Ramírez Sarah I, Partin Michael, Snyder Ashley H, Ko Elizabeth, Aruma Jane, Castaneda Marie C, Casas Rachel S
Department of Family and Community Medicine, Penn State College of Medicine, 500 University Drive; HP 11, Hershey, PA, 17033, USA.
Internal Medicine, Penn State College of Medicine, Hershey, PA, USA.
J Gen Intern Med. 2025 Jan;40(1):258-272. doi: 10.1007/s11606-024-08987-1. Epub 2024 Aug 26.
While Women's Health (WH) is a priority for primary care, (Family Medicine (FM), Internal Medicine (IM), Pediatrics (Peds), and combined Medicine/Pediatrics (Med/Peds)), residency curricula remain heterogeneous with deficits in graduates' WH expertise and skills. The overall objective of this study was to assess the quality of WH curricula at primary care residency programs in the United States (US), with a focus on topics in obstetrics and gynecology (OBGYN).
PubMed®, ERIC, The Cochrane Library, MedEdPORTAL, and professional organization websites were systematically searched in 2019 and updated in 2021. Included studies described OBGYN educational curricula in US primary care residency programs. Following abstract screening and full-text review, data from eligible studies was abstracted and quality assessed using the Medical Education Research Study Quality Instrument (MERSQI).
A total of 109 studies met the inclusion criteria. Over a quarter of studies were interdepartmental or interdisciplinary. The most common single-department studies were IM (38%) and FM (26%). Twenty (25%) studies addressed comprehensive OBGYN curricula; the most common individual topics were cervical and breast cancer screening (31%) and contraception (16%). Most studies utilized multiple instructional modalities, most commonly didactics (54%), clinical experiences (41%), and/or simulation (21%). Most studies included self-reported outcomes by residents (70%), with few (11%) reporting higher-level assessments (i.e., patient, or clinical outcomes). Most studies were single-group pre- and post-test (42%) with few randomized controlled trials (4%). The mean MERSQI score for studies with sufficient data (90%) was 9.8 (range 3 to 15.5).
OBGYN educational curricula for primary care trainees in the US was varied with gaps in represented residents, content, assessments, and study quality.
虽然女性健康(WH)是初级保健(家庭医学(FM)、内科(IM)、儿科学(Peds)以及内科/儿科学联合专业(Med/Peds))的重点,但住院医师培训课程仍然参差不齐,毕业生在女性健康方面的专业知识和技能存在欠缺。本研究的总体目标是评估美国初级保健住院医师培训项目中女性健康课程的质量,重点关注妇产科(OBGYN)主题。
2019年对PubMed®、教育资源信息中心(ERIC)、考克兰图书馆、医学教育门户网站以及专业组织网站进行了系统检索,并于2021年更新。纳入的研究描述了美国初级保健住院医师培训项目中的妇产科教育课程。经过摘要筛选和全文审查,从符合条件的研究中提取数据,并使用医学教育研究质量工具(MERSQI)进行质量评估。
共有109项研究符合纳入标准。超过四分之一的研究是跨部门或跨学科的。最常见的单部门研究是内科(38%)和家庭医学(26%)。20项(25%)研究涉及全面的妇产科课程;最常见的单个主题是宫颈癌和乳腺癌筛查(31%)以及避孕(16%)。大多数研究采用了多种教学方式,最常见的是讲授法(54%)、临床经验(41%)和/或模拟(21%)。大多数研究纳入了住院医师的自我报告结果(70%),很少有研究(11%)报告更高层次的评估(即患者或临床结果)。大多数研究是单组前后测试(42%),随机对照试验很少(4%)。有足够数据(90%)的研究的平均MERSQI评分为9.8(范围为3至15.5)。
美国初级保健学员的妇产科教育课程各不相同,在住院医师代表性、内容、评估和研究质量方面存在差距。