1. Student Interest in Learning about Fertility Awareness Based Methods An Unaddressed Competency in the Curriculum Lucy Guevara, Georgetown MS4 Marguerite Duane, MD, MHA, FAAFP Megan Janni, MD, Ashley Stone, MD

2. Disclosures No Disclosures

3. Study Objectives: Identify key indications for teaching fertility awareness based methods (FABMs), including family planning and medical applications. Review students’ familiarity with evidence based FABMs, including effectiveness rates, as well as their desire to learn more. Discuss ways in which medical school and/or residency faculty can address the knowledge gap about evidence based FABMs, including modalities most preferred by students

4. Fertility Awareness Based Methods (FABMs) Evidence Based FABMs which provide information about a woman’s potential fertility so she can make informed family planning choices Cervical Mucus Urinary Metabolites Basal Body Temperature Marquette Method Billings Ovulation Method Creighton Model System Two-Day Method Sympto-Thermal Methods Cycle Length Standard Days Method CycleBeads

5. Importance of Teaching and Learning FABMs During Medical School When presented with information about FABMs, 22-61% of women express interest in using FABMs to achieve or avoid pregnancy. 1 Many women express an interest in using FABMs, however only 1% of them came to use them due to lack of advice from medical practitioners. 2 Despite the efficacy of FABMs, the medical school curriculum does not typically provide students with sufficient instruction to address patients’ needs or address student interest in learning more about FABMs.

6. Relevance – Patients’ Interest and Benefit of FABM Use Safe and effective Affordable - Cost-effective No artificial hormones to disrupt women’s physiology No medical or environmental side effects Educates women about their menstrual cycles Empower women and couples to appreciate fertility Versatile – family planning and health monitoring

7. Rates of Effectiveness*: FABMs vs. Conventional Birth Control *Women with Unintended Pregnancy Within 1 Year of Use MethodTypical Use (%)Perfect Use (%) None85 IUD (Mirena)0.2 Combined OCPs /Minipill90.3 Condom (Male)182 Billings10.51.1 Creighton Model *0.5 Two Day Method13.73.5 Sympto-Thermal1.6 – 2.20.4 – 0.6 Marquette10.60.6 Standard Days Method125

8. Methods Brief online survey to assess medical students’ familiarity with FABMs Student researchers from 3 different medical schools identified contacts from 4 other geographically distinct medical schools to ensure broad representation of students

9. Methods Surveyed pre-clinical medical students at 7 different medical schools –Georgetown University –UT Southwestern University –Wayne State University –Texas A&M Health Science Center –Texas Tech University –Dartmouth –University of Pennsylvania A total of 654 medical students completed the survey –Response rate: 23%

10. Medical Student’s Level of Familiarity With FABMs

11. Medical Student Interest in Learning More Regarding FABMs

12. What can FABMs be used for?

13. Which of the Following FABMs Have Been Presented in the Medical School Curriculum?

14. Effectiveness of FABMs vs. OCPs for Preventing Pregnancy

15. Should Physicians Have Knowledge of FABMs?

16. Are Students Interested in Learning More about FABMs?

17. Preferred Ways to Learn About FABMs

18. Conclusion Students have limited familiarity, knowledge and exposure to FABMs Students recognize that FABMs may have many different applications Students are interested in learning more: 1.Most interested in learning how to teach different FABMs 2.Also interested in learning via live lectures or self directed online classes

19. Next Steps Development of an online elective Consider replicating survey at: –Additional medical schools –Family Medicine, OB/Gyn or Pediatric residencies –Nursing or PA schools Launch Student Ambassador program

20. References 1.Fehring, R. The Future of Professional Education in Family Planning. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2004; 36. 2.Mosher WD, Jones J. Use of Contraception in the United States: 1982- 2008. National Center for Health Statistics. Vital Health Stat. 2010; 21. 3.Manhart MD, Duane M, Lind A, et al. Fertility Awareness-Based Methods of Family Planning: A review of effectiveness for avoiding pregnancy using SORT. Osteopathic Family Physician. 2013; 5-6. 4.Frank-Hermann P, Heil J, Gnoth C, eta l. The effectiveness of fertility awareness based method to avoid pregnancy in relation to a couple’s sexual behavior during the fertile time: a prospective longitudinal study. Hum Reprod; 2007: 1310-1319. 5.Pallone MD S, Bergus MD G. Fertility Awareness-Based Methods: Another Option for Family Planning. JABFM; 2009: 147-157.

21. Thank You! Dr. Megan Janni and Dr. Ashley Stone Dr. Marguerite Duane Dr. Ling Cai & Bo Chen

22. Questions?

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