Assessment and Implementation of Preconception Training for Internal Medicine Residents

Abstract

Background: Graduates of General Internal Medicine programs are expected to be able to provide quality women’s health (WH) care. Studies have revealed the overall weakness of this topic outside of Obstetrics and Gynecology. To our knowledge, other studies have not specifically assessed preconception counseling with Internal Medicine (IM) residents. Our objective was to assess resident’s understanding of the general internist’s role related to preconception counseling and to explore if providing curriculum on the topic could improve translation of this counseling into practice. Methods: An ambulatory half-day interactive lecture reviewed topical information and case study. IU residents in any year of training in IM or Medicine-Pediatrics programs who were on their ambulatory rotation from September through November, 2024 were eligible to participate. Pre and post surveys were distributed, assessing residents’ understanding of preconception counseling within IM scope of practice, their comfort with the material, and their anticipated likelihood of utilizing preconception counseling. Results: 26 residents responded to the pre-survey and 31 responded to the post-survey. Prior to intervention, 46% of residents felt that preconception counseling was within general internist’s practice compared to 100% in the post-survey. 46% of residents felt comfortable with preconception counseling in the pre-survey compared to 97% in the post-survey. 73% felt they would engage in preconception counseling with their patients over the next 12 months in the pre-survey compared to 87% in the post-survey. Unpaired t-tests found statistical significance in attitude toward the role of internists in preconception counseling (p-value <0.0001) as well as confidence in doing it (p-value <0.0001), while likelihood to engage in preconception counseling did not achieve significance (p-value 0.0602). Conclusions: Residents deepened understanding of preconception counseling and felt more comfortable with the material following topical curriculum integration into an ambulatory rotation.