437 - A Standardized Curriculum to Increase Pediatric Trainee Comfort and Knowledge Regarding Long Acting Reversible Contraception
Friday, April 28, 2023
5:15 PM – 7:15 PM ET
Poster Number: 437 Publication Number: 437.1
Sydney M. Hartman-Munick, University of Massachusetts Medical School, Northborough, MA, United States; Alexandra J. Edwards, Boston Children's Hospital, Boston, MA, United States; Areej Hassan, Boston Childrens Hospital, Boston, MA, United States
assistant professor of pediatrics University of Massachusetts Medical School Northborough, Massachusetts, United States
Background: Long acting reversible contraception (LARC) methods, including the implant and the intrauterine device (IUD), are safe and effective for use among adolescents. Despite this, rates of uptake are low compared with other contraception methods. Studies show that one barrier to uptake is low provider comfort and knowledge regarding LARC, especially among pediatric residents. Objective: Our study aimed to assess whether residents demonstrated immediate and short-term increased knowledge and comfort after receiving training with a novel standardized LARC curriculum. Design/Methods: We developed a 3-hour evidence-based curriculum for all PGY-1 pediatric residents at an academic medical center. The curriculum session consisted of an introduction, an IUD lecture, and the FDA mandated implant clinical training program. Participants completed an in-person pre-curriculum survey, an in-person post-curriculum survey immediately after the session, and a 6-month post-curriculum survey by email. The survey assessed LARC experience, attitudes, knowledge, and comfort level. We compared the total percentage of correct knowledge questions across time using repeated measures analysis of variance (ANOVA). Results: 43 PGY-1 pediatric residents (65% female, mean age 29.2 yrs) participated in the training and completed the pre and immediate post-curriculum surveys; 19 (44.2%) completed the 6-month post-curriculum survey. Only a quarter (n=11, 25.6%) had prior formal training in LARC counseling or procedures. Table 1 shows % of residents answering knowledge questions correctly across time. Participants demonstrated significantly improved knowledge (mean correct 63.8% pre-curriculum vs 87.5% immediate post-curriculum, p< .001). Six-month follow-up data demonstrated statistically significant retention of knowledge (mean correct 75% 6-month post-curriculum, p< .001). Participant confidence in patient counseling on LARC risks and benefits as well as comfort utilizing reputable resources to answer questions about LARC also significantly increased across the three time points (p< .001). However, most participants (94.7%) had not had the opportunity to participate in LARC placement in the six months following the training, and just over a third (36.1%) reported making practice changes as a result of the training.
Conclusion(s): This novel curriculum demonstrated improvements in resident knowledge and comfort with LARC counseling. Practice changes were limited, and likely related to insufficient opportunity to practice skills, an important consideration for future directions of curriculum implementation and study.
