Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
J Adolesc Health. 2023 Jun;72(6):964-971. doi: 10.1016/j.jadohealth.2023.01.016. Epub 2023 Mar 10.
Although pediatricians are primary care providers for most adolescents, pediatric residents receive limited training on long-acting reversible contraceptive (LARC) methods. This study aimed to characterize pediatric resident comfort with placing contraceptive implants and intrauterine devices (IUDs) and assess pediatric resident interest in obtaining this training.
Pediatric residents in the United States were invited to participate in a survey assessing comfort with LARC methods and interest in LARC training during pediatric residency. Bivariate comparisons used Chi-square and Wilcoxon rank sum testing. Multivariate logistic regression was used to assess associations between primary outcomes and covariates including geographic region, training level, and career plans.
Six hundred twenty seven pediatric residents across the United States completed the survey. Participants were predominantly female (68.4%, n = 429), self-identified their race as White (66.1%, n = 412), and anticipated a career in a subspecialty other than Adolescent Medicine (53.0%, n = 326). Most residents were confident counseling patients on the risks and benefits, side effects, and effective use of contraceptive implants (55.6%, n = 344) and both hormonal and nonhormonal IUDs (53.0%, n = 324). Few residents reported comfort with inserting contraceptive implants (13.6%, n = 84) or IUDs (6.3%, n = 39), with most of these respondents having learned these skills as a medical student. Most participants believed that residents should receive training on insertion of contraceptive implants (72.3%, n = 447) and IUDs (62.5%, n = 374).
Although most pediatric residents believe LARC training should be a component of pediatric residency training, few pediatric residents are comfortable with provision of this care.
尽管儿科医生是大多数青少年的主要医疗服务提供者，但儿科住院医师在长效可逆避孕（LARC）方法方面接受的培训有限。本研究旨在描述儿科住院医师对放置避孕植入物和宫内节育器（IUD）的舒适度，并评估儿科住院医师对获得这种培训的兴趣。
邀请美国的儿科住院医师参加一项调查，评估他们对 LARC 方法的舒适度和对儿科住院期间 LARC 培训的兴趣。使用卡方检验和 Wilcoxon 秩和检验进行二元比较。使用多变量逻辑回归评估主要结果与包括地理区域、培训水平和职业规划在内的协变量之间的关联。
全美共有 627 名儿科住院医师完成了这项调查。参与者主要是女性（68.4%，n=429），自认为是白人（66.1%，n=412），并期望从事除青少年医学以外的专业（53.0%，n=326）。大多数住院医师对避孕植入物（55.6%，n=344）和激素和非激素 IUD（53.0%，n=324）的风险和益处、副作用和有效使用方面有信心对患者进行咨询。很少有住院医师表示对插入避孕植入物（13.6%，n=84）或 IUD（6.3%，n=39）有信心，其中大多数受访者是在医学生时期学会这些技能的。大多数参与者认为住院医师应该接受避孕植入物（72.3%，n=447）和 IUD（62.5%，n=374）插入的培训。
尽管大多数儿科住院医师认为 LARC 培训应该成为儿科住院医师培训的一部分，但很少有儿科住院医师对提供这种护理有信心。
