Urinary tract infections are one of the most common hospital-acquired infections, with 70%-80% resulting from catheter-associated urinary tract infections (CAUTIs). We undertook a qualitative study to assess patient perspectives of indwelling urinary catheters using a semistructured interview. We found that patient awareness and patient engagement regarding indwelling urinary catheters and their consequences could be improved in the hospital setting. Implementing educational programs incorporating patient preferences for both health care workers and patients is likely to increase the involvement of patients in decision-making regarding urinary catheters and may lead to a decline in CAUTIs.

Background and Objectives: Pre-operative type and screen (T&S) is typically obtained if a patient is expected to require a blood transfusion; however, in cases of minimal blood loss, routine T&S may be unnecessary. The objective of our study was to examine the utility and cost of routine pre-operative T&S prior to minimally invasive hysterectomies (MIH). Methods: We performed a retrospective chart review of all MIH from January 1, 2018 to December 31, 2019. Patient demographics and surgical parameters were abstracted. The proportion of MIH with a preoperative T&S was compared to the rate of peri-operative blood transfusion. Statistical tests were used where appropriate. Logistic regression was used to examine the relationship between pre-operative hemoglobin (Hgb) and peri-operative transfusion. Results: Patients (n = 307) with a mean age of 54 (standard deviation = 12.6) underwent MIH. T&S was ordered in 42.7% of cases, with 2.9% requiring a blood transfusion. Two-thirds of women receiving a transfusion had a history of anemia (p = .004). Women with a pre-operative Hgb < 10.6 gm/dL (n = 30) had a 27% probability of a transfusion, while those with a pre-operative Hgb > 10.6 gm/dL (n = 264) had a 99% probability of no transfusion. A T&S costs ∼$190 at our institution; if routine T&S was eliminated prior to MIH, cost savings is projected to be ∼$11,590 annually. Conclusion: Approximately 42.7% of MIH had T&S ordered, but only 2.9% received transfusions. Most patients who required a transfusion had a history of anemia. Significant cost savings could be incurred if routine T&S was eliminated prior to MIH.

OBJECTIVES: Cost-utility analyses need a measure to summarize the quality of life in a single index. A single score is often obtained by the EQ-5D questionnaire which is adaptable to each country with score tariffs. In clinical studies it is common to use questionnaires that measure the quality of life profile, such as the SF-36 psychometric questionnaire and then realized the mapping technique to obtain this utility score. Today no specific regression method has been recommended for a such mapping. The purpose of the study is to compare the different regression methods for the conversion of SF-36 into EQ-5D with a French database. METHODS: The EMOCAR study was a French cohort of patients with carotid endarterectomy where 904 adults completed both EQ-5D and SF-36 questionnaires. Ordinary least squares (OLS) and multinomial logit models were implemented to predict the overall score and the response to each of the 5 categories of EQ-5D with two types of specifications: item-based and summary score-based of SF-36. The performance of each model was determined by the estimated average score, the absolute and mean squared errors as well as the percentage of errors. RESULTS: The model including SF-36 items using OLS method has the most accurate predictions comparing to other models. This mapping performance was indicated by a significant prediction of EQ-5D score of 0.7327 and by MAE (0.116), MSE (0.026), R 2 (0.67) and the percentage of an absolute error > 0.1 (43.71%). The model including SF-36 dimensions scores predicted an EQ-5D score significantly different from the EQ-5D observed score. OLS models predicted better EQ-5D score of younger subgroups and multinomial model with SF-36 items older subgroups. CONCLUSIONS: Our models suggest that models using OLS method have good performance for mapping SF-36 onto EQ-5D. Low scores are underpredicted with both models which is already present in the existing literature.

Introduction In the United States, medical education on sexual medicine varies throughout the country and between institutions. With limited standardization, medical students and subsequent trainees have little to no training in how to approach a patient with concerns surrounding their sexual health. In 2018, half of the medical institutions in the United States required formal instruction in sexual medicine. Of those institutions that do include didactic material on sexual medicine, most of the material is dedicated to anatomy, physiology, and sexually transmitted infections, with limited or no information on sexual dysfunction and sexual history taking. Therefore, we identified a need to determine which components of sexual medicine, particularly female sexual medicine, are currently being covered in undergraduate medical education with the goal of proposing and developing standardized curriculum materials to be utilized by medical students during their preclinical education. Objective The aim of this study is to examine current preclinical curricula at all seven medical schools, including six allopathic and one osteopathic institution, in the Chicago, Illinois area to investigate which aspects of female sexual anatomy, physiology, pathology and pharmacology are being taught to medical students. Methods Curriculum materials on female sexual anatomy, physiology and pathology were collected from all seven medical schools in Chicago, Illinois. Courses covering topics on female sexual medicine varied between institutions due to differences in preclinical curriculum and coursework. To standardize our needs assessment, we utilized previous literature to identify specific components of anatomy, physiology, pathology, pharmacology, social sciences, and history and physical exam skills. Upon reviewing each institution's preclinical educational materials, we assessed curriculum content for saturation of specific concepts within each of the above areas. Results Curriculum materials were collected from seven (n=7) total medical schools in the surrounding Chicago, Illinois area. Out of the 7 institutions, 4/7 discussed clitoral anatomy, with 6/7 mentioning the glans, 1/7 mentioning the corona, 2/7 mentioning the clitoral hood, 6/7 mentioning the corpora cavernosa, 4/7 mentioning the corpus spongiosum, 6/7 mentioning the crus, 6/7 mentioning the bulb and 5/7 detailing the clitoral neurovasculature. In addition to the anatomy, 4/7 discussed the physiology of the female orgasm, 3/7 highlighted the rate and epidemiology of female sexual dysfunction (FSD), 3/7 included information on treatment for FSD, 1/7 taught a genitourinary physical exam specific to assessing FSD (external exam, internal exam, pelvic floor assessment), and 6/7 institutions included information on how to take a sexual history asking about sexual function, pleasure, and satisfaction. Conclusion Overall, our focused needs assessment of both allopathic and osteopathic medical schools in the Chicago, Illinois area highlights the need for restructuring of curriculum as it pertains to female sexual medicine and FSD in undergraduate medical education. Next steps include proposing individual curricular recommendations to institutions, due to the variation in current curriculum design, as to how they can better teach on areas surrounding FSD, while also aiming to standardize what medical students are learning during their preclinical years. Disclosure Work supported by industry: no.

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Introduction Sexual health is an essential component of overall health and wellness. It has been demonstrated that roughly one-third of patients in the United States have sexual dysfunction defined as persistent, recurrent problems with sexual response, desire, orgasm, or pain that cause distress. Currently, only half of United States medical schools require formal sexual health instruction, which contributes to the under-preparedness physicians experience in addressing essential issues related to female sexual medicine (FSM). Previous work from our group revealed a need for restructuring pre-clinical medical school curricula as they pertain to FSM and female sexual dysfunction. Thus, a comprehensive education in medical schools’ clinical curricula covering FSM, including standardized screening for sexual dysfunction, assumes an important role. Objective This study focuses on educational content within the obstetrics and gynecology (OBGYN) core clerkships of medical schools to determine if and how FSM is taught to third-year medical students as they interact with patients. Methods OBGYN clerkship syllabi, synchronous lecture materials, and supplemental resources were collected from four medical schools, including three allopathic and one osteopathic institution, in the surrounding Chicago, Illinois area. To standardize our clinical curriculum needs assessment, we limited content review to lectures and resources provided directly from the institution to students during their OBGYN rotation. Upon review of each institution’s clerkship materials, we assessed the goals set forth in each syllabus in terms of lecture or online learning content required for completion by rotating students. Results Clerkship curriculum materials were collected from four (n=4) medical schools. Three of the four institutions dedicate 6 weeks to the core OBGYN clerkship, while one dedicates only 4 weeks. When comparing the specific aims and course content outlines in the rotation syllabi, 3 out of 4 institutions included topics on FSM or female sexual dysfunction. Of these, only one institution had corresponding synchronous clerkship time dedicated to these topics as a one-hour-long required lecture for students. Furthermore, only one program offered training to third-year clinical students in comprehensive sexual history-taking practices, including screening for female sexual dysfunction. The format in which this was fulfilled was through a recommended online module for interested students to complete independently. Conclusions Our focused needs assessment of both allopathic and osteopathic medical schools in the Chicagoland area reveals inconsistencies in the outlined institution-specific goals of their OBGYN clinical rotation and the content that was available and required for students to complete. A single one-hour lecture was included at only one institution specifically dedicated to the screening, diagnosis, and treatment of female sexual dysfunction. This same school was the only of the four to offer any training in screening for female sexual dysfunction, and this was not required, only recommended. Future work includes emphasizing FSM as crucial a domain for medical students to gain proficiency and confidence during clerkships, particularly in a didactic setting that can be utilized clinically on the wards. Disclosure No

Introduction Sexual health is a critical aspect of overall health and well-being. While research shows that roughly one-third of patients in the United States (US) have sexual dysfunction, only half of US medical schools require formal sexual health instruction. With limited standardization, medical students and trainees have little to no training in how to approach a patient with sexual health concerns. This results in under-preparedness among physicians in addressing essential issues related to female sexual medicine (FSM). Therefore, we identified the need to determine which components of FSM are included in medical education. Objective This study examines current preclinical and clinical curricula from medical institutions in the Chicagoland area to evaluate the extent to which FSM is being included in medical education in this major US city. Methods Preclinical curriculum materials on female sexual anatomy, physiology, and pathology, as well as Obstetrics and Gynecology (OBGYN) clinical materials (i.e., syllabi, synchronous lecture materials, and supplemental resources) were collected from all seven medical schools, including six allopathic and one osteopathic institution, in the Chicagoland area. To standardize our needs assessment, we utilized previous literature to identify specific components of medical school content to evaluate. Upon reviewing each institution's educational materials, we assessed goals of each syllabus in terms of required content and evaluated materials for topic saturation. Results Curriculum materials were collected from seven (n=7) medical schools. In the preclinical assessment, 4/7 discussed clitoral anatomy, with 1/7 mentioning the corona, 2/7 mentioning the clitoral hood, and 4/7 mentioning the corpus spongiosum. In addition, 4/7 discussed the physiology of the female orgasm, 3/7 highlighted the prevalence and epidemiology of female sexual dysfunction (FSD), 3/7 included information on treatment for FSD, and 1/7 taught a genitourinary physical exam specific to assessing FSD. When assessing clinical materials, 5/7 institutions dedicate 6 weeks to the core OBGYN clerkship. When comparing the aims specified in the clerkship syllabi, 5/7 institutions included topics related to FSM. Of these, only one institution had corresponding required synchronous clerkship time dedicated to these topics as a one-hour long lecture. One other program offered supplemental case-based gynecology modules including topics such as vulvar and vaginal diseases and chronic pelvic pain, though sexual pleasure, arousal, and libido were not discussed. Furthermore, only one program offered training to third-year clinical students in comprehensive sexual history taking practices, including screening for female sexual dysfunction. The format for this was an optional online module for students to complete independently. Conclusions Our focused needs assessment of both allopathic and osteopathic medical schools in the Chicagoland area reveals inconsistencies in outlined institution-specific course goals and thus highlights the need for restructuring the medical school curricula to include topics related to FSM. Future directions of this work will include proposing curricular recommendations to these institutions with the goal of standardizing and enhancing medical student exposure to FSM topics. FSM is a critical domain that requires consistent representation in medical education to equip physicians to recognize and treat patients with sexual dysfunction. Disclosure No