Just in Time Training for Internal Medicine Residents to Initiate State-Mandated Waiting Periods for Abortion Care.

Abstract

Primary care providers may be patients' first contact for unwanted pregnancy. In states with mandatory waiting periods for abortion, training internal medicine (IM) residents to initiate these waiting periods may reduce barriers to abortion care. To develop and evaluate the feasibility and early implementation signals of a brief, cognitively optimized training enabling IM residents to recall and initiate Pennsylvania's mandatory waiting period. Fifty-four IM residents participated across four sessions as part of regularly scheduled educational programming. We developed an electronic medical record (EMR) smart phrase checklist for initiating the state-mandated waiting period. We delivered the training session on abortion law and checklist use four times, incorporating resident feedback after each session. Evaluation focused on feasibility and short-term learning (embedded knowledge questions, participant feedback), with EMR smart phrase use as an exploratory uptake signal over 5 months. Findings revealed knowledge gaps about state abortion law. Residents requested additional information in the first three sessions, but not the fourth. Six smart phrase users published EMR notes using the checklist. Two residents initiated the waiting period outside EMR capture. This training was feasible to implement and supported learners' ability to recall and access a workflow-embedded tool.