Counselling of adolescent women on contraceptive methods

1. Counselling of adolescent women on contraceptive methods Educational Slide Kit Introduction and terms of use

2. The global Contraception: Awareness, Resources, Education (CARE) group The global CARE group is a panel of independent physicians from 13 countries with expert interest in sexual and reproductive health in adolescence They have developed a manuscript as well as a series of educational tools to aid delivery of best practice when counseling adolescents about contraception Formation of the CARE group and its ongoing work is supported by Bayer.

3. The global CARE group members • Andrew Kaunitz, USA • Linan Cheng, China • Xu Ling, China • Ricardo Martin, Colombia • Rossella Elena Nappi, Italy • Jung Ryeol Lee, Korea • Sven Skouby, Denmark • Larisa Suturina, Russia Virginia Abalos, Philippines Biran Affandi, Indonesia Dan Apter, Finland Johannes Bitzer, Switzerland Amanda Black, Canada Rogério BonassiMachado, Brazil Jeffrey Jensen, USA

4. Manuscript and educational tools • Manuscript • Educational tools • Counselling Checklist • Educational Slide Kit • Patient case studies and accompanying workshop materials • Educational Videos for HCPs and patients

5. Aims of the Educational Slide Kit • Describe the global challenge of unintended pregnancy among adolescents • Identify the barriers to accessing effective contraceptive counseling for this age group • Summarize key elements of effective contraceptive counselling and care in adolescent women • Make recommendations for best practice in delivering contraceptive counselling and care that can be applied at regional level

6. Educational Slide Kit: Agreed terms of use • If any adjustments are made to the originals, neither Bayer nor the CARE Group can accept responsibility whatsoever for their content. • If you make changes you should not use the CARE slide template. • When using any of these slides, even if you modify them in some way, please acknowledge to your audience that the original slides were provided by the CARE Group: • “The global CARE group is a panel of independent physicians from 13 countries with expert interest in sexual and reproductive health in adolescence. They have developed a series of educational tools to aid delivery of best practice when counseling adolescents about contraception. Formation of the CARE group and its ongoing work is supported by Bayer Pharma AG”. • You may select any combination of slides to present on to others; however, the context of the slides should be maintained wherever possible. • Please be aware that recommendations and regulations around communications on contraception as well as product labels vary globally, and ensure that the content and recommendations included in the slides are aligned to the local regulations and product labels of the country where you are presenting.

7. The rationale for case-based learningto aid the counselling of adolescent women

8. Healthcare professionals are faced with a number of challenges when counselling adolescents about contraception1 • 1. Bitzer J, et al. Eur J ContraceptReprod Health Care 2016;21(6):417-30; 2. Bitzer J. Best Pract Res Clin Endocrinol Metab 2013;27:77–89; 3. Porter C. Gynaecology Forum 2013;18(3):8–10; 4. American College of Obstetricians and Gynecologists. Obstet Gynecol 2011;118:184–96; 5. American Academy of Pediatrics; Committee on adolescence. Pediatrics 2014;134(4):e1244–56; 6. National Institute for Health and Care Excellence. NICE public health guidance 15, March 2014. Sexual behaviour in adolescence is influenced by a number of biological and psychosocial factors2 A disruptive home life, incomplete education, alcohol or drug use, and smoking are all associated with early initiation of sexual intercourse and exposure to health risk3 Although long-acting reversible contraceptive (LARC) methods have been emphasized as a contraceptive option for adolescents by professional organisations and some health authorities,4,5,6 difficulties with accessibility and acceptability of LARC methods remain1 Adolescent women have different needs to those of older women; they therefore need to be counselled differently about contraception1

9. Case-based learning uses authentic clinical practice scenarios to complement didactic learning1 1. Thistlethwaite JE, et al. Medical Teacher 2012;34:e421–e444 • Links theory to practice through the application of knowledge to ‘real-life’ cases • Facilitates inter-professional learning • Fosters effective learning in small groups • Can increase participant engagement and motivation for learning

10. Example cases and learning goals

11. How to use these case studies • Progress through each fictional case study is facilitated by: • A detailed description of the patient • Interactive questions • Table discussions • Key learning points • All slides are supported by: • Fully referenced notes where relevant • An accompanying booklet containing case descriptions and expert comment

12. Generalised structure of each case • Learning objective Initial patient presentation Question? – what is most important here? Key information [linked back to Educational Slide Kit] Additional information from patient history Round table discussion – what do you do now? Key information [linked back to Educational Slide Kit] Variation– what if?

13. Opportunities for discussion are guided by two symbols This symbol indicates an opportunity for participants to consider and discuss their response to a specific question as a whole group This symbol indicates an opportunity for participants to consider their response to a specific question using smaller group discussion These two symbols indicate the type of discussion

14. An overview of the issues addressed within each case

15. Introducing your patients Martyna Emma Nadia

16. Using these case studies to achieve successful and productive discussions

17. As facilitator, you can play an important role in the creation of a respectful and positive learning environment Allow everyone to participate. Provide opportunities to share experiences and knowledge. Exercise strict time management specified by the discussion guide. Try to be as clear as possible – especially when you are explaining what is required during the table discussions. Be familiar with the topic and workshop content. Be a part of the process – you don’t have to know it all nor do everything perfectly.

18. Helpful questions for facilitators during workshop discussions 1. Queen's University MD Program Phase II. Problem-based Learning Student/ Tutor Handbook. Accessed at http://meds.queensu.ca/medicine/pbl/pblhome.htm Encourage participants to make connections – ‘How might issues about patient lifestyle be related to this problem?’ Direct participants along another path – ‘What do you need to know next?’ Emphasize mechanisms of patients’ problems – ‘What could have caused this problem?’ Ask participants to explain or define medical terminology used – ‘What other investigations might you be looking for?’ Ask higher order questions – ‘How do we decide on the best treatment?’

19. Other helpful hints for facilitators 1. Queen's University MD Program Phase II. Problem-based Learning Student/ Tutor Handbook. Accessed at http://meds.queensu.ca/medicine/pbl/pblhome.htm Use open-ended questions to promote discussion Learn to tolerate silence – wait 30 seconds for someone to talk Do not be afraid to join the group as a participant Do not dominate with your opinions Always consider whether your comments will help the group to learn Encourage participants to focus their discussion rather than go off in different directions