The practical abortion curriculum and training for independent/freestanding clinics (PRACTICE) project
Awarded 2018
Complex Family Planning Fellowship Research
Elissa Serapio, MD, MPH
University of California, San Francisco

Background: Residents often receive abortion training in hospital-based settings; however, freestanding abortion clinics are a uniquely different setting, as there may be only one physician (and no anesthesiologist or registered nurse, RN). Prospective freestanding clinic providers have knowledge gaps related to handling rare emergencies and performing tasks that are typically done by RNs in larger clinics. Two challenges related to these knowledge gaps may prevent abortion providers from beginning to work in freestanding clinics: (1) prospective provider’s fear of being a solo physician lacking sufficient training; and (2) clinic administrators’ concern about hiring a provider without the training to practice in this unique clinical setting.
To our knowledge, there is no standardized curriculum that prepares physicians to work in freestanding abortion clinics. A curriculum that focuses on non-procedural aspects of abortion care, such as management of oversedation and starting IVs, could fill these knowledge gaps and potentially remove the challenges described above.
1.    Develop an online curriculum to prepare prospective providers to work in freestanding abortion clinics.
2.    Pilot test the curriculum and gather recommendations for improvement. Outcomes to be assessed include: acceptability of the curriculum, determination of whether objectives were met based on a comparison of quiz scores before and after the curriculum, and an assessment of intention to work and self-efficacy around working in freestanding clinics.
Methods: Using the Kern model of curricular development, we will 1) identify key topics, using a Delphi method to gather input from a panel of experts; 2) assess the needs of learners to inform learning strategies; 3) delineate goals and objectives; 4) draft the educational content; 5) publish the series of lecture-based modules online; and 6) evaluate the content through a pilot test among current and former family planning fellows who express interest in providing abortion services in freestanding clinics.
Potential Impact/Results: The pilot study will enable revisions of the initial draft of the curriculum and inform a larger study to assess longer-term outcomes. The longer-term goal is to increase the number of providers who work in freestanding abortion clinics. Though there are many factors that contribute to a provider’s intention to work in a given setting, we aim to remove the barrier related to lacking this required specialized knowledge.