Travel Histories in Children: How Well Do Interns and Medical Students Do?

Blakemore, Shaundra; Hofto, Meghan E; Shah, Nipam; Gaither, Stacy L; Chilukuri, Pranaya; Tofil, Nancy M

OBJECTIVE To evaluate the knowledge of obtaining travel histories in medical students and interns. METHODS Medical students and interns participated in a high-fidelity pediatric simulation with two cases (malaria or typhoid fever) that hinged on travel history. After the simulation, appropriate methods of obtaining travel histories were discussed. Participants completed surveys regarding their previous education and comfort with obtaining travel histories. If and how a travel history was obtained was derived from simulation observation. RESULTS From June 2016 to July 2017, 145 medical trainees participated in 24 simulation sessions; 45% reported no prior training in obtaining travel histories. Participants asked for a travel history in all but 2 simulations; however, in 9 of 24 simulations (38%), they required prompting by either a simulation confederate or laboratory results. Participants were more comfortable diagnosing/treating conditions acquired from US domestic travel than from international travel (32.9% vs 22.4%, P < 0.001). Previous education in obtaining travel histories and past international travel did not significantly influence the level of comfort that participants felt with travel histories. CONCLUSIONS This study highlights the lack of knowledge regarding the importance of travel histories as part of basic history taking. Medical students and interns had low levels of comfort in obtaining adequate travel histories and diagnosing conditions acquired from international travel.