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美国妇产科住院医师培训项目中的堕胎培训

Abortion training in United States obstetrics and gynecology residency programs.

作者信息

Eastwood Katherine L, Kacmar Jennifer E, Steinauer Jody, Weitzen Sherry, Boardman Lori A

机构信息

Women and Infants' Hospital of Rhode Island, Brown Medical School, Providence, USA.

出版信息

Obstet Gynecol. 2006 Aug;108(2):303-8. doi: 10.1097/01.AOG.0000224705.79818.c9.

Abstract

OBJECTIVE

To identify characteristics of programs which provide training in abortion, to calculate the number of procedures done during training, and to compare the availability of abortion training in 2004 with that of prior national surveys.

METHODS

An investigator-designed questionnaire about abortion training in obstetrics and gynecology residency programs was mailed to all U.S. residency directors. Collected data included program information, abortion training, and numbers of residents trained. Data were analyzed to estimate differences in abortion training by region, program size, and type of training offered.

RESULTS

Of the 252 questionnaires mailed, 185 (73%) were returned. Of the 185, 94 (51%) program directors reported routine instruction in elective abortion, 72 (39%) optional training, and 19 (10%) no training. Large programs and programs located in the Northeast and West Coast were significantly more likely to offer routine training in terminations (P < .01). In the programs offering routine training, more than 50% of residents received instruction in termination practices. Of those practices, the most common were first-trimester surgical abortion (85% of programs), followed by medical abortion (59%), second-trimester induction (51% of programs), and dilation and extraction (36%). As compared with those in programs with optional training, residents in programs with routine training were significantly more likely to receive instruction in all modalities of abortion provision and performed proportionally more first- and second-trimester terminations (P < .01).

CONCLUSION

Routine training in elective abortion resulted in greater exposure to abortion practices and greater experience in more complicated abortion techniques during residency.

摘要

目的

确定提供堕胎培训项目的特点,计算培训期间进行的手术数量,并将2004年堕胎培训的可获得性与之前的全国性调查结果进行比较。

方法

向所有美国住院医师培训项目主任邮寄一份由研究者设计的关于妇产科住院医师培训项目中堕胎培训的调查问卷。收集的数据包括项目信息、堕胎培训情况以及培训的住院医师人数。对数据进行分析,以估计不同地区、项目规模和所提供培训类型在堕胎培训方面的差异。

结果

在寄出的252份调查问卷中,185份(73%)被返还。在这185份问卷中,94位(51%)项目主任报告有选择性堕胎的常规教学,72位(39%)报告有选择性培训,19位(10%)报告没有培训。大型项目以及位于东北部和西海岸的项目显著更有可能提供终止妊娠的常规培训(P < 0.01)。在提供常规培训的项目中,超过50%的住院医师接受了终止妊娠操作的教学。在这些操作中,最常见的是孕早期手术堕胎(85%的项目),其次是药物流产(59%)、孕中期引产(51%的项目)和扩张刮除术(36%)。与接受选择性培训项目的住院医师相比,接受常规培训项目的住院医师在所有堕胎方式的教学方面显著更有可能接受指导,并且在孕早期和孕中期终止妊娠的比例更高(P < 0.01)。

结论

选择性堕胎的常规培训使住院医师在培训期间更多地接触到堕胎操作,并在更复杂的堕胎技术方面积累了更多经验。

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