(24) Contraceptive Education in Pediatric Residency: Exploring the Knowledge, Barriers, and Initiatives that Contribute to Effective Adolescent Healthcare

Background: The adolescent population makes up a significant portion of the outpatient panel seen by pediatric residents during their training. Pediatric residency programs notoriously lack the exposure to gynecology and the education needed to address adolescents in regards to contraception care. With this study, we aim to assess contraceptive education practices from the lens of pediatric residents contributing to the enhancement of education in pediatric residency programs.

Methods: A questionnaire was distributed to residents from four pediatric residency programs across the United States. It was used to survey experiences and attitudes on contraceptive education, prescribing comfortability, educational gaps, and future directions. The data was collected anonymously and analyzed categorically by percentages and descriptive statistics, as well as multivariate analysis in search of statistical significance.

Results: Of the over 300 pediatric residents who received the questionnaire, 42 responded to the survey. Only 66% of residents reported having formal education on contraceptive counseling in medical school, although the majority of residents (59.5%) prescribe it up to 5 times per month. In terms of education, 69% of residents report learning most about contraception in residency on rotations such as Adolescent Medicine. For those who received their contraceptive education during residency, roughly 71% report < 10 hours of education was provided. Of the residents expressing discomfort with prescribing one or more methods, 42.9% related that it was due to inadequate knowledge of the topic. A large majority express the desire to have more hands-on procedural labs to enhance their contraceptive training. Overall, 73% of respondents desired more contraception during their residency training with trends suggesting that contraceptive prescription comfortability increases with PGY year, implying that increased exposure may strengthen skills and knowledge.

Conclusions: Many of the residents involved in this study will go on to become primary care providers who will be expected to prescribe contraception independently, bolstered with knowledge gained during their training. However, the data suggests that residents are not receiving equal training in contraception across the spectrum. This in turn is impacting the frequency in which counseling and prescription of contraception occurs in their clinic. This study reinforces the need for a standardized curriculum set in place to ensure residents are gaining the tools needed to provide adequate reproductive healthcare to their adolescent patients and beyond.