A youth standardized patient working through scenarios with clinicians
To improve health care for youth in western Kenya, the Arnhold Institute for Global Health at Mount Sinai and our AMPATH Kenya partnership held a pivotal clinical training for health care providers who work with adolescents.
The Institute leads the adolescent health initiative of the AMPATH Kenya partnership, a collaboration between Moi Teaching and Referral Hospital and Moi University in Eldoret, Kenya, and a consortium of global academic medical centers. The need for this training was identified at the AMPATH Kenya Youth Summit held in January 2024 and became a strategic priority of the partnership.
Hands-On Skills-Based Learning: About Youth, With Youth
The training, held in Eldoret, Kenya, brought together nurses, doctors, clinical officers, and other health care professionals from Moi Teaching and Referral Hospital, USAID AMPATH Uzima, and community clinics across Western Kenya that frequently interact with adolescent patients. Over five days, clinicians participated in a rigorous 30-hour course focused on developing youth-friendly interviewing skills and counseling techniques, earning continuing education credits upon completion of the course.
Participants of the adolescent health clinical provider training in Eldoret, Kenya
Youth played an essential role in the course’s success. In the days leading up to the course, which was held in January, a group of young people received two days of training to serve as “standardized patients.” These trained youth acted in the role of the adolescent in common clinical scenarios corresponding to the lecture content. This allowed clinical providers to immediately practice the skills they learned in the lecture portion of the training with the youths themselves.
Content lectures were delivered by faculty from the Arnhold Institute, Moi Teaching and Referral Hospital, Moi University, and adolescent medicine experts from East African countries. Topics included the HEADDSS interview (a psychosocial tool for assessing adolescents); motivational interviewing; consent and confidentiality; pubertal assessment, sexual history and family planning; mental health and substance use; and adolescent transitions.
The training paired one hour of skills lab practice session for every hour of content. Each skills lab group included four to five participants, a facilitator, and one youth standardized patient. Clinicians took turns practicing scenarios with the youth standardized patient while the facilitator and other participants provided structured feedback at the end of each scenario. Youth participants also gave feedback on how providers could be more youth friendly.
Scaling Up and Looking Ahead
This training is part of the Arnhold Institute’s broader effort to strengthen adolescent care within our global partnerships. An upcoming educational quality improvement project will focus on implementing locally the World Health Organization’s guidelines for adolescent health and refining the clinical provider training model to improve providers’ knowledge, attitudes, and confidence in adolescent care.
Additionally, key implementation outcomes of the clinical training—including reach, feasibility, acceptability, and sustainability—will be evaluated to further implement and scale the training.
In March, the Arnhold Institute and our AMPATH Nepal partnership culturally adapted and delivered a similar clinical provider training in advance of launching an adolescent health clinic at Dhulikhel Hospital in Nepal in April. With these early successes, the Arnhold Institute hopes to implement this training across all of the Institute’s partnership sites.
Sakshi Sawarkar is an Associate Researcher at the Arnhold Institute for Global Health, where she supports the Adolescent Health initiatives.