Literature DB >> 12823647

Teaching women's health skills: confidence, attitudes and practice patterns of academic generalist physician.

James G Dixon1, Bryan A Bognar, Thomas C Keyserling, Connie T Du Pre, Sharon X Xie, Glenda C Wickstrom, Maria M Kolar.   

Abstract

OBJECTIVE: This study assesses the readiness of academic general internists to perform and precept a commonly utilized women's health examination, and procedural and management skills.
DESIGN: Full-time faculty from divisions of general internal medicine and departments of family practice in 9 states reported their encounter frequency with, comfort precepting, and the importance they ascribe to several examination, procedural, and management skills relevant to women's health care; and their attitudes toward performing the pelvic exam and obtaining a Pap smear.
MEASUREMENTS AND MAIN RESULTS: A total of 331 general internal medicine physicians (GIMs) and 271 family medicine physicians (FPs) completed questionnaires, with response rates of 57% and 64%, respectively. More than 90% of GIMs and FPs indicated they were confident precepting the breast and Pap/pelvic examinations. A relatively small percentage of GIMs expressed confidence precepting the management of dysfunctional uterine bleeding (22%), initiating Depo-Provera (21%), and initiating oral contraceptives (45%), while a substantially larger percentage indicated that these skills were important to primary care practice (43%, 44%, and 85%, respectively). Although GIMs indicated they were confident precepting the Pap/pelvic exam, they were less likely than FPs to agree with the following statements: "Performing routine Pap smears is a good use of my time" (GIMs 65%, FPs 84%); "It is a waste of health care dollars for primary care physicians to refer patients to gynecologists for routine Pap/pelvic exams" (GIMs 69%, FPs 90%); "I feel very well trained to do a routine bimanual exam" (GIMs 71%, FPs 98%), and "The clinic where I practice is well equipped to do a Pap smear" (GIMs 78%, FPs 94%).
CONCLUSIONS: Although most academic GIMs are confident precepting the breast and pelvic examination, only a minority are confident precepting the management of dysfunctional uterine bleeding, initiating Depo-Provera, and initiating oral contraceptives. These findings suggest that a number of academic GIMs may not be prepared or willing to perform or precept important women's health skills.

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Mesh:

Year:  2003        PMID: 12823647      PMCID: PMC1494877          DOI: 10.1046/j.1525-1497.2003.10511.x

Source DB:  PubMed          Journal:  J Gen Intern Med        ISSN: 0884-8734            Impact factor:   5.128


  14 in total

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8.  Assessing the needs of women and clinicians for the management of menopause in an HMO.

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  7 in total

1.  Women's health education: progress and promises.

Authors:  Deborah S Kwolek
Journal:  J Gen Intern Med       Date:  2003-06       Impact factor: 5.128

2.  Competency-based learning: the impact of targeted resident education and feedback on Pap smear adequacy rates.

Authors:  Raquel S Watkins; William P Moran
Journal:  J Gen Intern Med       Date:  2004-05       Impact factor: 5.128

Review 3.  Changing habits of practice. Transforming internal medicine residency education in ambulatory settings.

Authors:  Judith L Bowen; Stephen M Salerno; John K Chamberlain; Elizabeth Eckstrom; Helen L Chen; Suzanne Brandenburg
Journal:  J Gen Intern Med       Date:  2005-12       Impact factor: 5.128

4.  Needs and priorities in women's health training: perspectives from an internal medicine residency program.

Authors:  Evelyn Hsieh; Marcella Nunez-Smith; Janet B Henrich
Journal:  J Womens Health (Larchmt)       Date:  2013-08       Impact factor: 2.681

5.  Introducing a Women's Health Clinic Improves Resident Comfort and Competence in Performing Women's Health Exams.

Authors:  Kristin A Swedish
Journal:  J Gen Intern Med       Date:  2019-07       Impact factor: 5.128

6.  Promoting safe prescribing in primary care with a contraceptive vital sign: a cluster-randomized controlled trial.

Authors:  Eleanor Bimla Schwarz; Sara M Parisi; Sanithia L Williams; Grant J Shevchik; Rachel Hess
Journal:  Ann Fam Med       Date:  2012 Nov-Dec       Impact factor: 5.166

7.  Preparing Internal Medicine Residents to Provide Primary Care for Women: Gender-Specific Clinics May Be the Answer.

Authors:  Meagan S Williams; Adelaide H McClintock
Journal:  J Gen Intern Med       Date:  2020-06-24       Impact factor: 6.473

  7 in total

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