A Novel Contraception Counseling and Shared Decision-Making Curriculum for Internal Medicine Residents

MedEdPORTAL. 2020 Dec 4;16:11046. doi: 10.15766/mep_2374-8265.11046.

Abstract

Introduction: Many women of reproductive age with complex medical conditions receive primary care through an internal medicine (IM) physician rather than an obstetrician/gynecologist. Long-acting reversible contraception methods are the most effective form of contraception; however, IM residents are not routinely trained in them. Infrequent training in, inadequate knowledge of, and discomfort with contraception counseling limit the counseling performed by IM residents. Shared decision-making (SDM) is a method of patient-centered communication that can improve communication about patient preferences and increase patient satisfaction with and adherence to contraception. We developed a curriculum to teach contraception counseling under the framework of SDM for IM residents.

Methods: The curriculum focused on contraception counseling through the lens of SDM designed for IM and medicine/pediatrics residents (PGY 2-PGY 4). We adapted an existing seven-step model of SDM to fit elements of contraception counseling. The curriculum consisted of a didactic teaching session with integration of an instructional video and structured interactive discussion. The session lasted 60 minutes.

Results: Fifty-eight residents participated in the curriculum. On pre- and postcurriculum surveys, residents reported improvement in contraception knowledge (overall mean precurriculum = 57%, postcurriculum = 70%, p < .001) and comfort with contraception counseling (overall mean precurriculum = 3.2, postcurriculum = 3.6, p < .01). Residents expressed strong support for SDM before and after the curriculum.

Discussion: Based on the survey results, the curriculum successfully addressed gaps in residents' comfort with contraception counseling and knowledge of contraception side effects and efficacy.

Keywords: Communication Skills; Contraception; Contraception Counseling; Family Planning; Long-Acting Reversible Contraception (LARC); Patient-Centered Communication; Primary Care; Shared Decision-Making; Women's Health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Contraception
  • Counseling
  • Curriculum
  • Decision Making, Shared
  • Female
  • Humans
  • Internship and Residency*