Can Experiential–Didactic Training Improve Clinical STD Practices?

Dreisbach, Susan; Devine, Sharon; Fitch, J. G.; Anderson, Teri; Lee, Terry; Rietmeijer, Cornelis A.; Corbett, Kitty

doi:10.1097/olq.0b013e3182045306

Cited by 12 publications

(7 citation statements)

References 25 publications

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“…They should be available for low‐threshold referral and consultation. They should also be a resource for sentinel surveillance research, including gonococcal resistance , and for research in the development of new STI diagnostics and treatment, as well as for clinical training and workforce development .…”

Section: Discussion: Improving Sti Servicesmentioning

confidence: 99%

Improving care for sexually transmitted infections

Rietmeijer

2019

J Intern AIDS Soc

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Introduction Rising rates of reported sexually transmitted infections (STIs) in the US and Europe are a public health priority and require a public health response. The diagnosis and treatment of STIs have been the cornerstone of STI control and prevention for many decades and, historically, publicly funded STI clinics have played a central role in the provision of STI care. Innovations in non‐invasive diagnostic techniques, especially nucleic acid amplification tests in the mid‐1990s, have facilitated the expansion of STI testing and treatment outside traditional STI clinics, including primary care, family planning, school‐based health, outreach, corrections, emergency departments and HIV prevention and care settings. As a result, the continued need for categorical STI clinics has been debated. In this Commentary, we discuss how practice can be improved at each level of STI care. Discussion STI practice improvement plans should be tailored to the strengths of each care setting. Thus, in primary care, the focus should be on improving STI screening rates, the provision of hepatitis B and human papillomavirus vaccines and, in jurisdictions where this is legal, expedited partner therapy for gonorrhoea and chlamydia. Extragenital (pharyngeal and rectal) testing for gonorrhoea and chlamydia should be available in settings serving populations more vulnerable to STI acquisition at these anatomical sites, including men who have sex with men. In family planning settings with a mostly female patient population, there are opportunities to serve male partners with both contraceptive and STI services. STI screening rates can also be improved in other settings serving populations at increased risk for STIs, including school‐based clinics, emergency departments, correctional health facilities and providers of HIV care and prevention. These improvements are predominantly logistical in nature and not dependent on extensive STI clinical expertise. While some providers in these settings may have the clinical knowledge and skills to evaluate symptomatic patients, many do not, and STI speciality clinics must be available for consultation and referral and evolve from “safety net” providers of last resort to STI centres of excellence. Conclusions A tailored practice improvement plan can be envisioned to achieve an optimally functioning STI care continuum.

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Section: Discussion: Improving Sti Servicesmentioning

confidence: 99%

Improving care for sexually transmitted infections

Rietmeijer

2019

J Intern AIDS Soc

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“…The barriers include a range of issues encountered in clinical interactions with patients such as lack of time, lack of availability of educational resources and training, lack of reimbursement, difficulties in maintaining privacy/confidentiality, and lack of counselling. Training has been identified as one of the major means of improving the quality of STI care [52, 53]. Physicians’ training has been reported to be associated with improved physicians’ comfort with STI patients [43, 54]; lower prejudicial attitude toward people living with HIV/AIDS [55]; improved skill for risk assessment, clinical examination, diagnosis and treatment [52]; more willingness to offer STI testing to patients [36]; improved patient adherence [56] and improved patient’s outcomes [53].…”

Section: Discussionmentioning

confidence: 99%

Physicians’ perceived barriers to management of sexually transmitted infections in Vietnam

Minichiello

Hussain

et al. 2014

BMC Public Health

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BackgroundSexually transmitted infections (STIs) are a public health problem in Vietnam with sub-optimal care in medical practice. Identifying practitioners’ perceived barriers to STI care is important to improve care for patients with STIs.MethodsA cross-sectional survey was conducted among 451 physicians. These physicians were dermatology and venereology (D&V) doctors, obstetrical/gynaecological (Ob/Gyn) doctors, general practitioners, and assistant doctors working in health facilities at provincial, district and communal levels in three provinces in Vietnam.ResultsAlmost all (99%) respondents mentioned at least one barrier to STI care. The barriers were “lack of STI training” (57%), “lack of professional resources” (41%), “lack of time” (38%), “lack of reimbursement” (21%), “lack of privacy/confidentiality” (17%), “lack of counselling” (15%), and “not the role of primary care provider” (7%). Multivariable logistic regression analysis showed that “lack of professional resources” was associated with respondents being in medical practice for ten years or under (vs. 11–20 years), and working at district or communal health facilities (vs. provincial facilities); “lack of time” were associated with respondents being female, seeing more than 30 patients a week (vs. <15 patients/week); and “lack of privacy/confidentiality” was associated with physicians’ seeing more than 30 patients a week (vs. <15 patients/week).ConclusionThe study has identified several barriers to STI care in medical practice in Vietnam. Results of the study can be used to improve areas in STI care including policy and practice implications.

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“…10 A study looking at the impact of didactic STD training on clinician practices found that after training, STD-specific knowledge and skills improved. 11 However, barriers such as time and staffing remained impediments to improved STD clinical services. 11…”

mentioning

confidence: 99%

“…11 However, barriers such as time and staffing remained impediments to improved STD clinical services. 11…”

mentioning

confidence: 99%

Systems Approaches to Improving Rates of Extragenital Chlamydia and Gonorrhea Screening Among Men Who Have Sex With Men Engaged in Human Immunodeficiency Virus Care

Bernstein

2015

Sexually Transmitted Diseases

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Can Experiential–Didactic Training Improve Clinical STD Practices?

Abstract: Experiential-didactic STD/HIV training can modestly improve knowledge, clinical skills, and implementation of STD recommended practices 6 months after training. Further research is needed to identify the impact of improved clinical practices on STD/HIV transmission.

Cited by 12 publications

References 25 publications

Improving care for sexually transmitted infections

Improving care for sexually transmitted infections

Physicians’ perceived barriers to management of sexually transmitted infections in Vietnam

Systems Approaches to Improving Rates of Extragenital Chlamydia and Gonorrhea Screening Among Men Who Have Sex With Men Engaged in Human Immunodeficiency Virus Care

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