Medical Student Education in Pregnancy Options Counseling: A Systematic Review [2C

Abstract

INTRODUCTION: Background: Non-directive pregnancy options counseling is an important skill for medical students to learn as physicians of multiple specialties will counsel patients regarding their desired pregnancy outcome. APGO lists options counseling as a “shows how” skill for all undergraduate medical students. Despite this, it is only taught at 36% of medical schools with an average of 60 minutes spent per school. Thus, students and faculty have attempted to supplement existing curriculum due to concerns about medical student competency. PURPOSE: To review peer-reviewed literature on pregnancy options counseling in undergraduate medical education. METHODS: A systematic search of Google Scholar and PubMed for post-2000 literature using keywords, “pregnancy options counseling,” “medical student education,” “OSCE,” “student competency.” Inclusion criteria were English language studies of M.D. and D.O. programs in North America with a discussion of both pregnancy options counseling and medical education. RESULTS: Educational modalities used most frequently included objective structured clinical examinations (OSCEs) (57%), novel clinical and patient experiences (43%), faculty run workshops (38%) and online teaching modules (14%). The most popular timing of interventions was 3rd year OB/GYN and family medicine clerkships (71%). Students routinely left out the following topics in counseling: adoption, intimate partner violence and reproductive coercion. CONCLUSION: Common educational modalities utilized to supplement medical student education include online modules, clinical shadowing, novel clinical experiences, role play, and OSCEs. The optimal combination of these modalities has yet to be elicited. However, much work has been done in the last five years to advance the OSCE as a learning tool for options counseling.