Wellness Wednesday: Utilization of Strategic Duty-free Hours by OB/GYN Residents
Purpose: To detail the specifics of how OB/GYN residents utilize a
monthly duty-free afternoon for wellness activities.
Background: Much attention is paid to burnout and high rates of
depression among physicians. Some speculate these difficulties may start in
medical school but that they become cemented and sometimes problematic in
residency. Studies have made implications that interventions, specifically
promotion of self-care and work-family balance, and work hour restrictions,
early in residency can decrease burnout and depression levels.
Methods: Starting in 2016, all residents of an OB/GYN program
were allowed to have the first Wednesday afternoon of each month free from
clinical duties. Faculty members covered all clinical services from noon to
5pm. Residents were then permitted to use the time for whatever they felt
promoted their well-being. Two years of data were collected through surveys to
determine the specific activities completed by the residents.
Results: The commonly reported activities included health care
visits, financial planning activities, leisure time with family/friends,
community or church group events, every day errands, home chores, and fitness.
Additionally, the residents also used the time away from clinical
responsibilities to study and fulfill administrative requirements.
Discussions: By better understanding what residents choose to do to
promote their own well-being, programs can then tailor structured wellness
activities to those choices. Alternatively, programs can look at an
open-ended wellness day as a possible intervention for fostering excellent
overall health and welfare of their residents. More research is needed to
validate this approach to wellness promotion.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Professionalism, Systems-Based Practice & Improvement, GME, CME, UME, Quality & Safety,
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Use of Video Interviews for Selection of Obstetrics and Gynecology Residents
Purpose: To improve the residency selection process using asynchronous
Background: Residency applications have increased, while data
available for decision making in ERAS has been static. One-way (asynchronous)
video interviews (OWVI) involve the candidate recording answers to pre-selected
Methods: Applicants to an OB/GYN residency program with USMLE
Step 1 ≥ 220, no USMLE failures and at least 3 months of US clinical experience
were scored using five criteria (USMLE 1 score, clinical clerkship grades,
letters of recommendation, research achievements and extracurricular/leadership
activities) scored 1-5, with 5 as the top score. Applicants with scores from 19
to 22 were invited to complete an OWVI. The OWVI consisted of 1 open
ended question and 2 behavioral questions, scored from 1-5. Applicants were
invited for an in person interview based on their video interview scores.
Results: For the 2018 residency application season, 495
applications were received, 272 applications were scored and invited to
complete a video interview, 234 applicants completed OWVI and 97 OWVI were used
for the decision to invite for an in-person interview. Mean OWVI score was 10.4
(range 4-15). For the 2018 season, OWVI scores were weakly correlated with rank
list placement (Pearson coefficient = 0.29), in-person interview scores (0.18)
and application scores (0.33). The mean in-person interview
score increased after implementation of OWVI screening from 59.0 in 2017
to 62.2 in 2018 (P<0.01).
Discussions: Use of OWVI led to higher in-person interview scores,
suggesting that video interviewing is a useful supplemental tool for selecting
competitive residency candidates.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Clerkship Director, Residency Director, Professionalism, Interpersonal & Communication Skills, GME, UME, Assessment,
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Transgender Healthy Care: On-line Survey of Physician Knowledge and Comfort
Purpose: To evaluate OB/Gyn provider knowledge and comfort with
transgender health care
Background: Transgender and gender non-conforming patients (TGNC)
are an underserved population that often encounters inadequate or ‘unsafe’
clinical care. Education regarding TGNC patient care has traditionally been
minimal, contributing to gaps in Ob/Gyn care for many of these individuals,
including transgender men.
Methods: An IRB approved, anonymous online non-validated survey
was emailed to 130 APGO program coordinators to distribute to their Ob/Gyn
faculty and post-graduate learners. Questions addressed included years of
practice, experience with TGNC patients, provider comfort, and TGNC education.
Results: One hundred and sixty four surveys were completed and
an additional ~50 were opened but no information was provided. Of the 164
completed surveys, 76.3% of participants reported less than 5 hours of TGNC
specific healthcare education, despite the fact that 75.7% of responders had
cared for at least one TGNC patient. Overall most respondents felt
comfortable/very comfortable (79.8%) caring for this population. No correlation
was found between years in practice and overall provider comfort caring for
TGNC patients. Major obstacles reported by participants included concern
for patient comfort, appropriate language, and lack of sufficient clinical
education for both providers and support staff
Discussions: These data suggest that enhanced TGNC clinical education for
the entire health care team is warranted.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Professionalism, GME, Advocacy,
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Residents Express Emotional, Social and Physical Stress in the Clinical Learning Environment
Purpose: To evaluate OBGYN residents’ perceptions of personal wellness
in relation to their clinical learning environment
Background: Resident wellbeing is a significant issue affecting
our future physicians’ abilities to fulfill their training potential.
Methods: The Council on Resident Education in OBGYN (CREOG)
administered a voluntary, anonymous, six-item wellness survey. One
question asked about personal experience with mental health problems
(burnout, depression, binge drinking, eating disorders or suicide attempt) and
then provided a free text response for “other” issues. The free text
responses were reviewed and analyzed. The ACOG IRB determined this survey
exempt from review.
Results: Of 5,061 residents, 4,099 completed the question on
personal issues experienced in residency (81% RR), and 200 free text responses
were submitted. 1593 residents (32%) endorsed clinical depression.
34 (0.8%) wrote in anxiety, although this was not a formal category. The
free text responses clustered into three categories: physical health (n=56),
social concerns (n=34), and mood symptoms (n=115). Symptoms of clinical
depression comprised 5,992 responses, combining structured questions and free
text responses. 18 (0.4%) had attempted suicide, and 18 additional
residents wrote in suicide ideation or attempt, translating into almost 1% of
our residents having contemplated or tried self-harm, likely related to work
Discussions: Significant mood disorders and self-harm are under-recognized
among OBGYN residents, even as they acknowledge these symptoms. Programs
must consider formal evaluations for depression, anxiety, and suicide risk,
conduct thorough culture evaluations to ensure these symptoms are not being
normalized, and tailor their interventions to provide accessible, confidential
support services within the clinical learning environment.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Osteopathic Faculty, Residency Director, Residency Coordinator, Professionalism, Interpersonal & Communication Skills, GME, CME, Assessment, Team-Based Learning,
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Resident Wellness: Barriers to Seeking Mental Health Services Among OB GYN Residents
Purpose: Residency predisposes residents to the development of burnout
and mental health complications. The culture of residency inevitably places barriers
to wellness through expectations of perfectionism, increasing stress levels,
and long hours. This study aims to highlight the main reasons why OB GYN
residents may not seek help for depression in residency.
Background: Residency is a period of extreme stress, lack of sleep
and long work hours. Factors such as embarrassment and confidentiality play key
roles into why physicians don’t seek help. Some additional barriers cited in
the literature include lack of time, fear of documentation on academic record,
cost and lack of confidentiality.
Methods: This was a qualitative study to assess the barriers
that may keep OB GYN residents from seeking access to mental health
resources. The surveys were electronically distributed via Survey Monkey
to OB GYN resident programs
There were a
total of 18 questions that assessed demographics and the main barriers that may
keep OB GYN residency from seeking mental health services.•A 5 point Likert
scale was used to assess the following; ranging from strongly disagree to
strongly agree •I can manage my problems on my own •I don’t have enough time •I
am worried my privacy would be violated •I don’t know if my program offers
mental health services •I don’t have money or health insurance to seek help •I
don’t think treatment would be of any help •I am worried about the stigma of
Results: There were 275 respondents to the 18 question survey.
Lack of time was the most highly reported barrier, followed by a lack of
protected time for appointments. Not knowing if their programs offered services
or how to access those services and not thinking treatment would not be of help
were the least popular responses.
In summary, our data outlines that lack of time and protected
time in OB-GYN residencies are prevalent barriers to seeking help among OB GYN
residents that must be addressed. Understanding the barriers to seeking help
will help us to enact programs that will maintain the wellness of our
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Residency Coordinator, Practice-Based Learning & Improvement, GME,
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Professionalism Training in the Global Setting: Program at Ayder Hospital and Mekele University in Ethiopia
Purpose: Using the current partnership between University of Illinois
in Chicago, Illinois (UIC) and Ayder Hospital/Mekele University in Mekele,
Ethiopia (Ayder), this study evaluated the effectiveness of professionalism
training for medical students and resident trainees at Ayder.
Background: Threats to professionalism in medicine have led to
more universal teaching of professionalism to trainees and practicing
physicians. Currently, professionalism is listed by the ACGME as one of the 6
general clinical competencies. Many programs that include group sessions
and standardized patients have been implemented in American institutions,
although little research has been directed towards professionalism training in
a global health setting. This study aimed to determine the effect of a
professionalism training at Ayder.
Methods: Participants in a professionalism and communication
training were offered participation in a pre- and post-test survey. The survey
focused on the perception and function of professionalism in the medical
workplace, and included quantitative and qualitative data. The pre- and
post-test surveys were conducted prior to and at completion of the training.
Results: A convenience sample of medical students and resident
trainees at Ayder participated in the pre- and post-test surveys. The training
had a positive effect on the perception of professionalism and identified
opportunities for behavioral improvement.
Discussions: We saw that the professional training was an effective tool
for implementing professionalism into medical education curricula in this
global health setting. However, further research regarding the long term impact
and ability to implement clinical competencies into global health settings will
help determine the plausibility of repeating such a study in other sites.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Professionalism, Interpersonal & Communication Skills, GME, Simulation, Global Health, Public Health,
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Predictors of Trainees\' Willingness to Provide Family Planning Services: A Survey of Ob-Gyn Residents
Purpose: To determine factors that contribute to a resident’s
willingness to provide abortions post-residency.
Background: The shortage of abortion providers makes accessing
care difficult. Personal and environmentalfactors within the residency training
environment may be modified so that greater numbers ofgraduates opt to become
Methods: A multiple-choice survey was sent to all ACGME
accredited OB/GYN residency programs. Data on demographics,religious and
political views, residency training experience and intent to provide abortions
was collected anonymously (n=396).
Results: Sixty-eight percent of residents intended to provide
abortions (n = 269). The sample was 89% female, underage 35 (97%), heterosexual
(91%). In a multivariable logistical regression, the following demographic
factors predicted intent to provide abortion; being female (aOR 2.8; 95% CI
1.2-6.5), identifying as non-Christian (aOR 3.6; 1.9-6.6), and being raised in
the Northeast (vs South) (aOR 3.0; 1.3-6.7) .Modifiable predictors of intention
to provide included programs where 50% of the faculty provided abortions (aOR
3.3;95% CI 1.8-5.8). Additionally, residents who performed greater than 20
cases (uOR 3.3, 95% CI 1.6-6.7) were three times more likely to plan
toprovide.Selection of a residency emphasizing family planning significantly
correlated with intent toprovide (aOR 4.3; 95% CI 2.4-7.8). Those training at
Ryan Programs were twice as likely (uOR2.4; 95% CI 1.6-3.8) to intend to
Discussions: Modifiable factors such as early exposure of medical students
to family planning, faculty selection, robust case volumes and establishment of
a Ryanprogram may enhance the number of graduates offering abortions while in
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Clerkship Director, Osteopathic Faculty, Residency Director, Patient Care, Systems-Based Practice & Improvement, GME, UME, Advocacy, Contraception or Family Planning,
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P&S Partners in Pregnancy: A Longitudinal, Patient-Centered Program for Preclinical Students
Purpose: To develop a longitudinal clinical program pairing first-year
medical students with prenatal patients.
Background: Students who participate in early clinical,
longitudinal experiences report greater confidence in communication, comfort in
clinical settings, and self-esteem during transition to clerkship year.
However, few longitudinal experiences exist for preclinical students at
Columbia University Vagelos College of Physicians and Surgeons.
Methods: A retrospective needs assessment evaluating interest,
motivating factors, and perceived barriers to participation was distributed to
second-year students. In response, we developed a program pairing ten
first-year students with pregnant patients. Students partake in lectures and
accompany patients to prenatal visits. Initial perceptions about the
patient-physician relationship were assessed in both groups using the
Patient-Practitioner Orientation Scale (PPOS), with 1 indicating
“doctor-/disease-centered,” and 6 indicating “patient-centered.”
Results: 49% of students completed the needs assessment. 90%
reported that they would be at least “somewhat interested” in a longitudinal
prenatal pairing program. Motivating factors included desiring longitudinal
experience (87%), early clinical exposure (82%), and patient advocacy/community
engagement (78%). Our program was designed accordingly. All first-year students
were invited to apply; ten were accepted. At recruitment, mean student PPOS
score was 4.64 compared to 3.95 for patients.
Discussions: Students in early medical education are enthusiastic about
longitudinal patient experiences and demonstrate patient-centered mindsets.
Programs such as ours may help maintain and cultivate patient-centeredness,
with the potential to improve patient satisfaction(1) and create positive
attitudes towards medical student involvement.
E et al. Patient orientations of physicians and patients: the effect of
doctor-patient congruence of satisfaction. Patient Educ Couns 2000;
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Patient Care, Medical Knowledge, Professionalism, UME, Independent Study, Team-Based Learning, Advocacy, General Ob-Gyn,
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Outcomes of a Transgender Care Training Program in Obstetrics and Gynecology Resident Education
Purpose: We sought to evaluate outcomes of an Obstetrics and
Gynecology (OB/GYN) resident education program on transgender health.
Background: OB/GYNs are often frontline providers for the
transgender community, as patients may first present to an OB/GYN with symptoms
of gender dysphoria or postoperative care needs and complications. Both the
American College of Obstetricians and Gynecologists (ACOG) and the Council on
Resident Education in Obstetrics and Gynecology (CREOG) have developed key
areas of competency pertaining to the care of transgender patients by OB/GYNS.
To date, standardized educational curriculums on these competency areas
are not available.
Methods: Residents at our institution completed a 2.5-hour
training on transgender health comprised of a standardized patient interaction,
debriefing session, and didactic session led by an expert on transgender
gynecological care. A 42 item pre- and post-training survey evaluated
participant demographics, a validated transphobia questionnaire, medical
knowledge of transgender care and preparedness to provide transgender care.
Results: Eighteen residents and medical students completed the
training. The average pre- and post-training knowledge assessments scores
significantly improved from 74.8% to 88.9%, (p<0.001). Specifically,
knowledge of transgender health disparities, professional guidelines, and
management of abnormal uterine bleeding all significantly improved. Baseline
transphobia scores were low and did not significantly change. Residents felt
more prepared to collect a transgender focused medical history, provide
referrals, and access additional educational resources.
Discussions: Our training improved residents’ knowledge and preparedness
to provide a variety of aspects of transgender care. This training was
feasible, reproducible and positively received by the resident participants.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Professionalism, CME, Assessment, Standardized Patient, Advocacy, General Ob-Gyn, Sexuality,
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One Size Doesn’t Fit All for Wellness: Residents’ Perception of Wellness Programming
Purpose: To investigate which wellness interventions have the most meaning
for a modern cohort of OB/GYN residents.
Background: The 2017 CREOG Resident Survey found significant
associations between the learning environment and wellness. The primary
analysis indicated that PGY-1’s prioritized wellness, and that a sense of
wellness decreased with each PGY level. In order to explore whether
developmental stage influenced how wellness initiatives were perceived, we
performed a secondary analysis of the survey to determine how residents at
different PGY levels perceived wellness interventions.
Methods: A six-item survey on wellness was administered before
the 2017 CREOG exam. IRB exemption was obtained. Participation was
voluntary and anonymous, linked only to PGY level. A mixed-methods
analysis of the data was performed. Descriptive statistics were analyzed with
Microsoft Excel 2010. Mann-Whitney U tests were used to explore
differences between PGY-levels. Thematic analysis of text responses was
Results: Among the 5855 residents, 4,753 answered questions
regarding wellness programming (81% RR). Significant differences existed
between year of training and perceived effectiveness for several initiatives.
PGY1 residents valued peer mentorship (p=0.003) and strategic napping
(p<0.001) more than senior residents, while PGY3 residents emphasized
faculty mentoring (p=.005). Regardless of training level, residents
prioritized the same three activities: wellness days to address personal needs,
team-building retreats, and facilitated exercise programs.
Discussions: OBGYN residents perceive some wellness activities as valuable
throughout training, while the importance of others may vary based on resident
year. Most programs do not yet provide the wellness programs (retreats,
facilitated exercise, personal time) that OBGYN residents identify as most
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Residency Coordinator, Patient Care, Professionalism, GME, CME, Team-Based Learning,
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Medical Student Wellness
Purpose: The purpose of this study was to evaluate medical student
wellness at our institution. We distributed a survey intended to identify
sources of stress as well as coping mechanisms.
Background: Psychological distress is higher in medical students
than in age-matched peers2. Studies have shown that both the mental and general
health of medical students decline within the first year.3 Fifty percent of
medical students experience burnout3, and ten percent experience suicidal ideations4.
Only fifteen percent seek psychiatric care.
Methods: A survey was electronically distributed to all medical
students with a 43% response rate. Statistical analysis was performed using
Students t-test and Fisher Exact test.
Results: Students identified the amount of pressure placed on
themselves and pressure others placed on them as a prime source of stress.
Female students were more likely to identify volume needed to learn as a source
of stress. Female students were also more likely to identify a support system
as a coping mechanism, utilize counseling, and feel more anxiety. Students who
took a gap year were more likely to own a pet that provided stress relief.
Financial concerns were not found to be a significant source of stress.
Discussions: Stress, burnout, and mental health issues are issues that
must be identified and managed in order to promote wellness. Male and female
students may have different perceptions about sources of stress and coping
mechanisms. Age and life experience appears to impact coping mechanisms. This
data may help schools develop resources to assist students, and may help target
the development of wellness programs.
CREOG & APGO Annual Meeting, 2019, Student, Professionalism, UME,
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Lifting the Mask: Exploring Factors That Influence Medical Students\' Perceptions of Resident Teaching on the OB/GYN Clerkship
Purpose: To determine factors that influence medical students\'
perceptions of resident teaching on the OB/GYN rotation.
Background: The Liaison Committee on Medical Education directs
that residents “are prepared for their roles in teaching and
assessment.\" Our goal was to ascertain if medical student year and
use of pre-made teaching tools impact views of residents as teachers.
Methods: A cross-sectional survey based on the Baker Clinical
Educator Self-Assessment using a 1-5 Likert scale was given to 37 medical
students who participated in end-of-OB/GYN clerkship focus groups from October
2017-June 2018. The survey consisted of 13 questions regarding resident
teaching skills along with 2 questions regarding resident use of pre-made
teaching tools and medical student year. Unpaired t-test and
one-way ANOVA was used for analysis.
second year, eleven third year, and eight fourth year medical students completed
the survey. There was significant difference amongst the medical student
levels (p<0.01), with third year medical students rating resident teaching
skills the highest (3.55), second year medical students in the middle (2.98)
and fourth year medical students rating teaching skills the lowest
(2.55). The 12 students that had residents use pre-made teaching tools
rated resident teaching skills significantly higher than the 25 students who
did not have residents use pre-made teaching tools (3.39 vs 2.90, p < 0.01).
Discussions: Medical student year affects perception of resident
teaching. This may be due to interest in the rotation or that teaching
needs to be individualized to year of training. Resident preparedness to
teach positively influences student views of teaching skills.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Clerkship Director, Residency Director, Practice-Based Learning & Improvement, GME, UME, Team-Based Learning,
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Let\'s Get Jazzy: Career Preparedness in OB/GYN Residents; Assessing the Need, and Developing a Curriculum
Purpose: To assess the need for
a formal and structured curriculum focused on OB/Gyn resident career and
residents rely on mentors and resident colleagues to help determine their
career paths. Curriculum during residency in obstetrics and gynecology often
lacks an emphasis on preparing residents to enter the job field as practicing
physicians. Often physicians complete training with significant amount of
education debt. Some employment scenarios may have negative financial
implications. Residents need to be formally educated on the impacts changes in
research funding, the healthcare system, and insurance market play in their
career decisions. It is important to determine how to best prepare residents to
choose a career path.
administered a career curriculum needs assessment and a validated career
readiness survey, which included questions relating to mentorship, job search
strategies and opportunities, negotiation, and practice climate to 28
residents. The survey results determined the topics that were needed.
Results: 89% of
residents agreed it was important to learn about career paths during residency.
96% of the residents believed that a career-planning curriculum would be helpful.
89% thought it was important to have a career mentor. Overall, 67.9% of
respondents do not feel confident about their ability to negotiate a contract.
The majority of resident were not familiar with medical practice finance and
Discussions: The survey results were
used to inform curriculum for the academic year. Topics included career
mentoring and individual planning, negotiation, finance, and insurance.
Comparison of pre/post curriculum will be performed after 1 year.
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Residency Coordinator, Professionalism, GME, CME, Lecture, Independent Study,
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Keeping Residents Well: How Important Are Perceptions of Program Support and Psycholocical Safety to Resident Wellness?
Purpose: We aimed to test
whether measures of resident well-being correlated with perceptions of program
support and psychological safety.
well-being is a crucial component of developing competent and skilled OB/GYN
physicians. While there are several measures of well-being collected at the
national-level, there is little insight in the role of individual programs to
foster trainee well-being. Perceived organizational and psychological safety
are two constructs that can help identify cultural aspects of the clinical
learning environment that may relate to trainee well-being.
residents in a training program were recruited to complete an IRB-approved
survey through paper and electronic methods between May-June 2018. Measures
included the Survey of Perceived Organizational Support (POS), Psychological
Safety Scale (PS), Perceived Stress Scale (PSS), Wayne State Wellness Scale
(RWS) and Physician Well-Being Index (PWBI); all demonstrate validity and
reliability evidence to assess factors of well-being and cultural aspects of
the training program.
Results: 20 OBGYN
residents completed our survey. Results indicated a strong relationship between
perceived organizational support and wellness (r= .62, P<.01 for
RWS, r=.50, P<.05 for PWB)., suggesting greater perceptions of support
relate to better wellness. Similarly, psychological safety also had a strong
relationship with wellness (r=.56, p<.05 for RWS; r= -.72, p<.01
Our findings suggest that there is a strong relationship between trainee
wellness and the cultural measures of support and safety, especially between
psypschological safety and negative indicators of well-being (e.g,. feeling
burnt out from work, feelings of irritation). Further research should include
interventions to improve percpetions of suport and safety.
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Residency Coordinator, Professionalism, Interpersonal & Communication Skills, GME, Quality & Safety, Advocacy, CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Residency Coordinator, Professionalism, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, Lecture, Advocacy,
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Implementing a Longitudinal Social Determinants of Health Curriculum at an Academic Residency Program
Purpose: To examine feasibility
and reception of a city-specific social determinants of health (SDH) curriculum
at an academic medical program
understanding of health acknowledges that an individual’s social milieu impacts
health as much as genetics. Healthcare providers must consider SDH to provide
just, equitable care to a diverse patient population. However, despite a
growing emphasis on teaching SDH in medical school, these factors are not
formally addressed in traditional residency curriculum.
literature review and consultations with local educators identified best
practices for teaching SDH to medical professionals. Topics were incorporated
into resident teaching activities, including grand rounds, resident retreat,
discussions with content experts and community stakeholders, clinic teaching,
morbidity and mortality conferences, and a city tour conducted by Rochester, NY
natives. Pre- and post-surveys (n=32) were conducted to assess resident knowledge
of city resources/demographics and attitudes towards SDH in patient care.
Results: In the
pre-survey, 73.3% of trainees reported familiarity with SDH. After the
curriculum, 88% of residents reported a better understanding of the effects of
SDH, and 78% felt that the lessons learned from the curriculum affected
interactions with their patients. 97% of residents felt more knowledgeable
about Rochester demographics. Overall, residents recognized the importance of
formal SDH training and felt that social hardships are important to acknowledge
in their clinical interactions. However, some expressed concerns that it took
time away from the traditional didactic curriculum.
Discussions: A comprehensive,
longitudinal, city-specific curriculum on the SDH enriches residents’
understanding of their patient population and available social resources to
address these factors.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Patient Care, Medical Knowledge, Professionalism, GME, Advocacy,
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Differences in Male and Female Medical Student Perceptions of the Gender Gap in Obstetrics and Gynecology
Purpose: Describe medical
student opinions about the gender gap in the OB-GYN workforce and how student gender
influences perceptions of an OB-GYN career.
has significantly more women in training and in practice. Previous research
cites this gender imbalance as a reason for decreased student interest
among men. No study has elaborated on the reasons why gender influences
interest in this specialty.
performed a mixed methods analysis on survey data from MS3/MS4 students to
determine how gender influences perceptions of an OB-GYN career choice.
Results: A 51%
(90/176) response rate was achieved (45% male, 54% female, 1% other). Both men
and women considered the current gender gap undesireable (95% vs 89%, p = .68).
Among men, negative themes included stigma from providers and patients,
perceptions of limited career opportunities, and perceived difficulty relating
to patients. Among women responses included female empowerment and ease of
connecting with patients despite preference for a more gender-balanced
specialty. Male students not pursuing OB-GYN more often decided before medical
school (p = .03), while women more often determined this after their third-year
clerkship (p = .04).
Discussions: Our study suggests that
the gender gap negatively influences opinions of OB-GYN for all students. Men
believed their gender negatively impacts career opportunities and patient
relationships. Women viewed the gender gap negatively and desired equal gender
representation, but they also perceived it to be an example of women empowering
other women. Career counseling to increase male interest may benefit from
targeted responses to these insights.
CREOG & APGO Annual Meeting, 2019, Faculty, Clerkship Director, Residency Director, Professionalism, Practice-Based Learning & Improvement, GME, UME, General Ob-Gyn,
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Clinical Vignettes: A Novel Residency Group Interview Technique
Purpose: To compare residency
applicants experience with a novel group interview technique to a traditional
Background: A unique
group interview has been used by George Washington University’s OBGYN Residency
for many years. The group interview involves reading and discussion of several
short literary vignettes. There are no studies looking at this type
of interview. We wanted to ensure that the diversity of our program
is not limited by making minority applicants uncomfortable in the group setting.
Methods: A brief
questionnaire about the group and faculty interview was sent to all applicants
following the completion of the match using a 5 point Likert scale. The
responses were analyzed using paired/non-paired t-tests.
(45%) of interviewed applicants completed the survey. Applicants did not feel
as comfortable with the group interview when compared to the individual
interview (Mean 3.32 and 4.39, p value 0.0001). The applicants felt the group
format did not allow for interviewers to get an accurate impression of them
when compared to the individual interview (Mean 3.11 and 4.34, p value
0.0001). Minority candidates (Men, non-Caucasians, and
non-native English speakers) felt more comfortable with the group interview
than their peers (Mean 3.37 and 2.8, p value 0.02).
Discussions: Applicants felt less
comfortable with our novel group interview when compared to the traditional
individual interview. Interestingly, minority candidates felt more comfortable
in the group setting than their female, Caucasian, native English-speaking
counterparts. This study demonstrates that our group interview does
not discourage minority applicants and may improve the diversity of our
CREOG & APGO Annual Meeting, 2019, Residency Director, Interpersonal & Communication Skills, GME, Assessment,
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Burnt out and yet Engaged: Are We Asking the Right Questions in Faculty Wellness Research?
Purpose: To examines rates of
work engagement and work empowerment in ob-gyn faculty, together with their
perceptions on connection at work, in correlation with burnout.
appears to be an accelerating phenomenon, threatening the health and well-being
of providers and patients. There is concern, however, that the term is becoming
overused and that the measures may not capture the full picture, with an
assumption that the end-goal is the absence of burnout rather than the
promotion of wellness.
study of 25 ob-gyn faculty at a large academic medical center in the United
States. Outcome measures: Utrecht Work Engagement Scale, Work Empowerment
Scale, 2-item Maslach Burnout Inventory, and perceptions of connection in the
percent of faculty met criteria for emotional exhaustion, 19% for
depersonalization, and 19% for high burnout. There was no difference in years
of practice and the presence of burnout (P=.74), and no association between
burnout and work engagement or work empowerment (P=.33 and P=.25, respectively).
Ninety-two percent feel a sense of connection and community at work and 92%
trust their colleagues and feel safe discussing concerns with them.
Discussions: Emotional exhaustion,
sometimes capitulated to be a sign of pathological burnout, may be an appropriate
and normal response to daily activities which does not impact engagement at
work. Shifting the focus away from burnout to positive psychology measures and
building community may be the key to nourishing joy in practice and
transforming the workplace to one that promotes wellness in the face of
adversity and challenge.
CREOG & APGO Annual Meeting, 2019, Faculty, Professionalism, Systems-Based Practice & Improvement, CME, General Ob-Gyn,
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Bring Back the Tubal: An Intervention to Provide Postpartum Bilateral Tubal Ligation in the Underserved Population
Purpose: Improve educational
awareness and receptiveness to the PPBTL procedure.
Background: 50% of
women requesting a PPBTL undergo the procedure. Barriers exist to obtain the
PPBTL, including lack of available operating rooms and concern for patient
regret. Half of pregnancies in the U.S. are unintended, occurring
disproportionately higher in low-income and minority populations. Children
resulting from unintended pregnancies are at risk for poor health outcomes
including low birth weight and developmental delay. Additionally, the U.S.
financial burden of unintended pregnancy accounted for approximately 21 billion
dollars in 2010.
retrospective chart review was conducted from 2015-2016 to document the
baseline prevalence of PPBTLs performed at IFMC. Educational sessions with pre-
and post-session questionnaires were conducted for departments of OB/GYN, Anesthesia,
and Nursing. Data was collected from April 2017 - April 2018 regarding patients
desiring the procedure, those completing the procedure, and reasons for
unsuccessful procedure completion. A pre-post comparison was performed to
assess the impact of the educational sessions and the overall prevalence of
multidisciplinary staff members at IFMC participated in the educational
sessions. All departments showed significant improvement in knowledge of the
PPBTL (OB/GYN p=0.0117, Anesthesia p=0.0002, Nursing p=0.0001). A baseline
prevalence of three PPBTLs were performed from 2015-2016, which increased to
fifty-six from 2017-2018. Comparing pre-post intervention, the percentage of
PPBTLs requested and ultimately performed increased from 39% to 60%.
multidisciplinary educational sessions were effective in identifying barriers
and increasing educational awareness. Overall, this resulted in increased
access to and performance of sterilization in the underserved population.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Patient Care, Professionalism, Interpersonal & Communication Skills, GME, Quality & Safety, Team-Based Learning, Advocacy, Contraception or Family Planning,
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The Impact of a Structured Wellness Curriculum on Burnout Among Obstetrics and Gynecology Residents
primary aim was to evaluate the effects of a formalized wellness curriculum on
the rate of burnout among University of New Mexico (UNM) obstetrics and
gynecology (OBGyn) residents. Our
secondary aim was to evaluate the effect of a wellness curriculum on rates of
depression, alcohol abuse and suicide risk.
Background: Burnout is a pathological syndrome characterized by depersonalization,
emotional exhaustion and a low sense of personal achievement. Burnout is a
concern for resident physicians due to their heavy workload and low sense of
Methods: A structured wellness curriculum was instituted at the start of the 2016
academic year. A 45-item survey,
consisting of the Maslach Burnout Inventory Human Services Survey (MBI-HSS),
personal health questionnaire-9 (PHQ9), suicide behaviors questionnaire-revised
(SBQr), and the alcohol use disorders identification test (AUDIT), was to be
administered at the start, midpoint, and end of the academic year.
Results: The study included 23 UNM OBGyn residents. Midpoint and end of curriculum
surveys were collected as planned and demonstrated no difference in rate of burnout. Upon completion of the 2016 academic year 18
(78.2%) residents reported moderate to severe emotional exhaustion; 13 (59.1%)
moderate to severe depersonalization; and 5 (21.7%) low personal achievement. SBQ-R identified 4 (18.2%) residents at high
risk for suicide and AUDIT-C identified 15 (68.2%) at high risk for alcohol
rates of burnout, depression, alcohol abuse, and suicide risk did not change
between the midpoint and end of a structured wellness curriculum.
CREOG & APGO Annual Meeting, 2018, Resident, Faculty, Residency Director, Interpersonal & Communication Skills, GME, UME,
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