Among medical trainees, 54% were confident in confidential care and 81% were confident in STI management, with those receiving relevant training and those who recalled private discussions with their own healthcare provider as adolescents reporting significantly greater confidence.
Key Findings
Results
Overall confidence in confidential care for adolescents was lower than confidence in STI management among medical trainees.
54% of respondents were confident in confidential care (scored ≥3 on a four-point Likert scale)
81% of respondents were confident in STI management
Survey was completed by 228 trainees out of 361 invited, representing a 63% response rate
Trainees were from paediatric, obstetrics and gynaecology, and family medicine programs at an academic medical centre in Texas
Results
Trainees who received training in aspects of confidential care and STI management reported significantly greater confidence in many of these areas.
Training in confidential care and STI management was associated with significantly higher confidence scores
Confidence was measured on a four-point Likert scale, dichotomised into confident (≥3 points) and not-so-confident (<3 points)
The finding held across multiple areas of confidential care and STI management
The study did not specify which exact training components were most impactful
Results
Trainees who recalled having private discussions with their personal healthcare provider as an adolescent reported greater confidence in STI management.
This association was statistically significant (P = 0.02)
The comparison was between respondents who recalled private adolescent healthcare discussions versus those who did not
This personal experience effect was specifically observed for STI management confidence
The finding suggests that clinicians' personal healthcare experiences as adolescents may influence their clinical confidence
Conclusions
The study identified gaps in confidence particularly regarding adolescent confidentiality among medical residents and fellows.
Only 54% of trainees were confident in confidential care, indicating nearly half lacked confidence in this area
Participants were from paediatric, obstetrics and gynaecology, and family medicine residency and fellowship programs
The study was conducted at a single academic medical centre in Texas
The authors identified communication training related to adolescent confidentiality as a key area requiring improvement in medical education
Conclusions
Personal and professional experiences may affect medical residents' and fellows' confidence in counselling adolescents about sexual health services.
The study examined demographics, medical training, and personal sexual healthcare experiences as potential factors influencing confidence
Both having received relevant medical training and having had personal private healthcare discussions as an adolescent were associated with higher confidence
The authors highlighted the importance of encouraging trainees to reflect on how their background might influence their clinical practice
This was a survey-based study at a single academic centre, which may limit generalisability
What This Means
This research surveyed 228 medical residents and fellows in pediatrics, obstetrics and gynecology, and family medicine at a Texas academic medical center about their confidence in two areas: managing sexually transmitted infections (STIs) and providing confidential sexual health care to adolescents. The study found a notable gap between the two areas — while about 81% of trainees felt confident managing STIs, only about 54% felt confident providing confidential care to adolescent patients. This suggests that while trainees may feel comfortable with the clinical aspects of STI treatment, many struggle with the communication and confidentiality aspects of adolescent sexual health care.
Two key factors were linked to higher confidence. First, trainees who had received specific training in confidential care and STI management felt significantly more confident in those areas. Second, trainees who remembered having private, confidential conversations with their own doctors when they themselves were adolescents were more confident in STI management — suggesting that personal healthcare experiences can shape how clinicians approach similar situations with their own patients.
This research suggests that medical training programs should place greater emphasis on communication skills and adolescent confidentiality, as this is an area where many trainees feel underprepared. It also highlights that doctors' own personal histories and experiences as patients may influence how they practice medicine, pointing to the value of encouraging trainees to reflect on their own backgrounds and how those experiences might affect their interactions with adolescent patients.
Wynn C, Wong C, Lee M, Tiro J, Francis J. (2025). Exploring residents' and fellows' confidence in sexually transmitted infection management and confidential care for adolescents.. Sexual health. https://doi.org/10.1071/SH24156