LARC Trainee Materials

This page was formerly used to support trainees involved in hands-on training in IUD and contraceptive implant insertion and removal. You can use this page to inform information and resources that may be helpful to provide trainees before starting hands-on training. 

 

LARC Training Objectives

By the end of this training, you will be able to:

1. Provide patient-centered counseling on the different types of IUDs and implantable contraception.
2. Utilize the CDC MEC and the SPR in their clinical practice.
3. Comfortably and appropriately place a speculum.
4. Insert and remove IUDs.
5. Insert and remove contraceptive implants.
6. Manage expected complications and common side-effects of all contraceptives.

This training addresses the following ACGME/IOM competencies:

ACGME:

• Healthcare Knowledge
• Interpersonal and Communication Skills
• Patient Care
• Professionalism
• Practice-based Learning and Improvement
• System-based Practice

IOM:

• Provide patient-centered care
• Work in interdisciplinary teams
• Employ evidence-based practice

 

Intake Questionnaire

It is helpful for us to have a sense of your experience and comfort level providing reproductive health exams and uterine procedures. We have developed a very short questionnaire we’d like for you to complete, if you haven’t done so already. Click here to access the online questionnaire. (If the hyperlink doesn’t work, cut and paste this URL: https://www.surveymonkey.com/r/LARCIntake).

 

Apps to Download

CDC Medical Eligibility Criteria (MEC) and Selective Practice Recommendations (SPR)    iPhone   Android

Contraceptive Point of Care  iPhone   Android

 

Background Educational Resources

Please take some time to read/review the articles and resources below.  They will provide you with background on the evidence and science that guides our clinical practice in providing IUDs and progestin implants.

Intrauterine Devices: An Update. Hardeman J, Weiss BD. American Family Physician. 2014 Mar 15;89(6):445-50.

In-Office retrieval of intrauterine contraceptive devices with missing strings. Prabhakaran S, Chuang A. Contraception, 2011 Feb; 83(2):102-6.

Long-Term Reversible Contraception: Twelve Years of Experience with the TCu380A and TCu220C. Contraception. 1997. 56:341-352.  This is the evidence that supports using the copper IUD (Paragard) for up to 12 years.

Prolonged Intrauterine Contraception: A Seven Year randomized study of the Levonorgestrel 20mcg/day (LNg 20) and the Copper T 380 Ag IUDs. Contraception. 1991. Vol. 44 No 5. 473-480.  This article is the evidence that supports using the progestin IUD (Mirena) for up to 7 years.

“This may hurt”: predictions in procedural disclosure may do harm.  BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h649 (Published 06 February 2015) 

IUDs – Dispelling the Myths  Powerpoint presentation that covers basic clinical information, including commonly held myths, regarding IUDs.

Quick Start Algorithm  This is the protocol followed at the health center where you will be training. It is a best practice.

Medical Eligibility for Initiating Contraception  This useful tool will be helpful in determining which patients are eligible for IUDs and contraceptive implants. 

Long-Acting Reversible Contraception Statement of Principles  This statement of principles created by SisterSong and the National Women’s Health Network, and endorsed by RHAP and other organizations,  outlines values necessary to protect the bodily autonomy and to respect the agency, health, and dignity of marginalized communities so that they feel safe when making reproductive decisions. 

 

Videos to Watch Prior to First Session

IUD Tray Set-up  This video, developed by the training team at the Institute for Family Health, provides an overview of the IUD insertion tray set-up.  This is the tray set-up you will be working with throughout your training.

Mirena/Skyla/Kyleena Insertion  This video was developed by the Association of Reproductive Health Professionals, the manufacturer of these devices.

Paragard Insertion  This video, developed by Paragard, covers counseling, inserting and removing the Paragard copper IUD.

Implant Removal  This video is a great demonstration of the fingers-only or pop-out method of implant removal. This is the method we teach.   It requires less anesthesia, a smaller incision, and causes less swelling.

For longer videos about the pelvic exam, LARC methods, counseling, and IUD insertion and removal, visit the Papaya Workshop Site or the Innovating Education in Reproductive Health series on LARC Insertion and Removal.

 

Patient Education Materials and Commonly Used Forms

These are the patient educational/counseling tools and clinical forms used at the health center where you will be training. You will provide counseling, obtain consent, and document care using these forms. Please take some time to familiarize yourself with the documents below.

IUD Fact Sheet (Which IUD is right for me?)

Progestin Implant Fact Sheet

Copper IUD User Guide

Progestin IUD User Guide

Progestin Implant User Guide

IUD Consent Form

Progestin Implant Consent Form

IUD After Visit Information

Progestin Implant After Visit Information

IUD Insertion Procedure Note (EPIC Template)

IUD Removal Procedure Note (EPIC Template)

Progestin Implant Insertion Procedure Note (EPIC Template)

Progestin Implant Removal Procedure Note (EPIC Template)

 

Assessment Tools

These forms will be used to track and assess your progress. Feel free to review them so you have an idea of the key elements we will be using to assess your clinical training.

Daily Session Trainee Assessment

Comprehensive Trainee Assessment

 

LARC Cases to Discuss 

Case-based Curriculum for LARC Eligibility 

 

Other Helpful Tools & Websites

Bedsider

Reproductive Health Access Project

        RHEDI

Innovating Education in Reproductive Health

        Partners in Contraceptive Choice and Knowledge (PICCK)

Contraceptive Fact sheets used by NYCDOH School-based Health Centers

Copper IUD Fact Sheet

Depo Fact Sheet

EC Fact Sheet

Ella ED Fact Sheet

Hormonal IUD Fact Sheet

Mini-pill Fact Sheet

Nexplanon Fact Sheet

NuvaRing Fact Sheet

Patch Fact Sheet

The Pill Combined Fact Sheet 

 

Continuing Education Credit

This Live activity, with a beginning date of 9/1/2019, has been reviewed and is acceptable for up to 21.00 Prescribed credit(s) by the American Academy of Family Physicians (AAFP). Physicians should claim only the credit commensurate with the extent of their participation in the activity. AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)™ toward the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed credit must be reported as Prescribed, not as Category 1. 

Questions or concerns should be directed to 1-800-274-2237 or cmecredit@aafp.org.

Regarding, Continuing Nursing Education:

University of Virginia School of Nursing Continuing Education (SONCE) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. University of Virginia SONCE awards 18 contact hours for nurses who participate in this educational activity and complete the post activity evaluation. Questions or concerns should be directed to Linda Hanson, Project Coordinator at 434-982-4136 or sonce@virginia.edu.