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- Title
Teaching women's health skills: confidence, attitudes and practice patterns of academic generalist physician.
- Authors
Dixon, James G; Bognar, Bryan A; Keyserling, Thomas C; Du Pre, Connie T; Xie, Sharon X; Wickstrom, Glenda C; Kolar, Maria M
- Abstract
<bold>Objective: </bold>This study assesses the readiness of academic general internists to perform and precept a commonly utilized women's health examination, and procedural and management skills.<bold>Design: </bold>Full-time faculty from divisions of general internal medicine and departments of family practice in 9 states reported their encounter frequency with, comfort precepting, and the importance they ascribe to several examination, procedural, and management skills relevant to women's health care; and their attitudes toward performing the pelvic exam and obtaining a Pap smear.<bold>Measurements and Main Results: </bold>A total of 331 general internal medicine physicians (GIMs) and 271 family medicine physicians (FPs) completed questionnaires, with response rates of 57% and 64%, respectively. More than 90% of GIMs and FPs indicated they were confident precepting the breast and Pap/pelvic examinations. A relatively small percentage of GIMs expressed confidence precepting the management of dysfunctional uterine bleeding (22%), initiating Depo-Provera (21%), and initiating oral contraceptives (45%), while a substantially larger percentage indicated that these skills were important to primary care practice (43%, 44%, and 85%, respectively). Although GIMs indicated they were confident precepting the Pap/pelvic exam, they were less likely than FPs to agree with the following statements: "Performing routine Pap smears is a good use of my time" (GIMs 65%, FPs 84%); "It is a waste of health care dollars for primary care physicians to refer patients to gynecologists for routine Pap/pelvic exams" (GIMs 69%, FPs 90%); "I feel very well trained to do a routine bimanual exam" (GIMs 71%, FPs 98%), and "The clinic where I practice is well equipped to do a Pap smear" (GIMs 78%, FPs 94%).<bold>Conclusions: </bold>Although most academic GIMs are confident precepting the breast and pelvic examination, only a minority are confident precepting the management of dysfunctional uterine bleeding, initiating Depo-Provera, and initiating oral contraceptives. These findings suggest that a number of academic GIMs may not be prepared or willing to perform or precept important women's health skills.
- Subjects
ATTITUDE (Psychology); CLINICAL competence; COMPARATIVE studies; FAMILY medicine; HEALTH education; INTERNAL medicine; LEARNING; RESEARCH methodology; MEDICAL cooperation; MEDICAL personnel; RESEARCH; SELF-perception; TEACHING; WOMEN'S health; LOGISTIC regression analysis; EVALUATION research
- Publication
JGIM: Journal of General Internal Medicine, 2003, Vol 18, Issue 6, p411
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1046/j.1525-1497.2003.10511.x