**Background**
Nearly a quarter of the population lives with a disability, of which 10% have an intellectual or developmental disability. There is a dearth of formal curricula that address transitions of care from pediatric to adult providers and the complex medicolegal implications such as guardianship for individuals with developmental disabilities (IDDs). Internal medicine residents do not currently have ACGME-required educational experiences on IDDs and it is not universally taught in medical school. Likewise, pediatric residents do not receive formal training in transitioning care of IDDs to adult providers. Given that the life expectancy of individuals with IDDs is approaching that of the general population, a growing number of them are aging out of pediatric care, tasking pediatricians to transition their care and internists to assume their care with minimal training.

**Methods**
Study participants included PGY 1-3 internal medicine, pediatrics and med-peds residents. A pre-workshop questionnaire was used to assess trainees’ baseline knowledge of medical and social issues specific to IDDs. The workshop is a 1-hour interactive session with didactics, clinical cases and role playing that use two common developmental disabilities, autism and cerebral palsy, to teach about school services, applying for guardianship and the transition of care from pediatric to adult providers. Immediately after, 2 months after and 6 months after the workshop, trainees’ knowledge was reassessed using the same questionnaire. Data were analyzed using SAS statistical software, employing random-intercept logistic regressions to determine whether respondent accuracy changes over study time points.

**Results**
Ninety-one residents in total participated in the workshop. Sixty-six residents responded to the baseline questionnaire, a majority of whom were PGY-2 internal medicine residents (79%) with no prior experience working with IDDs (68%). Among the 13 pediatrics trainees, 38% completed a developmental pediatrics rotation. Among all trainees, there was a significant increase in knowledge from pre- to immediate post-workshop in the areas of transitions of care (5 to 71%, p<0.0001), school services (32 to 67%, p=0.002) and guardianship (23 to 60%, p=0.0003). Pre-workshop to 6-months post-workshop, the significant increase in knowledge of transitions of care persisted, though to a lesser extent (5 to 24%, p=0.008). When all knowledge questions were combined into a single score, there were significant increases in knowledge from baseline to immediate post-workshop (p<0.0001) and baseline to 6-months post-workshop (p=0.04).

**Conclusions**
A multimodal workshop on young adults with developmental disabilities led to significant increases in knowledge among internal medicine and pediatrics residents, both immediately and 6-months after the workshop. The workshop also increased residents’ recognition of the topic as highly important immediately afterwards, though there were no significant attitudinal changes at later time points. These data suggest an even greater potential for impact with a longitudinal curriculum.

A Multimodal Workshop to Improve Internal Medicine and Pediatrics Residents’ Knowledge in the Care of Young Adults With Developmental Disabilities

Consortium for Graduate Medical Education 13th Annual Resident Research Day

Icahn School of Medicine at Mount Sinai

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