VA Mini Residencies Advance Clinical Breast Exam Skills

The Journal of Women’s Health published a landmark report on the 10 year mini-residency training program provided to thousands of VA Primary Care Providers (PCPs). MammaCare provided the hands-on Clinical Breast Exam CBE Simulator-Trainer  for the VA mini-residency program. The PCPs retained and used the performance skills acquired at the mini-residences reporting significantly greater comfort/confidence levels in performing clinical breast exams.

Improving Public Health

The MammaCare CBE Simulator-Trainer was developed and validated with the support of the National Science Foundation and was adopted for clinical training in the Woman Veterans Health Program as well as in CDC’s sponsored National Breast and Cervical Early Detection and Prevention Programs (NBCCEDP).  The skill-based technology has begun training advanced clinicial students in U.S. colleges of nursing and medicine to advance clinical breast exam skills. 

Mini-Residencies Improve Care for Women Veterans: A Decade of Re-Educating Veterans HealthAdministration Primary Care Providers

Linda Baier Manwell, MS, Melissa McNeil, MD, MPH, Megan R. Gerber, MD, MPH, Samina Iqbal, MD, Sarina Schrager, MD, MS, Catherine Staropoli, MD, Roger Brown, PhD, Laure Veet, MD, Sally Haskell, MD, MS, Patricia Hayes, PhD, and Molly Carnes, MD, MS

Background: Many primary care providers (PCPs) in the Veterans Health Administration need updated clinical training in women’s health. The objective was to design, implement, and evaluate a training program to increase participants’ comfort with and provision of care to women Veterans, and foster practice changes in women’s health care at their local institutions. 

Methods: The Women’s Health Mini-Residency was developed as a multi-day training program, based on principles of adult learning, wherein knowledge gleaned through didactic presentations was solidified during small-group case study discussions and further enhanced by hands-on training and creation of a facility-specific action plan to improve women Veterans’ care. Pre, post, and 6-month surveys assessed attendees’ comfort with and provision of care to women. The 6-month survey also queried changes in practice, promulgation of program content, and action plan progress 

Results: From 2008 to 2019, 2912 PCPs attended 26 programs. A total of 2423 (83.2%) completed pretraining and 2324 (79.3%) completed post-training surveys. The 6-month survey was sent to the 645 attendees from the first 14 programs; 297 (46.1%) responded. Comparison of pre-post responses indicated significant gains in comfort managing all 19 content areas. Six-month data showed some degradation, but comfort remained significantly improved from baseline. At 6 months, participants also reported increases in providing care to women, including performing more breast and pelvic examinations, dissemination of program content to colleagues, and progress on action plans

Keywords: Veterans health; clinical competence; continuing; curriculum; education; primary health care; women’s health.

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