Henrich Janet B, Gielissen Katherine A, McNamara Cynthia F, Pathy Shefali, Hirschman Allister F, Canarie Joseph X, Dhond Mukta, Richman Ilana, Rabin Tracy L, Vasquez Luz, Encandela John
is Professor, Section of General Internal Medicine, Department of Internal Medicine, and Director, Women & Gender Health Education Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
is Assistant Professor Adjunct, Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA, and Assistant Professor, and Program Director, Internal Medicine/Pediatrics Training Program, Division of General Medicine, Department of Medicine, Emory University, Atlanta, Georgia, USA.
J Grad Med Educ. 2024 Dec;16(6):723-729. doi: 10.4300/JGME-D-24-00140.1. Epub 2024 Dec 13.
Residency education in the United States faces challenges from evolving external influence on evidence-based reproductive and gender-affirming health care (R/GAHC). Curricula must incorporate information and resources to assist residents in navigating changes. To illustrate a process for expeditiously adapting curriculum in response to changing laws affecting R/GAHC. A 6-step model was used to tailor an R/GAHC module within an existing curriculum. Steps included identifying the medical education problem; conducting needs assessments with residents and educators; and designing, implementing, and evaluating the curriculum. The module was piloted in 2022 with internal medicine residents in 3 training programs at one institution during 4-hour small-group academic half-days. We evaluated the module's feasibility with time and cost analysis and residents' self-reported readiness to provide R/GAHC through essential tasks and knowledge. We evaluated acceptability by assessing whether residents and educators engaged in and completed the curriculum, and evidence of administrative support. A needs assessment clarified the educational problem as an urgent need to educate residents on the implications of legal changes affecting R/GAHC. Curriculum planning occurred over 2 months and implementation over 3 months. Of 175 eligible residents, 164 (94%) were trained. Evaluation showed that the curriculum was well received by residents, whose post-training self-assessment showed readiness to provide R/GAHC. Faculty time to plan and implement the module was substantial (estimated 207 person hours), yet participation was consistent, and administrative commitment constant. We demonstrated a generalizable approach for expeditiously tailoring curricula to prepare residents to navigate changing laws affecting health care provision.
美国的住院医师教育面临着不断演变的外部因素对循证生殖健康和性别肯定性医疗保健(R/GAHC)的影响所带来的挑战。课程必须纳入信息和资源,以帮助住院医师应对这些变化。为了说明一种针对影响R/GAHC的法律变化迅速调整课程的过程。我们使用了一个6步模型,在现有课程中定制一个R/GAHC模块。步骤包括确定医学教育问题;对住院医师和教育工作者进行需求评估;以及设计、实施和评估课程。该模块于2022年在一所机构的3个培训项目中对内科住院医师进行了试点,时间为4小时的小组学术半天。我们通过时间和成本分析以及住院医师自我报告的通过基本任务和知识提供R/GAHC的准备情况来评估该模块的可行性。我们通过评估住院医师和教育工作者是否参与并完成了课程以及行政支持的证据来评估可接受性。需求评估明确了教育问题,即迫切需要对住院医师进行关于影响R/GAHC的法律变化的影响的教育。课程规划历时2个月,实施历时3个月。在175名符合条件的住院医师中,164名(94%)接受了培训。评估表明,该课程受到住院医师的好评,他们培训后的自我评估显示已准备好提供R/GAHC。教师规划和实施该模块的时间相当可观(估计207人时),但参与情况一致,行政支持也持续存在。我们展示了一种可推广的方法,即迅速调整课程,以使住院医师做好准备,应对影响医疗保健提供的法律变化。