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Evaluating Shared Decision-Making in Postpartum Contraceptive Counseling Using Objective Structured Clinical
Brownsyne Tucker Edmonds1, Shelley M Hoffman1, Tatiana Laitano1
1Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Women'S Health Reports (New Rochelle, N.Y.)
|January 13, 2023
Summary
Shared decision-making (SDM) in postpartum contraception counseling is crucial but often lacking. Objective Structured Clinical Examinations (OSCEs) can help train residents to integrate patient preferences and values into contraceptive discussions.
Area of Science:
- Reproductive Health
- Medical Education
- Contraception
Background:
- Shared decision-making (SDM) is vital for increasing the use of postpartum long-acting reversible contraceptives.
- Objective Structured Clinical Examinations (OSCEs) were piloted to assess resident physicians' SDM skills in postpartum contraception counseling.
Purpose of the Study:
- To evaluate first-year obstetrics and gynecology resident physicians' application of SDM during postpartum contraceptive counseling.
- To identify gaps in resident training regarding SDM in postpartum care.
Main Methods:
- First-year OB/GYN residents counseled a standardized patient (SP) on postpartum contraception.
- Encounters were scored using a 10-item SDM rubric, video-recorded, transcribed, and analyzed.
- Descriptive statistics were generated using SPSS version 24.
Main Results:
- Most residents (78%) discussed contraceptive options and timing.
- Only 33% elicited patient preferences, and few discussed breastfeeding implications (6%).
- Critical SDM elements like patient values and fertility goals were largely unaddressed.
Conclusions:
- Residents often fail to incorporate patient preferences and values into postpartum contraceptive counseling.
- Targeted training, such as OSCEs, is necessary to improve resident communication skills for effective SDM.
- Enhanced SDM can support the uptake of postpartum contraception.
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