Background/Purpose: The transition from pediatric to adult healthcare is a vulnerable time for adolescents and young adults (AYA) with chronic conditions. EULAR and the Pediatric Rheumatology European Society jointly published expert opinions regarding transition care of AYA with juvenile-onset rheumatic diseases, and the ACR recently developed a transition toolkit. However, there are no published curricula for teaching transition guidelines, skills, or utilization of existing tools. We therefore designed and evaluated a workshop to help adult rheumatology fellows learn key skills for providing effective transition care to transferring young adult patients.

Methods: A 1-hour skills-based workshop on transition and transfer best practices was developed alongside an objective standardized clinical examination (OSCE) station in which trainees welcomed a young adult with lupus – and her parent – to a first visit in an adult clinic. Adult rheumatology fellows (n=19) from 5 institutions were asked to self-asses their ability to perform 10 transition/transfer skills pre- and post-workshop on a Likert scale from 1-4, with 1 being “not at all prepared” and 5 being “completely prepared.” The OSCE evaluation rubric assessed 5 transition/transfer skills on a Likert scale of 1-5, with 5 being the best performance. Twelve fellows were tested with the OSCE de novo, whereas 7 were tested with the OSCE after participating in the workshop. Aggregated pre- and post-workshop survey responses were compared using Fisher’s exact test, and OSCE scores were compared using an unpaired t-test.

Results: After participating in the workshop, fellows felt significantly more prepared with regards to 8 of the 10 transition/transfer skills (table 1). In addition, OSCE performance (table 2) was significantly better among the fellows who participated in the OSCE after the workshop than among those who took the OSCE de novo (p=0.01).

Conclusion: This brief educational intervention successfully increased adult rheumatology fellows’ confidence with many transition/transfer skills as well as increasing fellows’ ability to employ transition best practices in an OSCE setting. Making this curriculum available to all rheumatologists-in-training would likely improve the care young adult rheumatology patients receive when transferring from pediatric to adult rheumatology. Further exploration is needed to determine optimal teaching strategies to enhance communication between pediatric and adult rheumatologist and to equip adult rheumatologists with rapport-building skills for working with young adults.

Table 1

Table 2