A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates.
BACKGROUND
Multiple resident-related factors contribute to 'missed opportunities' in providing comprehensive preventive care for female patients, including comfort level, knowledge and experience--all of which are compounded by resident turnover rates. Of particular concern among Internal Medicine (IM) residents is their knowledge and comfort level in performing pelvic exams.


OBJECTIVE
To evaluate the impact of a quality improvement project of implementing a Women's Preventive Health Clinic (WPHC) on addressing gaps identified by needs assessments: residents' comfort and knowledge with female preventive care and cervical cancer screening.


METHODS
The WPHC, a multidisciplinary weekly clinic, focused on preventive services for women with chronic conditions. The alternating didactic and clinic sessions emphasised women's preventive health topics for IM residents.


RESULTS
Sixty-three IM residents participated in WPHC between 2002 and 2005. Pre- and post-test design was used to assess resident knowledge and comfort levels. Cervical cancer screening rates of residents' patients were assessed pre- and post-WPHC initiation. There was a significant improvement in general knowledge (64% correct at pretest vs 73% at post-test, p=0.0002), resident comfort level in discussing women's health topics and performing gynaecological exams (p<0.0002). Cervical cancer screening rates among IM residents' patients improved from 54% (pre-WPHC initiation) to 65% (post-WPHC initiation period).


CONCLUSIONS
The results indicate that a focused resident preventive programme can meet gaps identified by education and needs assessments, and simultaneously have a positive impact on cervical cancer screening rates and thus may serve as a model for other residency programmes.
Singh
Mamta K
MK
Louis Stokes Cleveland Department of Veterans Affairs Medical Center, VA HSR&D Center for Quality Improvement Research, Cleveland, Ohio 44106, USA. mamta.singh@case.edu
Einstadter
Douglas
D
Lawrence
Renee
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007318:Inservice Training; D007396:Internship and Residency; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009820:Ohio; D011315:Preventive Medicine; D011785:Quality Assurance, Health Care; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult