Making Sense of Medical Education: An Examination of Contraception Counselling, Unplanned Pregnancy Counselling, and Abortion Services Curricula in Ontario Medical Schools

Background: To date, little information exists about contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. Identifying existing curricula, including influences on whether and how curricula are delivered, is an essential starting point for evaluative processes. Purpose and Objectives: The purpose of this study was to explore contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. The objectives were to 1) identify the existence of such curricula in undergraduate (preclinical, obstetrics and gynecology clerkship, and family medicine clerkship) and post-graduate (obstetrics and gynecology and family medicine) programs; and 2) explore factors influencing the existence and form of these curricula from the perspective of program directors. Design: An exploratory qualitative approach was used for this study whereby, Ontario program directors responsible for contraception counselling, unplanned pregnancy counselling, and abortion services curricula were interviewed. Results: Overall, the inclusion of routine curricula in contraception counselling, unplanned pregnancy counselling, and abortion services was limited and variable between schools, as well as within clerkship and post-graduate programs. Program directors were often uncertain about iii whether such routine curricula were present in their programs. Four factors were found to influence whether these curricula were included in a program: 1) program structure, 2) program resources, 3) the interests of residents/students, and 4) personal philosophy of the program director. A typology was developed to understand how program directors resolved uncertainty when asked about the existence of these curricula in their programs. The emergent sensemaking typology revealed strategies used by directors to either justify the current system of medical teaching (i.e., defending the status quo) or support change (i.e., responsive). Program directors were consistent across programs in terms of the factors they identified as influencing the curriculum offered. The perceived impact of these factors varied according to the sensemaking processes employed by each director. Conclusions: This study provides an outline of curriculum variability within and between medical school programs. Further, if offers a typology of the ways program directors explain their uncertainty regarding the inclusion of these curricula in their programs. In so doing, program director sensemaking as a key influence on the curriculum is revealed.

Department dc:contributor.department

Dalla Lana School of Public Health

Year dc:date.issued

2011

Author dc:creator

• Perkins-Ceccato, Natalie

Advisor dc:contributor.advisor

• Ferris, Lorraine E.

• Contraception Counseling, Unplanned Pregnancy Counselling, Abortion Services, Medical Education, Family Medicine, Obstetrics and Gynecology, Routine, Training, Curricula, Program Directors

Language dc:language.iso

en_ca

Handle dc:identifier.uri

http://hdl.handle.net/1807/26222

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/26222