Department of Obstetrics and Gynecology, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY 10003, USA.
Contraception. 2012 Mar;85(3):294-8. doi: 10.1016/j.contraception.2011.06.014. Epub 2011 Aug 26.
Abortion provision remains threatened by the paucity of physicians trained to provide them. Lack of training during residency has been cited by obstetrician and gynecologist (ob-gyn) physicians as a reason for not including abortion in their practice.
We administered surveys on interest, competency and intention to provide abortions to two groups of ob-gyn residents: one experiencing a new comprehensive and structured family planning rotation, and another group at our affiliate hospital's residency program receiving "ad hoc" training during their routine gynecology rotations. Surveys were anonymous and blinded to investigator.
The structured family planning rotation group compared to the ad hoc group reported significantly increased competency score using a Likert scale in manual vacuum aspiration (MVA) (4.5 vs. 1; p=.003) and had a higher proportion reporting intent to provide office MVA postresidency (100% vs. 39%; p=.01) and being trained to 22.5 weeks' vs. 12 weeks' gestation (p=.005). In bivariate analysis, competency in MVA was associated with higher intentions to provide MVA after residency (p=.007).
A structured rotation in family planning and abortion for obstetrics/gynecology residents results in increases in competency and intentions to provide abortion, and an association between the two. In-hospital structured training proved to be superior to ad hoc training in our affiliate institution in improving competency and intention to provide abortion after residency.
由于缺乏接受过提供堕胎手术培训的医生,堕胎服务仍然受到威胁。妇产科医生将住院医师培训期间缺乏培训列为不在其执业范围内提供堕胎服务的原因之一。
我们向两组妇产科住院医师发放了关于堕胎兴趣、能力和提供堕胎意愿的调查问卷:一组是在接受新的综合和结构化计划生育轮转的住院医师,另一组是在我们附属医院的住院医师项目中,在常规妇科轮转期间接受“临时”培训的住院医师。调查是匿名的,调查员也不知道调查结果。
与临时培训组相比,结构化计划生育轮转组在使用 Likert 量表评估手动真空抽吸术(MVA)的能力时,报告的能力得分显著提高(4.5 分比 1 分;p=.003),报告毕业后愿意提供门诊 MVA 的比例更高(100%比 39%;p=.01),并且接受过培训至 22.5 周妊娠的比例更高(12 周妊娠比 12 周妊娠;p=.005)。在单变量分析中,MVA 能力与毕业后提供 MVA 的意愿更高相关(p=.007)。
为妇产科住院医师提供结构化的计划生育和堕胎轮转培训可提高其能力和提供堕胎的意愿,且两者之间存在关联。与我们附属机构的临时培训相比,医院内的结构化培训在提高毕业后提供堕胎服务的能力和意愿方面效果更好。