P2C113: Communicating and Connecting: Developing a Curriculum on Prenatal Counseling for Residents

Background: Late preterm infants comprise 75% of premature births and are born physiologically immature with a greater risk of health complications than term infants. Residents in pediatrics (peds), obstetrics (OB) and family medicine (FM), are often called upon to provide prenatal counseling for families expecting late preterm infants. Training opportunities typically focus on the very preterm infants and there is a lack of known prenatal counseling curricula that focus on late preterm counseling skills. Our aim was to perform a ‘needs based’ assessment and assess a curriculum to teach residents, of various specialties, skills in late preterm prenatal counseling.

Methods: Participants were recruited from the University of Washington peds, OB, and FM residency programs to complete an anonymous pre and post survey, 30 minute didactic, and virtual simulation of a late preterm consult. Data was collected on confidence in elements of a late preterm prenatal counseling visit based on the previously validated Antenatal Counseling Milestones Scale (ACoMS).

Results: 69 pre-surveys and 20 post-surveys were completed. Most participants were in their first year of training and 90% had little to no previous experience with prenatal counseling. Prior to the curriculum, participants felt most confident in their ability to build rapport, identify emotional cues, and respond to those emotions and least confident about sharing medical information about premature babies (Figure 1). After the curriculum, there was improvement across all elements that were assessed, with a majority of participants feeling quite or extremely confident (Figure 2). There was improvement in self-expertise with the curriculum. Most (64%) of participants identified as "novices" pre-curriculum, which improved to 60% identifying as "advanced beginners" post-curriculum. Additionally, the percentage self-identifying as "competent" or "proficient" increased from 7% to 27%.

Conclusion: Most residents had limited exposure to prenatal counseling for late preterm infants and were least confident in sharing information about late preterm babies and making recommendations based on family’s values. After our curriculum initiation, there was improvement in comfort levels for all assessed elements and self-assessed expertise demonstrating usefulness and effectiveness of our curriculum. Our post-survey results are limited by number of responses, though data collection is ongoing. The results of this evaluation will help adjust our curriculum for essential late preterm prenatal counseling.