Summit Aleza K, Gold Marji
Montefiore Medical Center, Bronx, NY; and Albert Einstein School of Medicine.
Fam Med. 2017 Jan;49(1):22-27.
RHEDI, Reproductive Health Education in Family Medicine, offers technical assistance and funding to family medicine residency programs to support integrated opt-out abortion and reproductive health training for residents. This study assessed the impact of this enhanced training on residents' reproductive health experience.
Investigator-developed pre- and post-surveys were administered online to 214 residents at 12 family medicine residency programs before and after their RHEDI training experience. Surveys addressed experience in contraception and abortion, attitudes around abortion provision, and post-residency intentions. Descriptive statistics were generated, and statistical tests were performed to assess changes after training.
Surveys had a 90% response rate. After the RHEDI enhanced reproductive health rotation, residents reported increased experience in contraception provision, early pregnancy ultrasound, aspiration and medication abortion, and miscarriage management. After training, residents with experience in IUD insertion increased from 85% to 99%, and contraceptive implant insertion experience rose from 60% to 85%. Residents who had performed any abortions increased from 15% to 79%, and self-rated competency in abortion increased. Finally, almost all residents agreed that early abortion was within the scope of family medicine, and training confirmed residents' intentions to provide reproductive health services after residency.
Integrated training in reproductive health, with an emphasis on abortion, increases residents' experience and underscores their understanding of the role of these services in family medicine. Increasing the number of family medicine residency programs that offer this training could help prepare family physicians to meet their patients' needs for reproductive health services.
家庭医学中的生殖健康教育（RHEDI）为家庭医学住院医师培训项目提供技术援助和资金，以支持为住院医师开展综合的选择退出式堕胎及生殖健康培训。本研究评估了这种强化培训对住院医师生殖健康经历的影响。
在12个家庭医学住院医师培训项目的214名住院医师接受RHEDI培训前后，通过在线方式进行由研究者开发的预调查和后调查。调查涉及避孕和堕胎经历、对堕胎服务的态度以及住院医师培训结束后的意向。生成描述性统计数据，并进行统计检验以评估培训后的变化。
调查的回复率为90%。在RHEDI强化生殖健康轮转之后，住院医师报告称在提供避孕服务、早期妊娠超声检查、吸宫术和药物流产以及流产管理方面的经历有所增加。培训后，有宫内节育器放置经验的住院医师从85%增至99%，有避孕植入物放置经验的住院医师从60%增至85%。进行过任何堕胎手术的住院医师从15%增至79%，且自我评估的堕胎能力有所提高。最后，几乎所有住院医师都认为早期堕胎属于家庭医学范畴，培训也坚定了住院医师在培训结束后提供生殖健康服务的意向。
以堕胎为重点的生殖健康综合培训增加了住院医师的经验，并强化了他们对这些服务在家庭医学中作用的理解。增加提供此类培训的家庭医学住院医师培训项目数量，有助于培养家庭医生以满足患者对生殖健康服务的需求。
