Medical Education Research 2019 Research Projects

Project Title: Assessing Knowledge of and Preference for Long-Acting Reversible Contraceptives in a Student-Run Free Healthcare Clinic Network

Faculty Mentor’s Name: Breann Garbas
Email: breann.garbas@pap.ufl.edu

Student’s Name: Daniela Ramirez
Email: danielar96@ufl.edu

Project Description:

Contraception and family planning are not only essential components of preventive health care to women in general, but also provide a significant reduction of cost to the healthcare system. During the past few decades, there has been a significant decrease in the rate of unintended pregnancies, in large part due to the use of longer-acting and more effective contraceptive methods known as LARCs. (1) However, about half of pregnancies in the United States remain unintended and cost taxpayers $21 billion each year. (2) In Florida alone, $1.3 billion was spent in 2010 on births, abortions, and miscarriages resulting from unintended pregnancies. (2). A recent report suggests that if all women had access to effective contraception including LARC methods, there would be an estimated $12 billion savings in public health care costs. (3). Furthermore, a 2015 study assessing women’s choice in contraceptive use in Planned Parenthood clinics across the country indicated that when long-acting reversible contraceptives were available, women were more likely to choose these methods and less likely to become pregnant. (4)

There are significant disparities in rates of unintended pregnancies when analyzing women by socioeconomic status (SES), age, and race. Historically, the rate of unintended pregnancies among low-income and less educated women has increased while the rate for higher income and more educated women has decreased.(5) Many women, especially uninsured and with low SES, face barriers to obtaining LARC methods of birth control due to high out of pocket costs, transportation limitations, and lower health literacy. (6) As a result, they often rely on short-acting hormonal methods of contraception with higher failure rates due to easy misuse. A recent study suggested that by promoting and providing long-acting reversible contraceptives at no cost, there can be a significant reduction in unintended pregnancies. (7) Further, a study showed that once financial barriers were removed almost two-thirds of women chose long-acting reversible contraception methods. (6)

The Equal Access Clinic is a student-run free healthcare clinic that provides care to Gainesville’s uninsured and underinsured residents. The generally low SES patients seen at Equal Access makes access to long-acting reversible contraception (LARC) a major priority for our clinics. Although we currently have funding for multiple forms of LARCs, we would like to help other free clinics prioritize which contraceptive methods to offer at their clinics. Our aim is to identify the preferred contraceptive option of choice for low-income women in Alachua County.

  1. Kost K, Unintended Pregnancy Rates at the State Level: Estimates for 2010 and Trends Since 2002, New York: Guttmacher Institute, 2015,
  2. Sonfield A and Kost K, Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010, New York: Guttmacher Institute, 2015
  3. Welti, K., & Manlove, J. (2017). How increasing the use of effective contraception could reduce unintended pregnancy and public health care costs. Child Trends, 2017(03). Retrieved from https://www.childtrends.org/wp-content/uploads/2017/03/2017-03IncreasingEffectiveContraception.pdf
  4. Harper, C. C., Rocca, C. H., Thompson, K. M., Morfesis, J., Goodman, S., Darney, P. D., . . . Speidel, J. J. (2015). Reductions in pregnancy rates in the USA with long-acting reversible contraception: A cluster randomised trial. The Lancet,386(9993), 562-568. doi:10.1016/s0140-6736(14)62460-0
  5. Finer, L. B., & Henshaw, S. K. (2006). Disparities in Rates of Unintended Pregnancy in the United States, 1994 and 2001. Perspectives on Sexual and Reproductive Health,38(2), 90-96. doi:https://doi.org/10.1363/3809006
  6. Secura, GM, Allsworth, JE, Madden, T, Mullersman, J, & Peipert, JF. (2016). The Contraceptive CHOICE Project: Reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol., 203(2), 115.e1-115.e7. doi:10.1016/j.ajog.2010.04.017
  7. Peipert JF, Madden T, Allsworth JE, Secura GM. Preventing unintended pregnancies by providing no-cost contraception. Obstet Gynecol. 2012;120(6):1291–1297. doi:10.1097/AOG.0b013e318273eb56

Project Title: Can the Medical Humanities Enhance Empathy in Medical Students?

Faculty Mentor’s Name: Nina Stoyan-Rosenzweig
Email: nstoyan@ufl.edu

Student’s Name: Catherine Elko
Email: celko@ufl.edu

Project Description:

Empathy, compassion, and sympathy are just some of the characteristics make us human. In particular, empathy has been viewed as central to the physician-patient relationship (Garden, 2007). There has been growing concern in the medical community that the rigors of medical training are making students emotionally numb. Some worry that the challenges of medical education and the overwhelming focus on the hard sciences are beginning to inhibit the growth of students’ empathy (Pedersen, 2010).

The specific aim of this project is to explore the effects of the implementation of medical humanities on the development of student empathy, compassion, and sympathy. The paper will start by defining empathy, and then discuss the ways in which students’ empathy has shown to decrease in traditional medical school settings. The paper will explore different modes of humanities intervention in medical education (poetry, literature, visual arts, etc). Before concluding, the paper will consider opposing viewpoints as well as viewpoints of medical students on the implementation of the humanities into medical education.

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