Development and Evaluation of a Contraception Curriculum for Neurology Residents
Abstract number :
1.356
Submission category :
4. Clinical Epilepsy / 4E. Women's Issues
Year :
2024
Submission ID :
1112
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Sarah Betstadt, MD, MPH – University of Rochester Medical Center
Rationale: Neurological conditions including epilepsy, migraine headaches, strokes, myasthenia gravis and multiple sclerosis present challenges for pregnancy and contraception. Key concerns are the multiple drug-drug interactions between enzyme inducing anti-seizure medications and contraception as well as potential teratogenicity of these medications. In 2017, The American Academy of Neurology made “[reproductive] counseling for women of childbearing potential with epilepsy” a quality metric and stated that this should be documented at least once per year. Yet, the American Board of Psychiatry & Neurology, Neurology Core Competencies Outline does not have specific objectives that address contraception or family planning. This project will address this discrepancy between education and quality of care by developing a reproductive health curriculum specific to neurology residents.
Methods: In February of 2023, 22 neurology residents, at a single academic institution, took an on-line baseline contraceptive and family planning knowledge and attitude assessment. This was administered via REDCap and included questions about knowledge of indications and contraindications for contraceptive use, and their comfort level with contraceptive counseling and prescribing. Neurology residents then participated in six interactive in-person didactic sessions that focused on contraceptive methods, case-based learning for neurology patients needing contraception and a contraceptive counseling shared decision-making session. These sessions occurred during regularly scheduled, protected didactic times. In June of 2023, 10 neurology residents completed the on-line post-test contraceptive and family planning knowledge and attitude assessment. Changes in responses for the pre and post-test scores were analyzed using Fisher’s Exact Tests.
Results: There was no significant change when comparing the pre-test (n=22) and the post-test (n=10) results for the 50% of residents who felt that learning about contraceptive counseling was “very” or extremely” important for their careers. However, while only 4.5% of respondents felt that they could “review contraception options” independently or “teach others” to do so in the pre-test response, 40.0% of post-test resident respondents felt that they could review contraception options independently or teach others (p= 0.02). After completing this reproductive health curriculum, the percentage of neurology resident respondents who “routinely” or “often” performed contraceptive counseling went from 9.1% to 60.0% (P= 0.005). The percentage of residents who felt confident counseling a patient about combined hormonal contraception increased significantly from 59.1% to 100.0% (p= 0.03).
Conclusions: This small, pilot curriculum that taught neurology residents about contraception was successful in increasing knowledge and conversations about contraception. Specifically, neurology residents felt significantly more comfortable talking to patients about combined hormonal contraception, which has many drug-drug interactions with anti-seizure medications.
Funding: University of Rochester Dean's Teaching Fellowship
Clinical Epilepsy