Original Study Medical Students' Acquisition of Adolescent Interview Skills after Coached Role Play Paritosh Kaul MD 1 , *, Jennifer H. Fisher DNP, WHNP 2 , Janice L. Hanson PhD, EdS 3 1 Section of Adolescent Medicine, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado 2 University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, Colorado 3 Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado abstract Study Objective: To develop and evaluate an educational activity designed to teach the adolescent Home, Education and employment, Eating, Activities, Drugs, Sexuality, Suicide/depression, and Safety (HEADS) examination. Design, Setting, Participants, Interventions, and Main Outcome Measures: Participants were third-year medical students in their pediatric clerkships. Students received an article on the HEADS interview and attended an adolescent medicine educational session. The session included individualized goal-setting and coached role play. Students’ skills in doing a HEADS interview were evaluated through a stan- dardized patient encounter (SPE) with a checklist and a retrospective pre- and post-test survey. The SPE checklist was used to assess whether the students included questions in 6 key areas of a HEADS interview. Results: One hundred fifty-two students participated. During the SPE, 90% of students queried the adolescent's home life, 91% education, 82% activities, 84% drug/substance abuse, 95% sexual history, and 61% symptoms of depression. Pre- and postintervention data were compared using the Kruskal-Wallis Test and showed a statistically significant difference in the students' ability to list key topic areas of the HEADS exam (P ! .001) and to use the skills needed for an adolescent interview using the HEADS exam (P ! .001). Conclusion: After an introduction to the HEADS examination, most students covered almost all of the topic areas of this screening interview during a SPE. Only three-fifths of the students, however, included questions about symptoms of depression. Coached role play with goal- setting facilitated effective learning of this approach to adolescent interviewing. Key Words: Adolescent medicine education, Medical education, Coached role play, HEADS interview Introduction Adolescents, who constitute 13% of the population in the United States, have specific health care needs, and address- ing their needs requires skillful communication. Although pediatric residents must complete a rotation in adolescent medicine, other residents receive inconsistent training, although most family physicians, surgeons, obstetricians/ gynecologists, and internal medicine physicians as well as many subspecialists care for adolescents in their practices. 1,2 National organizations have called for increased preparation for health care providers to better work with adolescents. The Institute of Medicine report on adolescent health ser- vices noted that existing adolescent health care training across health care provider disciplines fails to address ado- lescents’ specific health needs. 3 Professional organizations, including the North American Society for Pediatric and Adolescent Gynecology (NASPAG), American Academy of Pediatrics, Physicians for Reproductive Health, American Nurses Association, and the Society for Adolescent Health and Medicine, have recognized the unique needs of adoles- cents and have advocated for more training in this area. 4e9 Although pediatric residencies require an adolescent medicine rotation, even with this residency training, prac- ticing pediatricians believe they are less competent to care for adolescents than for infants or children. 2 Because resi- dents in other specialties receive inconsistent adolescent medicine training, their training as medical students has greater importance. Most studies have focused on resident training in adolescent medicine, although the 2008 William T. Grant Foundation Conference on Improving Adolescent and Young Adult Health recommended incorporating more teaching and mentoring in adolescent health education for medical students. 10e13 Few data exist, however on medical student education in adolescent medicine. The amount and content of instruction about adolescent care currently offered to medical students nationally is unknown. A few articles describe using adolescent standardized patients for instructional or assessment purposes. 14,15 In our previous study using an adolescent objective structured clinical ex- amination case the focus was to conduct an interview with an adolescent coming in to initiate contraceptive care. 16 In response to the needs for education about pediatric and adolescent gynecology (PAG), NASPAG 4 developed the Short and Long Curriculum. 17,18 An evaluation study of the short curriculum showed improved self-reported knowledge in PAG after residents used the NASPAG Short Curriculum to guide self-study, even without access to PAG-trained fac- ulty. 19 However, we still need specific approaches to teach The authors indicate no conflicts of interest. * Address correspondence to: Paritosh Kaul, MD, Section of Adolescent Medicine, University of Colorado School of Medicine, Children's Hospital Colorado, 13123 E 16th Ave, Box B025, Aurora, CO 80045; Phone (720) 777-6116 E-mail address: paritosh.kaul@childrenscolorado.org (P. Kaul). 1083-3188/$ - see front matter Ó 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. https://doi.org/10.1016/j.jpag.2017.11.003