Linda Baier Manwell1,2, Melissa McNeil3,4, Megan R Gerber5,6, Samina Iqbal7,8, Sarina Schrager9, Catherine Staropoli10,11, Roger Brown12, Laure Veet1,13,14, Sally Haskell1,15,16, Patricia Hayes1, Molly Carnes17,18. 1. Office of Women's Health, U.S. Department of Veterans Affairs, Washington, District of Columbia, USA. 2. Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. 3. VA Pittsburgh Health Care System, Pittsburgh, Pennsylvania, USA. 4. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. 5. VA Boston Healthcare System, Boston, Massachusetts, USA. 6. Division of General Internal Medicine, Department of Medicine, Albany Medical College, Albany, New York, USA. 7. VA Palo Alto Health Care System, Palo Alto, California, USA. 8. Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA. 9. Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. 10. VA Maryland Health Care System, Baltimore, Maryland, USA. 11. Division of General Internal Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. 12. Research Design and Statistics Unit, University of Wisconsin School of Nursing and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. 13. VA New Jersey Health Care System, East Orange, New Jersey, USA. 14. Hackensack-Meridian School of Medicine, Nutley, New Jersey, USA. 15. VA Connecticut Healthcare System, West Haven, Connecticut, USA. 16. Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA. 17. Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. 18. William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.
Abstract
Background: Many primary care providers (PCPs) in the Veterans Health Administration need updated clinical training in women's health. The objective was to design, implement, and evaluate a training program to increase participants' comfort with and provision of care to women Veterans, and foster practice changes in women's health care at their local institutions. Methods: The Women's Health Mini-Residency was developed as a multi-day training program, based on principles of adult learning, wherein knowledge gleaned through didactic presentations was solidified during small-group case study discussions and further enhanced by hands-on training and creation of a facility-specific action plan to improve women Veterans' care. Pre, post, and 6-month surveys assessed attendees' comfort with and provision of care to women. The 6-month survey also queried changes in practice, promulgation of program content, and action plan progress. Results: From 2008 to 2019, 2912 PCPs attended 26 programs. A total of 2423 (83.2%) completed pretraining and 2324 (79.3%) completed post-training surveys. The 6-month survey was sent to the 645 attendees from the first 14 programs; 297 (46.1%) responded. Comparison of pre-post responses indicated significant gains in comfort managing all 19 content areas. Six-month data showed some degradation, but comfort remained significantly improved from baseline. At 6 months, participants also reported increases in providing care to women, including performing more breast and pelvic examinations, dissemination of program content to colleagues, and progress on action plans. Conclusions: This interactive program appears to have been successful in improving PCPs' comfort in providing care for women Veterans and empowering them to implement institutional change.
Background: Many primary care providers (PCPs) in the Veterans Health Administration need updated clinical training in women's health. The objective was to design, implement, and evaluate a training program to increase participants' comfort with and provision of care to women Veterans, and foster practice changes in women's health care at their local institutions. Methods: The Women's Health Mini-Residency was developed as a multi-day training program, based on principles of adult learning, wherein knowledge gleaned through didactic presentations was solidified during small-group case study discussions and further enhanced by hands-on training and creation of a facility-specific action plan to improve women Veterans' care. Pre, post, and 6-month surveys assessed attendees' comfort with and provision of care to women. The 6-month survey also queried changes in practice, promulgation of program content, and action plan progress. Results: From 2008 to 2019, 2912 PCPs attended 26 programs. A total of 2423 (83.2%) completed pretraining and 2324 (79.3%) completed post-training surveys. The 6-month survey was sent to the 645 attendees from the first 14 programs; 297 (46.1%) responded. Comparison of pre-post responses indicated significant gains in comfort managing all 19 content areas. Six-month data showed some degradation, but comfort remained significantly improved from baseline. At 6 months, participants also reported increases in providing care to women, including performing more breast and pelvic examinations, dissemination of program content to colleagues, and progress on action plans. Conclusions: This interactive program appears to have been successful in improving PCPs' comfort in providing care for women Veterans and empowering them to implement institutional change.
Entities:
Keywords:
Veterans health; clinical competence; continuing; curriculum; education; primary health care; women's health