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Pediatricians’ confidence level in diagnosing and treating children with atopic dermatitis in Israel, based on a self-efficacy survey

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Abstract

Atopic dermatitis (AD) is one of childhood’s most common skin conditions. Although pediatricians often diagnose and manage it, more than half refer even mild cases to dermatologists. In this study, we aimed to evaluate pediatric residents’ and pediatricians’ self-confidence regarding their ability to diagnose and manage AD. A cross-sectional questionnaire study was conducted with Israeli pediatric residents and pediatricians in 2022. The questionnaire was designed to distinguish participants with high vs. low self-confidence characteristics regarding their ability to diagnose and treat AD. In total, 171 participants completed the questionnaire (59.4% women; age, 41.1 ± 10.6 years); 39.1% of the participants were residents, while 60.9% were board-certified pediatricians. Overall, 64.4% of the responders reported below or average confidence (score ≤ 3, on a scale of 1–5) in diagnosing and treating AD in children. The group with higher self-confidence was significantly older (44.39 vs. 39.14 years, P = 0.003), had more years of experience in evaluating pediatric AD (P = 0.004), had trained in dermatology during their residency (P = 0.02) with a longer training period (P = 0.01), and with more than three training methods (P = 0.009). Multivariable logistic regression analysis showed that high self-confidence was associated with age older than 40 years and training in dermatology during residency (odds ratios = 5.63 [P = 0.04] and 3.36 [P = 0.05], respectively).

  Conclusion: Most pediatric residents and pediatricians were not particularly confident in treating children with AD. Those with high self-confidence were older, had been exposed to more patients, and had been trained in dermatology during their residency with various methods and for longer periods. Therefore, we encourage the implementation of a training program in dermatology during pediatric residency programs.

What is Known:

• Atopic dermatitis (AD) is one of childhood’s most common skin conditions and often presents to pediatricians for diagnosis and management.

• Many pediatricians refer children with even mild cases of AD to dermatologists.

What is New:

• Most pediatric residents and pediatricians report low confidence in diagnosing and treating pediatric AD.

• Physicians with high self- confidence were older, exposed to more AD patients, and had been trained in dermatology during their residency with various methods and for longer periods. Therefore, the implementation of a training program in dermatology during pediatric residency programs is warranted. 

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Data availability

Raw data were generated at the Soroka University Medical Center. Derived Data supporting the findings of this study are available from the corresponding author (IGT) upon reasonable request.

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Authors and Affiliations

Authors

Contributions

IGT, AH, and ABS contributed to the study conception and design. Material preparation and data collection were performed by LM and DS. Statistical analysis was performed by LY. The first draft of the manuscript was written by IGT and NA, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Inbal Golan-Tripto.

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The authors declare no competing interests.

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Communicated by Peter de Winter

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Inbal Golan Tripto and Atar Ben Shmuel are equal first authors.

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Golan-Tripto, I., Ben Shmuel, A., Muallem, L. et al. Pediatricians’ confidence level in diagnosing and treating children with atopic dermatitis in Israel, based on a self-efficacy survey. Eur J Pediatr 182, 5223–5230 (2023). https://doi.org/10.1007/s00431-023-05197-5

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