Assessing family medicine residents' knowledge, awareness, and comfort levels with consent and confidentiality in adolescent healthcare

Introduction:
Adolescents (ages 10–19) are generally healthy and at unique stages of psychosocial, cognitive, and physical development that affect decision-making and overall health.
Despite these potential risks, adolescents are less likely to seek prompt medical care due to concerns about parental awareness of their personal health problems.Yet, adolescents are more likely to seek health care promptly if offered self-consenting and confidential care services. 
Well-trained primary care clinicians with experience and understanding of the impact of confidential care in this population are critical to improving their overall health. Prior  research  has found significant variability in knowledge and comfort with common adolescent health topics among clinicians. 
This project aimed to assess family medicine residents' knowledge, awareness, and comfort level regarding adolescent self-consenting to healthcare services and confidentiality.

Methods:
An anonymous 14-item electronic cross-sectional survey assessing knowledge, awareness, and comfort level of providing confidential healthcare services to adolescents was sent to mainland U.S. and Puerto Rico-based family medicine residents (n=14,010) in Post Graduate Years 1-3, expected to graduate between 2023 and 2025. 

Results:
A total of 714/14,010 (5%) completed the survey. The majority of respondents had not received  formal training on confidential adolescent care during residency education (50.3% received no training; 32.4% received training; and 17.4%  were uncertain of training status).
Most respondents reported little/no knowledge of laws that govern the provision of confidential adolescent care within their state (50.2%). 34.5% reported moderate knowledge and 15% reported being either very knowledgeable or extremely knowledgeable. Similarly, 53.2% reported little/no knowledge of the laws governing adolescent self-consenting to care in their state; 31.9% reported moderate knowledge, while only 14.8% reported very knowledgeable or extremely knowledgeable.

Conclusion:
The findings suggest additional education and training is needed to better equip family medicine residents to provide confidential adolescent health care.