Promotion of primary care screening in obstetrics and gynecology residency training

Abstract

We studied the effectiveness of a paper checklist prompt in improving obstetric/gynecologic residents' documentation and implementation of preventive health care procedures among women aged 40 years and older presenting for an annual examination. The study hypothesized that the presence of a prompt sheet would increase compliance with the performance and documentation of recommended primary care procedures in a residency setting. Eight obstetric/gynecologic residents, postgraduate year II–IV, participated in this prospective cohort study. A 10-item checklist prompt sheet of American College of Obstetricians and Gynecologists-recommended preventive procedures was placed nonsystematically in the front of eligible patients' charts. Residents in the study group received the checklist and were instructed to use it as a reminder to perform procedures and counseling and as a tool to document completion of those tasks. Residents consulted with 104 women aged 40 years and older who presented for their annual examinations between September 1995 and June 1996. Of those patients, 19% were seen by a resident in the study group. Residents in the study group were significantly more likely to perform and document procedures than residents in either control group. Based on the data from this study, we concluded that simple prompt sheets inserted in patients' charts effectively remind physicians to perform important preventive procedures.