title: Advancing non-directive pregnancy options counseling skills: A pilot Study on the use of blended learning with an online module and simulation.
abstract: Limitations on didactic time pose barriers to teaching non-directive pregnancy options counseling. This study set out to explore the use of an online module to support trainee performance in a pregnancy options counseling standardized-patient exercise implemented among third-year medical students, and to examine the effect of clinical experience on student performance.
  
  
  
  An online module was developed. A convenience sample of forty-six student performances in a family medicine clerkship participated in a standardized patient exercise. Trained faculty rated performances. Students completed a self-assessment and provided feedback on the online module. Chi-square and Mann-Whitney-U tests were used to analyze data. Three coders qualitatively examined narrative student comments.
  
  
  
  Thirty-four students passed, 11 achieved a minimal pass, and one failed. The mean global rating from faculty was 2.8 (pass). Students with prior clinical experience significantly outperformed those without on the global rating scale with mean scores of 3.1 compared to 2.7, respectively (p=.044). All students agreed that the online module helped prepare them for the exercise. Qualitative analysis of students' feedback on the module revealed strengths in content and pedagogy. In their self-assessments, all but two students referred to content explicitly conveyed in the module.
  
  
  
  All students agreed that an online module supported their performance of non-directive pregnancy options counseling skills. Prior clinical experience was associated with improved performance. This module, along with the simulated exercise, can be implemented as a blended learning exercise without additional faculty teaching effort in standardized patient resource centers.
  
  
  
  Students agreed that an online module facilitates simulated performance of non-directive pregnancy options counseling skills. Future work should compare the impact of this approach to others, and explore the additional training needed to maintain and build on initial learning.
authors.affiliation: Department of Obstetrics and Gynecology, Herbert Wertheim College of Medicine, Florida International University, 11200, SW 8th Street, Miami, FL, USA; Office of Medical Education, Herbert Wertheim College of Medicine, Florida International University, 11200, SW 8th Street, Miami, FL, USA. Electronic address: clupi@fiu.edu.
authors.forename: Carla
authors.initials: C
authors.lastname: Lupi
authors.affiliation: Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, 11200, SW 8th Street, Miami, FL, USA; Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200, SW 8th Street, Miami, FL, USA. Electronic address: mward@fiu.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Ward-Peterson
authors.affiliation: Office of Medical Education, Herbert Wertheim College of Medicine, Florida International University, 11200, SW 8th Street, Miami, FL, USA. Electronic address: wchang@fiu.edu.
authors.forename: Winnie
authors.initials: W
authors.lastname: Chang
mesh_terms: D016009:Chi-Square Distribution; D002982:Clinical Clerkship; D002983:Clinical Competence; D003376:Counseling / Q000193:education*; D003479:Curriculum; D004645:Empathy; D005193:Family Planning Services / Q000193:education*; D005260:Female; D058006:General Practice / Q000193:education*; D006801:Humans; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011247:Pregnancy; D036301:Qualitative Research; D000066908:Simulation Training; D018709:Statistics, Nonparametric; D013337:Students, Medical
keywords: Communication skills; Objective structured clinical examination; Online module; Pregnancy options counseling; Undergraduate medical education; Women's health