feedback (Response); Graduate Medical Education; Health Needs; High School Students; Humans; Injuries; Internship and Residency; Medical Education; Medicine; Medicine & Public Health; Mental Health; Patient safety; Pediatrics; Perceptions; Physicians; Pretests Posttests; Primary care; Psychiatry; Risk assessment; School Holding Power; Self destructive behavior; Self-Injurious Behavior; Skill Development; Suicide; Suicides & suicide attempts; Surveys and Questionnaires; Teaching Methods; United States > US; Texas; Adolescent health; Medical education; Resident; Self-harm; Nonsuicidal self-injury
• ISSN: 1042-9670; 1545-7230
• DOI: 10.1007/s40596-022-01684-3

Objective
The present study assessed changes in pediatric resident competence in addressing adolescent nonsuicidal self-injury (NSSI) following a brief, single-session didactic training during the educational unit in adolescent medicine. This study also evaluated knowledge acquisition and retention over time, overall helpfulness of the training, and changes in the perception of how important residents believe that physicians receive training in NSSI.
Methods
Pediatric residents participated in a single-session NSSI curriculum delivered as part of a monthlong clinical rotation from August 2016 to February 2019. Participants completed pretest, posttest, and 6-month follow-up surveys, and
t
tests and analyses of variance with post hoc comparisons evaluated changes in variables across the three time points.
Results
One hundred twenty-seven of 162 eligible residents participated (78.4% response rate), and 69 completed the 6-month follow-up (54.3% retention rate). Prior to the NSSI didactic, 107 (85.6%) reported feeling not at all competent or only somewhat competent in responding to patients with a history of NSSI. Residents’ self-perceived competence increased significantly (
p
< .001) from pretest to posttest and was sustained longitudinally. A measure of objective knowledge also showed retention over time. Residents were significantly (
p
< .001) more likely after the didactic to believe that training in NSSI for physicians is very important compared to before the training.
Conclusions
Following NSSI training, residents demonstrated increased knowledge and subjective competence in caring for adolescents who self-injure. It is feasible and important to integrate a brief, single-session NSSI curriculum into pediatric residency programs, such as in the adolescent medicine rotation.