Department of Family Medicine and Community Health, University of Kansas, Kansas City, Kansas, USA.
Department of Population Health, University of Kansas, Kansas City, Kansas, USA.
Teach Learn Med. 2024 Apr-May;36(2):174-182. doi: 10.1080/10401334.2022.2163399. Epub 2023 Jan 13.
Contraception and abortion care are commonly accessed health services, and physicians in training will encounter patients seeking this care. Curricula that teach contraception and abortion provision during medical school equip medical students with valuable skills and may influence their intention to provide these services during their careers. Family planning is nevertheless understood to be underrepresented in most medical curricula, including in North American medical schools where the laws on providing contraception and abortion have been consequentially changing. This study investigated the prevalence and predictors of contraception and abortion education in North American medical curricula in 2021. We asked family medicine clerkship directors from Canada and the United States (US) to report about contraception and abortion teaching in their clinical curricula and their school's whole curriculum and to report on associated factors. Survey questions were included in the 2021 Council of Academic Family Medicine's Educational Research Alliance (CERA) survey of Family Medicine Clerkship Directors at accredited North American medical schools. Surveys were distributed between April 29 and May 28, 2021, to the 160 clerkship directors listed in the CERA organization database. Seventy-eight directors responded to the survey (78/160, 48%). 47% of responding directors reported no contraception teaching in the family medicine clerkship. 81.7% of responding directors reported no abortion teaching in the clerkship, and 66% indicated abortion was not being taught in their school's whole curriculum. Medical school region correlated with the presence of abortion curricula, and schools with high graduation rates into the family medicine specialty reported abortion teaching more frequently. Fewer than 40% of responding directors had received training on both contraception and abortion care themselves. Contraception and abortion are both underrepresented in North American medical curricula. Formal abortion education may be absent from most family medicine clerkships and whole program curricula. To enhance family planning teaching in North American medical schools, we recommend that national curriculum resources be revised to include specific contraception and abortion learning objectives and for increased development and support for clinical curricula directors to universally include family planning teaching in whole program and family medicine clerkship curricula.
避孕和堕胎护理是常见的医疗服务，培训中的医生会遇到寻求这些护理的患者。在医学院教授避孕和堕胎知识可以为医学生提供宝贵的技能，并可能影响他们在职业生涯中提供这些服务的意愿。然而，计划生育在大多数医学课程中都没有得到充分体现，包括在北美医学院，那里提供避孕和堕胎的法律已经发生了变化。本研究调查了 2021 年北美医学课程中避孕和堕胎教育的流行率和预测因素。我们要求加拿大和美国的家庭医学实习主任报告他们的临床课程和学校整体课程中的避孕和堕胎教学情况，并报告相关因素。调查问题包含在 2021 年学术家庭医学理事会教育研究联盟（CERA）对北美医学院认可的家庭医学实习主任的调查中。该调查于 2021 年 4 月 29 日至 5 月 28 日期间分发给 CERA 组织数据库中列出的 160 名实习主任。78 名主任回应了调查（78/160，48%）。47%的回应主任表示，家庭医学实习中没有避孕教学。81.7%的回应主任表示，实习中没有堕胎教学，66%的人表示堕胎没有在学校的整个课程中教授。医学院所在地区与堕胎课程的存在相关，毕业率较高的学校更频繁地报告堕胎教学。不到 40%的回应主任自己接受过避孕和堕胎护理方面的培训。避孕和堕胎在北美医学课程中都没有得到充分体现。大多数家庭医学实习和整个课程课程中可能没有正式的堕胎教育。为了加强北美医学院的计划生育教学，我们建议修订国家课程资源，包括具体的避孕和堕胎学习目标，并增加对临床课程主任的开发和支持，以便在整个课程和家庭医学实习课程中普遍纳入计划生育教学。
