So You Think You Can Do An Injection: Comparison of Group versus Individual IVF Medication Teaching

Objective:

Comparison of how well traditional versus redesigned In Vitro Fertilization (IVF) cycle teaching methods addressed learning needs and concerns. Current practice was group teaching (2-4 couples/session) which included review of medications, monitoring processes, procedures and side-effects followed by individual practice of injections. Proposed change was computer-based education followed by individual instruction.

Design:

Effectiveness evaluation

Patients/Participants:

Patients undergoing IVF treatment cycle in an outpatient fertility clinic

Methods:

Phase 1: Survey developed and tested: internal consistency reliability was good (alpha=.81, N=10). Teaching materials developed.

Phase 2: Intervention: Traditional teaching subjects (n=10) received IVF education in groups of 2-3 couples/session. Training included medication administration and process of the IVF cycle, followed by individual instruction on injections. Redesigned teaching subjects (n=10) received IVF education via an informational packet, video presentation and computer-based education prior to in-person training on injections. Rather than 2-3 couples/session, the intervention subjects received individual training on the calendar review process.

Measures: Both groups were surveyed pre and post teaching intervention using Likert scale. Pre intervention survey addressed concerns and what patients believed most important to learn. The post intervention survey measured whether those concerns and learning needs were met. How important the group and individual review sessions were and value of teaching materials was also measured. Both groups were asked to identify their level of anxiety before and after teaching.

Implementation Strategies:

Developed a video PowerPoint with information about IVF cycle. The teachings were done by same nurse.

Results:

Subjects who received individual teaching reported significantly (p= .05) higher scores (mean= 4.7) compared to those who received group teaching (mean= 4.0) for the item Learning about side effects. The intervention group reported less anxiety prior to face-to-face instruction (mean 3.3) compared to traditional group (mean 4.1, p< .001); and following face-to-face instruction (mean 2.8) compared to group subjects (mean 4.2, p<.001).

Conclusion/Implications for nursing practice:

 Online and computer based information is a valuable tool for teaching basics of medication and procedures. Patients experienced less anxiety when their teaching was individualized and their learning needs and concerns were addressed.

Keywords:

IVF, injections, medication instructions