As the burden of unintended pregnancy and abortion in the United States now falls disproportionately to poor and uninsured women, appropriate contraceptive counseling requires strong limited health literacy communication skills. This standardized patient case was developed to assess patient-centered counseling skills for long acting reversible contraceptive (LARC) methods, low health literacy communication skills, and appropriate use of the Medical Eligibility Criteria for Contraceptive Use. The patient is a 27-year-old woman who underwent suction curettage for an incomplete abortion 2 weeks earlier in the emergency room and presents for a routine postoperative visit. The student assumes her care from an attending or resident who has already examined the patient and found her without complications, but has not yet determined possible contraceptive needs. All reviewers found the standardized patient realistic and appropriately detailed. Their recommended changes were for greater detail in risks, benefits, and efficacy for the methods and reassignment of some competencies to a higher trainee level.
- Determine whether a pregnancy was intended and/or desired.
- Determine a patient's baseline experience, knowledge, and preferences regarding contraception.
- Determine her risk for sexually transmitted diseases.
- Determine desire for and timing of future pregnancies.
- Determine desire for/tolerance of amenorrhea and/or irregular bleeding with a contraceptive method.
- Determine ability to pay for and obtain desired method.
- Explain efficacy and clinically important risks of methods most appropriate.
- Explain common side effects of intended method.
- Explain how to initiate a method.
- Apply the WHO Medical Eligibility Criteria.
- Conclude the interview with plan for follow-up.
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