Empowering the Youth Voice: Medical Students' Reflections on Adolescent Psychosocial History Taking

Medical students' experiences in clinical learning environments can present challenges, particularly surrounding communication with patients. Encounters with adolescent patients and their families can be especially challenging, as topics such as substance use, sexuality, and gender identity may be difficult to discuss. To further understand students' experiences with adolescent history taking, we sought to explore students' experiences communicating with adolescent patients during their pediatric rotation.

A descriptive qualitative design was utilized. A constructivist theoretical paradigm further guided the research to help understand multiple social constructions of knowledge. Medical students who had completed their pediatric clerkship were recruited to participate in individual semistructured interviews. The interviews were recorded, transcribed verbatim, and analyzed by the research team to identify themes and subthemes using reflexive thematic analysis.

Eleven participants were recruited between 2023 and 2024, at which point thematic sufficiency was achieved. Five overarching themes were identified: (1) emotional responses and coping; (2) influence of personal and professional experiences; (3) sticky interview topics; (4) strategies to improve skills; and (5) empowering the adolescent voice.

Medical students described many emotions, including distress, awkwardness, and feelings of hopelessness, particularly when unable to provide meaningful care to their adolescent patients. Personal and professional experiences contributed to these emotional responses. Students were particularly distressed by questions surrounding mental health, sexuality, and gender identities. Despite these emotions, students recognized and valued the adolescent psychosocial history as being important in empowering the adolescent voice. These findings provide insights into educational interventions that may improve the student experience.