Abortion training at multiple sites: an unexpected curriculum for teaching systems-based practice.

BACKGROUND

In 1999, the Accreditation Council for Graduate Medical Education endorsed systems-based practice as one of six general competencies.

PURPOSE: The objective is to explore the paradigm of teaching residents systems-based practice during a women's health rotation that included abortion training in multiple settings.

METHODS

During a routine women's health rotation, residents from two urban family medicine residency programs received early abortion training at a high-volume abortion clinic and their continuity clinic. Thirty-min semistructured interviews were conducted with all 26 residents who rotated between July 2005 and August 2006. Transcripts were analyzed using thematic codes.

RESULTS

Through exposure to different healthcare delivery systems, residents learned about systems-based practice, including understanding the failure of the larger system to meet patients' reproductive healthcare needs, differences between two systems, and potential systems barriers they might face as providers.

CONCLUSIONS

Abortion training in multiple settings may serve as a paradigm for teaching systems-based practice during other rotations that include training in multiple sites.