Abstract
Background Despite high rates of unintended pregnancy in the United States, there is a lack of comprehensive, high-quality education about intrauterine devices (IUDs) within U.S. medical school curricula. This study evaluated the impact of a simulated IUD insertion clinic on knowledge, attitudes, self-efficacy, and comfort regarding IUDs among preclinical osteopathic medical students in the southern United States. Methods A pre- and post-intervention survey was administered to preclinical medical students attending an IUD insertion simulation clinic. The survey assessed students' knowledge of IUDs, attitudes towards the role of different healthcare providers in contraceptive counseling and placement, perceived self-efficacy in counseling and IUD placement, and personal comfort with IUD use. McNemar tests were used to conduct the bivariate analysis of change in responses before and after the clinic. Results A total of 57 students completed the surveys before and after the clinic. The clinic significantly improved students' knowledge regarding the IUD mechanism of action, return of fertility, and common misconceptions (p<0.05). Further, the participants were more likely to recommend IUDs for appropriate candidates under 19 years of age (p<0.01) but less likely to recommend them for patients with active chlamydial infections (p<0.05) after the clinic. Attitudes toward IUD placement by midwives and nurse practitioners became significantly more favorable after the clinic (p<0.001). Additionally, participants reported increased comfort with personally receiving or recommending IUDs (p<0.05) and demonstrated a notable increase in perceived self-efficacy for IUD counseling and supervised placement (p<0.0001). Conclusion A short IUD simulation clinic effectively enhanced the knowledge, attitudes, comfort, and self-efficacy of osteopathic medical students. The study findings support the inclusion of hands-on IUD training in medical school curricula to better prepare future physicians for comprehensive contraceptive counseling and care. Furthermore, increased recognition of the role of advanced practice providers in reproductive healthcare may improve access to long-acting reversible contraceptives, particularly in underserved communities. Implementing similar simulation experiences across medical education could further strengthen reproductive health competencies and address barriers to contraceptive access.