Women Veterans’ health training on the move

Patty Axtell, RN, and Suzanne Rainforth, LPN, (pictured above) practice pelvic exam supply setup with  instructor Jonna Brenton, RN, at Grand Island VAMC. The number of women Veterans is increasing rapidly. Consequently, the number of women Veterans receiving health care from VA tripled from between 2000 and 2016, growing from 160,000 in 2000 to 475,000 in 2016, driving an increase in need for high-quality, gender-specific health care.

As of May 2017, 26 percent of enrolled women Veterans lived in rural and highly rural areas. These are areas in need of more trained primary care providers designated as Women’s Health Primary Care Providers (WH-PCPs) and nursing staff trained in women’s health.

The highest level of care for women Veterans in rural areas

Since 2008, the Women’s Health Services (WHS) has developed and delivered a comprehensive education and training model for clinical staff, called the Women’s Health Mini-Residency, to address gaps in knowledge and skills in women’s health topics. This training is traditionally a three-day, face-to-face program offered 1-2 times per year in Orlando, Florida.

Although more than 3,500 PCPs and 1,200 primary care nurses trained in this mini-residency model, additional training needs persist, including for staff in rural VA facilities.

WHS understands that rural VA clinics, with fewer staff, may face challenges sending staff off-site for training without disrupting normal clinic operations. Travel from rural areas also means more time away from clinical care.

Bringing the training to clinic sites

To better support women Veterans’ long-term health and well-being, address staff training need and minimize the burden on the clinic and staff, WHS, funded by the Office of Rural Health (ORH), launched a blended learning approach to the Women’s Health Mini-Residency intended for providers and nurses at rural Community Based Outpatient Clinics (CBOC) and VA medical centers (VAMC) by bringing this training program directly to clinic sites. This modified mini-residency includes:

• Core women’s health courses on topics such as abnormal uterine bleeding, contraception, breast issues and intimate partner violence offered via the Veteran Affairs’ Talent Management System (TMS) and done independently in advance of the one-day training delivered directly at clinic sites
• Tailored one-day on-site training includes interactive portions of the program such as facilitated case discussions, simulation equipment for hands-on activities, videos of gynecologic procedures and exams, and live models for breast and pelvic exam instruction

Instructor Aimee Sanders, MD, demonstrates contraceptive options to Steven Carlsen, PA, and Michael Adams, MD, at Norfolk CBOC

Patient-Aligned Care Team (PACT) providers and nurses train side-by-side in this inter-professional training program, which aligns with how care is provided. In all, each provider and nurse will receive more than 18 hours of accredited medical training. Launched June 2018, in partnership with ORH, WHS will provide this mini-residency for rural providers and nurses in up to 40 rural clinical sites per year to support the highest level of care for women Veterans in rural areas.

If you have any questions about the Women’s Health Mini-Residency for Rural Providers and Nurses, please contact whrmrteam@va.gov.

Aimee M. Sanders, MD MPH, is the Physician Educator with Women’s Health Services. The Women Veterans Health Program was created to streamline services for women Veterans in order to provide more cost-effective medical and psychosocial care.  VA’s Women’s Health Services office provides programmatic and strategic support to implement positive changes in the provision of care for all women Veterans.