Longitudinal assessment of a novel curriculum’s impact on attitudes about psychosocial issues in ob/gyn and surgery Jonathan Schaffir, MD; Nicole Verbeck,

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Longitudinal assessment of a novel curriculum’s impact on attitudes about psychosocial issues in ob/gyn and surgery Jonathan Schaffir, MD; Nicole Verbeck, MPH; Doug Post, PhD; Kristen Carpenter, PhD; Jack Stevens, PhD The Ohio State University College of Medicine, Columbus, Ohio. Purpose: To determine the impact of a new curriculum integrating ob/gyn and surgery on student opinions about psychosocial issues. Background: A curriculum launched at the Ohio State University College of Medicine replaced the traditional 6-8 week clerkships with an integrated 16- week rotation that covers elements of women’s health and surgical care, with added emphasis on psychosocial issues. The new rotation included weekly small groups with dedicated time to discuss psychosocial issues relating to clinical scenarios in obstetrics, gynecology, and surgery. Methods BackgroundResults Mean ratings of how important psychosocial issues are to topic (1= not at all; 5 = a great deal) Small group topicBefore curriculum (n=39) After curriculum (n=24) P value Routine prenatal care4.6(0.5) 0.94 GI bleeding3.8(1.0)3.5(0.8)0.27 Organ transplantation4.6(0.7)4.5(0.6)0.70 STIs4.5(0.9)4.5(0.6)0.95 Trauma4.0(1.0)3.7(0.9)0.18 Acute abdomen3.7(1.0) 0.92 Breast cancer4.6(0.6)4.5(0.5)0.43 Urinary incontinence4.2(0.9) 0.87 SICU care4.1(0.9)3.9(0.9)0.37 Preterm delivery4.4(0.7)4.4(0.6)0.71 Birth defects4.8(0.5)4.8(0.4)0.85 Vascular surgery3.8(0.8)4.1(0.8)0.09 Scores demonstrating student interest in and comfort with psychosocial topics rose significantly after completing integrated clinical curriculum Ratings of importance and relevance of psychosocial topics were already high before completing clinical curriculum Whether because of instruction in early medical school or due to inherent bias, students entering the third year of medical school already share a high level of appreciation for the role that psychosocial issues play in surgical and reproductive care Conclusions Statement Before curriculum (n=39) After curriculum (n=24) P value My clinical experience has exposed me to sociocultural issues that impact patient care. 4.1 (0.7)4.4 (0.5)0.08 My clinical experience has exposed me to sociocultural issues that may impact the physician-patient relationship. 4.1 (0.7)4.3 (0.6)0.11 My clinical experience has exposed me to ways that sociocultural issues may influence aspects of treatment. 4.1 (0.8)4.4 (0.6)0.04 In a clinical setting, I have observed how a patient’s sociocultural background influenced health care decisions. 4.2 (0.7)4.4 (0.6)0.12 I have read journal articles, books, and/or other educational material on sociocultural aspects of health care. 3.8 (1.1)3.7 (0.9)0.73 I anticipate that psychological and sociocultural factors will be important issues to consider when I care for patients. 4.6 (0.6)4.5 (0.6)0.24 Psychosocial issues play an important role in providing treatment for women’s gynecological health. 4.5 (0.6)4.6 (0.6)0.57 Psychosocial issues are important aspects of caring for pregnant women. 4.6 (0.5)4.8 (0.4)0.41 It is important for me to know about my patient’s psychosocial concerns when I am planning and treating their surgical issues. 4.5 (0.8)4.5 (0.6)0.76 I am comfortable asking a patient about his or her feelings and moods. 4.1 (0.9)4.5 (0.6)0.08 I am comfortable asking a patient about his or her culture and family background. 4.0 (0.8)4.2 (0.6)0.31 I understand how sociocultural issues can impact my plan of care for my patients. 4.1 (0.7)4.5 (0.5)0.04 Subjects Students before and after clinical instruction in obstetrics/ gynecology and surgery Intervention “LSI” curriculum featuring integrated surgery and ob/gyn curriculum with small group emphasis on psychosocial topics Measurements Psychological Medical Inventory for Students (PMI-S) scale Measures student interest and ability in psychosocial aspects of patient care Program evaluation re: psychosocial components Ratings of exposure to and comfort with psychosocial topics Ratings of importance of psychosocial approach to topics covered in small groups p<0.001 Mean ratings of agreement with statements (5 = strongly agree; 1 = strongly disagree)