116. WHERE DO PEDIATRIC TRAINEES LEARN ABOUT BEHAVIORAL AND MENTAL HEALTH CONDITIONS

Background/Objectives Although the development and behavior rotation (DBR) aimed to provide pediatric trainees with more experience in caring for children with behavioral and mental health (B/MH) conditions, gaps in B/MH training remain. This national study described the settings in which residents receive training in the assessment and treatment of B/MH problems Methods Cross-sectional survey of applicants for the initial American Board of Pediatrics certifying exam in pediatrics. Respondents rated where they received training in 7 B.M. assessment skills (eliciting parental MH concerns; using screening tools to identify MH concerns; using disorder specific rating scales to help with diagnosis; diagnosing ADHD, anxiety, or depression using DSM-V criteria; and assessing suicidality) and 9 treatment skills (using evidence-based communication strategies to engage patients in treatment; behavioral management counseling; non-medication strategies for ADHD or depression/anxiety; dosing ADHD or depression medications; titrating medications; safety counseling; and co-management with MH specialists). Response options included continuity clinic, DBR, adolescent rotation, subspecialty rotations, child psychiatry rotation, other elective/longitudinal rotation, and/or no training in the skill. Descriptive statistics analyzed these data. Results 62.3% responded to the survey (n=2,086) with an average age of 31.3 years, 73.5% were female, and 60.1% were white. There were no differences in demographics between respondents and non-responders. Respondents reported receiving B/MH training in several settings, with continuity clinic being the predominant training location for all assessment (79%) and treatment (74%) skills. Respondents reported that their DBR was the next most common training setting, followed by adolescent medicine. However, for most skills, less than 50% of respondents reported receiving training in these settings. Across all assessment skills, less than 15% of respondents reported receiving training in other settings, including child psychiatry. Conclusions The majority of learning to care for children with B/MH conditions is in continuity clinic. Efforts must be made to ensure that this learning environment provides teaching with knowledgeable role models.