Browsing by Subject "Pregnancy options counseling"

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    Evaluation of family planning and abortion education in preclinical curriculum at a large midwestern medical school
    (Elsevier, 2022) Brown, Lucy; Swiezy, Sarah; McKinzie, Alexandra; Komanapalli, Sarah; Bernard, Caitlin
    OBJECTIVE: Evaluate a Midwestern medical school's current pregnancy termination and family planning undergraduate medical curriculum (UMC) in accordance with Association of Professors of Gynecology and Obstetrics (APGO) guidelines. Assess 1) student interest 2) preparedness to counsel patients, and 3) preferred modality of instruction. STUDY DESIGN: A survey assessed students about UMC. Course syllabus learning objectives and APGO educational guidelines were compared. RESULTS: There were 309 responses total; six did not complete all survey questions and were excluded. Participants (n = 303) were primarily female (62%) and White (74%). Across all class levels, many (61%) students expected to learn about family planning and contraception in UMC. While most (84-88%) participants who completed the preclinical course with or without the clerkship felt prepared to counsel about common, non-controversial pharmacotherapies, only 20% of students felt prepared to counsel on abortion options, and 75% of students who had completed both the preclinical and OBGYN clerkship felt unprepared for abortion counseling Overall, 86% of all students surveyed believed that the medical school should enhance its reproductive health coverage in UMC. Traditional lectures, panels, and direct clinical exposure were the most popular instructional modalities. CONCLUSION: We identified potential gaps in UMC where students expressed high level of interest with low level of preparedness regarding abortion options counseling, even among senior students. Considering the high percentage of students expecting to learn about pregnancy termination and family planning in their UMC, this expectation is not being met. Students were open to a variety of modalities of instruction, indicating that several possible options exist for curricular integration. IMPLICATIONS: Despite evidence of need for training in family planning and abortion, few medical institutions have a standardized curriculum. Little available literature exists on curricula covering pregnancy options and contraception counseling, signifying a gap of knowledge and an opportunity to study how to integrate these important topics into UMC.
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    Preferences and Experiences Regarding Pregnancy Options Counseling in Adolescence and Young Adulthood: A Qualitative Study
    (Elsevier, 2023) Bell, Lauren A.; Tyler, Crystal P.; Russell, Margaret R.; Szoko, Nicholas; Harrison, Elizabeth I.; Kazmerski, Traci M.; Syed, Tahniat; Kirkpatrick, Laura; Pediatrics, School of Medicine
    Purpose: Perspectives of adolescents and young adults (AYAs) experiencing pregnancy options counseling (POC) are absent from the literature. This study explores AYA experiences and preferences related to POC to inform best practice guidelines. Methods: We conducted semistructured phone interviews in 2020-2021 among US-based individuals, 18-35 years old, who experienced a pregnancy less than 20 years of age. We performed qualitative descriptive analysis of positive and negative attributes of AYA's experiences with POC. Results: Fifty participants reported 59 pregnancies (16 parenting, 19 abortions, 18 adoptions, three miscarriages) between the ages of 13 and 19 years. Positive attributes of POC experienced included: (1) provider communication that was compassionate, respectful, supportive, and attentive to nonverbal cues; (2) provider neutrality; (3) discussion of all pregnancy options; (4) asking about feelings, choice, life plans, and additional supports; (5) provision of informational materials; and (6) warm handoffs/follow-up facilitation. Negative attributes of POC experienced included: (1) judgmental, impersonal, or absent communication; (2) lack of counseling on all options and/or coercive/directive counseling; (3) insufficient time and supportive resources; and (4) confidentiality concerns. We identified no differences in these perspectives across pregnancy outcomes reported. Participants generally desired counseling about all options, with rare exceptions of ambivalence. Discussion: Individuals who experienced an adolescent pregnancy described similar positive and negative attributes of POC regardless of preferred pregnancy outcome. Their perspectives highlight how crucial interpersonal communication skills are for effective POC for AYA. POC training across health care specialties should emphasize confidential, compassionate, and nonjudgmental care for AYA patients.