Influencing Medical Students' Attitudes Toward Intrauterine Contraception in the Third-Year Obstetrics and Gynecology Clerkship

Abstract

INTRODUCTION: Underuse of intrauterine contraceptives is attributable in part to health care provider misconceptions. Education of medical students is essential to improve intrauterine contraceptive uptake and referral for insertion. This study explores the effect of the obstetrics-gynecology clerkship on medical students knowledge and attitudes regarding intrauterine contraceptive use. METHODS: All students in the third-year obstetrics-gynecology clerkship participate in an intrauterine contraceptive insertion workshop on orientation day. All students are exposed to the clinical use of intrauterine contraceptive during their rotation. They complete a survey before the workshop and on the final day of the clerkship to assess their knowledge about common misconceptions about intrauterine contraceptive use. RESULTS: To date 81 students have completed both surveys. Students were significantly more likely to approve of intrauterine contraceptive use by teenagers at the end of the clerkship (22% at orientation compared with 60% on the last day P=.03). Opinions regarding use by nulliparas (52% compared with 84%) patients with a history of cervical sexually transmitted disease or pelvic inflammatory disease (22% compared with 77%; 17% compared with 57%) and insertion at the time of induced abortion (44% compared with 88%) improved but the change was not statistically significant (P>.05). There was a nonsignificant increase in the fraction recommending intrauterine contraceptive use to appropriate patients (72% compared with 91% P=.19). CONCLUSIONS: Incorporation of standardized education and experience with intrauterine contraceptive insertion may improve students attitudes toward intrauterine contraceptive use. This study is limited by a small sample size and was unable to demonstrate statistical significance. Ongoing enrollment may validate this effect. Furthermore longitudinal study is needed to assess the duration of its effect.