Assessment of resident knowledge and comfort with menopause and openness to integrative therapies: the short term impact of evidence based menopause hand-out
Handler H, Bernhard KA, Baumgardner DJ. Assessment of resident knowledge and comfort with menopause and openness to integrative therapies: the short term impact of evidence based menopause hand-out. J Patient-Centered Res Rev. 2014;1:57.
Presented at 2013 Aurora Scientific Day, Milwaukee, WI
Background/significance: Residents may not receive adequate training regarding menopause, may not be open to integrative therapies, or may prefer conventional therapies despite adequate evidence for the former.
Purpose: To assess resident knowledge, comfort and confidence with menopause and their openness to integrative treatments and determine the short term impact of a patient hand-out.
Methods: We developed an integrative evidence-based patient menopause hand-out, then distributed a survey to 8 OBGYN and 14 Family Medicine residents before and after respondents read it. The survey assessed factual knowledge of menopause (5 items) and asked 4 Likert scale questions regarding comfort, confidence and openness to integrative treatment and life-style modifications. Paired variables were analyzed using McNemar test (nominal data) or Wilcoxon Signed Rank Test (Likert scales). Unpaired variables were analyzed using Chi-Square or Fisher exact test (for nominal data) or Mann Whitney test (Likert scales).
Results: There were 22 respondents, 16 females and 6 males. The median pre-handout survey rating of resident comfort and training preparation regarding menopause symptoms was 2.0/5.0 and 3.0/5.0, respectively. Overall, 2/5 knowledge questions regarding integrative treatment of menopause improved after reading the hand-out (p<0.001), as did comfort treating menopause symptoms (p=0.001), and score on a question indicating willingness to use integrative modalities (p=0.014). The pre-handout survey indicated that OBGYN residents are significantly less willing to use integrative modalities than Family Medicine residents (p=0.001). There were no resident gender or other specialty differences in responses, however sample size limited analysis.
Conclusion: Residents perceive they are not receiving adequate training in integrative menopause therapies, which is a concern given that up to 75% of menopausal women have symptoms. Residents’ level of confidence significantly improved after an evidence based hand-out was reviewed. OBGYN residents may be inherently less willing to use integrative modalities for menopause symptoms. Future studies could assess what is the best way to supply this knowledge in residency so that residents are not resistant to integrative therapy, and that their comfort level is enhanced.