Context: U.S. Latinas have lower rates of contraceptive use and report more negative counseling experiences compared to non-Latina white women. Patient-centered approaches to contraceptive counseling are desired among Latinas and are also associated with patient satisfaction; yet, clinicians may not always use counseling methods that best support decision-making among marginalized groups. Objective: To examine Latinas' expectations of physician communication about contraceptive side effects, reported importance of personal knowledge about side effects, and the association of these with contraceptive use and use consistency. Materials and Methods: One hundred three self-identified Latinas aged 15–29 years at two urban federally qualified health centers completed a survey measuring factors associated with contraceptive use and consistency. Bivariate analysis was used to assess demographic and contraceptive information preferences. Associations between categorical variables were assessed using two-sided Fisher's exact tests. Continuous variables were compared using two-sided t -test. Results: The majority of respondents (85%) expected physicians to tell them about birth control side effects and reported that this information is important to use contraception, regardless of current contraceptive use. Among inconsistent and nonusers, importance of knowledge of side effects depended on expectations of information-sharing from physicians ( p < 0.05). Conclusions: Expectations regarding side effect information-sharing by physicians and patient knowledge of side effects are important for the contraceptive decision-making process of this Latina group, regardless of contraceptive use. Clinicians engaging in contraceptive counseling should focus on providing clear and accurate information about side effects of discussed methods to facilitate informed decision-making and equitable, patient-centered contraceptive care for this vulnerable population.
Medical schools in the United States, as well as across the world, have undergone curriculum reform in the delivery of anatomy courses, which recently required social distancing during the COVID-19 pandemic. The aim of this study was to compare total teaching time across three major types of anatomy curricular formats in preclerkship and clerkship phases of US medical education, and quantitatively describe which tools/teaching modalities are used within different curricula structures across preclinical and clinical anatomy courses as well as evaluate the relative percent of the curricular time their use comprised prior to and during the pandemic. An optional survey instrument (with skip patterns), developed using Qualtrics Software and approved by the author’s home Institutional Review Board, was sent to anatomy course directors at 152 allopathic medical schools, from all four geographic and size categories delineated by the Association of American Medical Colleges. Data were analyzed using Qualtrics XM Stats iQ software. Thirty allopathic US medical institutions were represented in this survey, among which there existed an even distribution across the three integration formats with the majority of instruction occurring in the first-year curriculum. Total anatomy teaching time varied widely, but cadaveric dissection and lectures were the predominant teaching modalities, even during the pandemic. Traditional dissection comprised the majority of contact time compared to alternative modalities, but less than half of respondents currently incorporate new modalities. Approximately half of the schools changed to an all-virtual format for 2020–2021. Among those that were fully virtual, time using 3D anatomy significantly increased. Our results demonstrate that traditional anatomic educational practices remain the mainstay of medical education. Surprisingly, total contact hours in anatomic education varied widely, but there were striking similarities in the use of traditional tools.
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