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针对儿科住院医师的妊娠选择咨询课程评估

Evaluation of a Pregnancy Options Counseling Curriculum for Pediatric Residents.

作者信息

Kirkpatrick Laura, Bell Lauren A, Borcky Theresa, Boutros-Khoury Hannah, Hooven-Davis Jayde, Rankine Jacquelin, Robbins Cynthia, Syed Tahniat, Szoko Nicholas, Allison Bianca A

机构信息

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.

Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee.

出版信息

J Adolesc Health. 2025 Mar;76(3):475-481. doi: 10.1016/j.jadohealth.2024.11.003. Epub 2024 Dec 15.

Abstract

PURPOSE

To evaluate an adolescent-centered pregnancy options counseling curriculum for pediatric residents.

METHODS

In 2022, we assessed the curriculum in one residency by randomizing half the residents to a pretraining or posttraining Observed Structured Clinical Exam (OSCE). We scored the OSCE by 15-item rubric and analyzed results by Wilcoxon Rank-Sum tests. From 2022 to 2023, we implemented the curriculum across 3 residencies. Surveys assessed knowledge and self-rated abilities before, immediately after, and 6-month posttraining. Two residencies also surveyed controls. We analyzed results using mixed-effects and ordinal logistic regression.

RESULTS

2022: 25 residents participated in the OSCE (13 pregroup, 12 post-group). Median score increased from 9/15 (interquartile range 8/15, 10/15) pretraining to 13/15 (13/15, 14/15) posttraining (p < .05). 2022-2023: Residents in the training arm completed presurveys (n = 79), immediate postsurveys (n = 65), and 6-month postsurveys (n = 40). Median baseline knowledge score was 57% (24%, 83%), which improved immediately posttraining [90% (81%, 95%), p < .05] and was sustained at 6 months [86% (57%, 90%), p < .05]. Median baseline self-rated ability to discuss pregnancy options was 8/12 (7/12, 9/12) and increased immediately posttraining [12/12 (10/12, 12/12), p < .05] with sustained improvement at 6 months [9/12 (8/12, 11/12), p < .05]. Median baseline self-rated ability to provide pregnancy-related referrals was 6/12 (5/12, 8/12) which improved posttraining [10/12 (9/12, 12/12), p < .05)] with sustained improvement at 6 months [8/12 (6/12, 9/12), p < .05]. Control residents completed presurveys (n = 140) and 6month postsurveys (n = 94). Trained residents performed better at 6 months on all measures (p < .05).

DISCUSSION

Pregnancy options counseling training for pediatrics residents led to improved knowledge, abilities, and behavior.

摘要

目的

评估以青少年为中心的针对儿科住院医师的妊娠选择咨询课程。

方法

2022年,我们在一个住院医师培训项目中评估该课程,将一半住院医师随机分配到培训前或培训后的客观结构化临床考试(OSCE)。我们根据15项评分标准对OSCE进行评分,并通过Wilcoxon秩和检验分析结果。从2022年到2023年,我们在3个住院医师培训项目中实施了该课程。通过调查评估培训前、培训后即刻以及培训后6个月的知识和自我评估能力。两个住院医师培训项目也对对照组进行了调查。我们使用混合效应和有序逻辑回归分析结果。

结果

2022年:25名住院医师参加了OSCE(13名培训前组,12名培训后组)。中位数得分从培训前的9/15(四分位间距8/15,10/15)提高到培训后的13/15(13/15,14/15)(p <.05)。2022 - 2023年:培训组的住院医师完成了培训前调查(n = 79)、培训后即刻调查(n = 65)和培训后6个月调查(n = 40)。基线知识得分中位数为57%(24%,83%),培训后即刻有所提高[90%(81%,95%),p <.05],并在6个月时保持[86%(57%,90%),p <.05]。讨论妊娠选择的自我评估能力基线中位数为8/12(7/12,9/12),培训后即刻增加[12/12(10/12,12/12),p <.05],6个月时持续改善[9/12(8/12,11/12),p <.05]。提供妊娠相关转诊的自我评估能力基线中位数为6/12(5/12,8/12),培训后有所改善[10/12(9/12,12/12),p <.05],6个月时持续改善[8/12(6/12,9/12),p <.05]。对照住院医师完成了培训前调查(n = 140)和6个月后调查(n = 94)。经过培训的住院医师在6个月时在所有指标上表现更好(p <.05)。

讨论

针对儿科住院医师的妊娠选择咨询培训导致知识、能力和行为得到改善。

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本文引用的文献

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How Is the Dobbs Ruling Affecting U.S. Adolescents?多布斯裁决如何影响美国青少年?
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Options Counseling for the Pregnant Adolescent Patient.青少年孕妇的选择咨询。
Pediatrics. 2022 Sep 1;150(3). doi: 10.1542/peds.2022-058781.

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