Three interactive half-day conferences

Available to PGY1, PGY2 and PGY3 residents. Topics include: options for unintended pregnancy, values clarification, basic skills in counseling, historical and public health perspectives on reproductive rights, procedures for medication and aspiration abortion, and abortion complications. (Handout: Sutter Quick Start Algorithm)

Early Abortion Training Workbook: Case and evidence based training manual

Case- and evidence-based training manual: Developed collaboratively through TEACH at UCSF. Includes a section on values clarification and an entire chapter on counseling, education and informed consent. Developed through visiting teacher series including abortion, values clarification and options counseling. (Handouts: Counseling Techniques and Challenges and Pregnancy Options Counseling)

Four days at Planned Parenthood on gynecology rotation

PGY2: Residents observe and are then observed doing counseling sessions. They can also be trained in ultrasound, medication abortion, aspiration procedures and options counseling if they desire.

Weekly early pregnancy options clinic at Family Practice Center

PGY3: Residents do all of the counseling, ultrasounds, medication abortions, aspiration procedures and follow-up of patients with a wide range of early pregnancy issues such as unintended pregnancy, miscarriage and ectopic pregnancy. (Handout: Telephone Management of Common Post-Abortion Problems and Work Up of Infections After Abortion)

Opt-out curriculum

Opt-out curriculum with alternative textbook and training

• Written policy informs prospective students and positively messages the training and opt-out provisions (Handout: values clarification, opt out letter to 2nd year res)
• Uses Alternative Curriculum Pathway including values clarification, options counseling, contraception, complication management and follow-up.
• Training and Planned Parenthood including: pregnancy options and contraceptive counseling, dating ultrasounds and exams, gynecologic skills including cervical anesthesia, miscarriage management, and IUD insertion, and discharge teaching and complication management.

Contraceptive training

One day per week on contraception rotation during PGY2 Planned Parenthood rotation

• Residents participate in women’s health clinic that sees complex contraceptive cases.
• Use Contraceptive Technology (Hatcher) and WHO Medical Eligibility Criteria (Handout: WHO chart)
• Annual Contraceptive Update grand rounds
• Call-in phone line for EC prescriptions without coming to clinic to role model EC prescribing

Grand Rounds

(Presentations: Management of First-Trimester Pregnancy Complications, Initiating Contraception, IUD Know-How)

Journal clubs and discussion groups

Please contact program directly for details.

“On-call” experiences

Please contact program directly for details.

PGY2: Personal and written feedback from Trainer at Planned Parenthood

Oral feedback is on a day-to-day basis during training. Written feedback is provided at the end of four sessions.

PGY3: Feedback from faculty after sessions at early pregnancy clinic

Please contact the program for more information.

PGY3: Self-assessment of skills doing options counseling by New Innovations evaluation standardized form

Average self-assessment of competency in options counseling score has risen from 3.17 on pre-rotation evaluations to 4.6 after completions of rotation.

New Innovations evaluation standardized form

Gathers data on communication, counseling skills, clinical management skills and procedure skills by all core faculty working with residents during month on rotation. Institution wide.

One-on-one teaching sessions with faculty

Training includes values clarification, options counseling, medical and surgical abortion care. Residents discuss and assess current knowledge base, experience and comfort level with options counseling and abortion care.

One-on-one self-reflection with faculty

Open-ended questions developed by Dr. Rachel Remen

OSCE evaluation

Evaluation: Observed Performance Assessment

Ongoing research and evaluation

Expand the evidence basis for training and share findings with other family medicine training sites:

• “You can’t do that round here: a case study of an Introduction of medical abortion into a university medical center,” February 2005 in Contraception. (Article: "You can't do that 'round here")

Continue to integrate training program and on-site reproductive health clinic

This has helped to change institutional culture and attitudes and transfer skills out of the OR into ambulatory settings more appropriate for FP residents and future service provision.

Enable residents to offer options counseling at medication abortion in continuity clinics

Please contact the program for more information.

Submitting article to Family Medicine on residency education on abortion

Please contact the program for more information.

Expanding TEACH curriculum

Will include a chapter on Miscarriage Management

Advocate for comprehensive reproductive health training locally and nationally

Done through collaborative regional networking of the TEACH program and Family Practice Associations