Abortion training at multiple sites: an unexpected curriculum for teaching systems-based practice
Cara Herbitter1, Vanita Kumar, Alison Karasz
1RHEDI/Center for Reproductive Health Education in Family Medicine, Montefiore Medical Center, Bronx, New York 10467, USA. cherbitt@montefiore.org
Background:
In 1999, the Accreditation Council for Graduate Medical Education endorsed systems-based practice as one of six general competencies.
Purpose:
The objective is to explore the paradigm of teaching residents systems-based practice during a women's health rotation that included abortion training in multiple settings.
Methods:
During a routine women's health rotation, residents from two urban family medicine residency programs received early abortion training at a high-volume abortion clinic and their continuity clinic. Thirty-min semistructured interviews were conducted with all 26 residents who rotated between July 2005 and August 2006. Transcripts were analyzed using thematic codes.
Results:
Through exposure to different healthcare delivery systems, residents learned about systems-based practice, including understanding the failure of the larger system to meet patients' reproductive healthcare needs, differences between two systems, and potential systems barriers they might face as providers.
Conclusions:
Abortion training in multiple settings may serve as a paradigm for teaching systems-based practice during other rotations that include training in multiple sites.
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