240 - A Novel Reproductive Health Curriculum Increases Pediatric Resident Confidence in Contraceptive Counseling

Poster Number: 240
Publication Number: 240.333

Erin H. Sieke, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Gia Yannekis, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Christopher Teng, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Katherine Donches, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Krishna White, CHOP Adolescent Medicine, Philadelphia, PA, United States; Sarah M. Wood, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Beth Rezet, CHOP, Havertown, PA, United States; Jeanine Ronan, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Sarah Green, Children's Hospital of Philadelphia, Philadelphia, PA, United States

Background: Despite the fact that pediatricians are the primary care providers for the majority of adolescents, pediatric residents receive limited training on long-acting reversible contraceptive (LARC) methods and are less likely to recommend LARCs for adolescents needing contraception as compared to family medicine and obstetrics and gynecology trainees. Our large pediatric residency program designed a novel reproductive health curriculum to meet this gap in pediatric resident knowledge.

Objective: This study aimed to assess whether a LARC-inclusive reproductive health curriculum improves pediatric resident confidence in reproductive health counseling.

Design/Methods: Pediatric residents participated in a 4-hour academic half-day including case-based contraceptive didactics and etonogestrel implant (Nexplanon) insertion and removal training. Residents were invited to participate in pre- and post-session surveys to assess confidence in contraceptive counseling and knowledge about contraceptive methods. Pre-survey and post-survey responses to contraceptive knowledge questions were compared using McNemar’s test for dichotomous questions. The McNemar-Bowker test was used to evaluate paired pre- and post-survey reports of contraceptive counseling confidence.

Results: 79 residents completed the pre-survey (29 PGY-1, 28 PGY-2, 18 PGY-3, 4 missing) and 77 (26 PGY-1, 27 PGY-2, 20 PGY-3, 4 missing) completed the post-survey for a response rate of 81.4% for the pre-survey and 79.4% for the post-survey. Residents self-reported increased confidence in counseling about the risks and benefits of available contraceptive options (p < 0.01), contraindications to estrogen-containing hormonal contraceptives (p < 0.01), the process of Nexplanon placement and removal (p < 0.01), and available emergency contraceptive options (p < 0.01) following training (Table 1). Residents were also more likely to correctly identify which methods should not be utilized in a patient with a contraindication to estrogen (35.3% on pre-survey vs. 70.6% on post-survey, p< 0.01).  After session completion, 74% (n=40) strongly agreed and 24.1% (n=13) agreed that pediatricians receive contraception training, including how to place and manage LARCs. Conclusion(s): A novel adolescent reproductive health curriculum led to increased self-reported confidence in contraceptive counseling and improved knowledge about available contraceptive options. Future research should examine whether pediatric residency graduates were able to use implant training in practice to provide a wider array of contraceptive options to their patients.
Sieke_CV_1-4-22.pdf