74. Pediatric Resident Interpersonal/Communication Skills: Do They Play a Role in Adolescent Contraception Knowledge After a Clinic Visit?

Abstract

One focus of resident education in adolescent medicine is contraception and it is difficult to assess how effective this education is on patient knowledge. Competencies, including interpersonal and communication skills, and evaluation continue to be a focus of the American Board of Pediatrics and Accreditation Council on Graduate Medical Education. There is no literature assessing real-time education and communication between residents and patients regarding contraception. The purpose of this study was to (a) assess patient's learned contraception knowledge, (b) assess resident-provided contraception education, (c) assess resident interpersonal/communication skills, and (d) determine which factors result in increased patient contraception knowledge. In this IRB approved study, resident physicians (n=19) and adolescent girls aged 14-21 years (n=33) were recruited from an urban primary care clinic to complete surveys regarding demographics, contraception knowledge and education, and resident communication skills. Data were analyzed using descriptive statistics for adolescent- and resident-level factors. Bivariate analyses were utilized to determine potential association between adolescent- and resident-level factors and patient contraception knowledge (SPSS 21.0). 82% of the adolescents were Black/African-American. Patients chose OCPs (n=17) and Depo-Provera (n=14) as their form of contraception. For OCP group, 41% of the patients knew what to do if pills were missed, 12% recognized OCP association with cancer, and 48% knew OCP relationship to getting pregnant after pill discontinuation. For Depo-Provera group, 29% knew relationship to bone health and 43% recognized Depo-Provera relationship to getting pregnant after injection discontinuation. The scale for percentage of resident-patient visit spent on contraception education was found to have a reliability statistic of 0.88 for OCP, 0.74 for Depo-Provera. For OCP group, 56% of the residents did not discuss relationship to cancer; 50% did not discuss relationship to getting pregnant after stopping OCP. For Depo-Provera group, 64% of residents did not discuss relationship to getting pregnant after injection discontinuation. The scale for resident interpersonal/communication skills was found to have a reliability statistic of 0.95. 64-79% of the residents were rated perfectly for their interpersonal/communication skill items, but 51.5% of residents were less than perfect at discussing confidentiality. Bivariate analyses were marginally significant for resident week of rotation and OCP (d=0.61), birth control counseling and OCP (d=0.67), and history of sexual education and Depo-Provera (d=0.69). This suggests these factors may be important predictors in larger studies. Despite resident report of education provided, patient contraception knowledge is lacking regarding relationship between stopping contraception and getting pregnant, OCP and cancer, OCP and missed doses, and Depo-Provera and bone health. Adolescents reliably assess resident interpersonal/communication skills but felt residents did not discuss confidentiality perfectly compared to other skills. Promising factors that may lead to increased contraception knowledge include increased resident week of rotation, resident history of birth control counseling in continuity clinic, and patient history of sexual education.