The Substantial Rise of Clinician Educators Among Obstetrics and Gynecology Faculty, 1977-2017
Purpose: To determine trends in faculty career development, stratified
by gender and under-represented minority (URM) status, for
obstetrician-gynecologists (ob-gyn) at all U.S. medical schools.
Background: The growing number of faculty and opportunities for
career pathways have expanded considerably at U.S. medical schools. This growth
differs between clinical specialties. Any dominance of non-tenure faculty has
important implications on academic promotion policies and teaching
Methods: In this observational study, we used the Association
of American Medical Colleges Faculty Roster to describe trends in career
pathways (clinician educator, tenure-track, tenure) of full-time faculty at all
U.S. MD-granting medical schools between 1977 and 2017. Proportions of
female and URM faculty on each pathway were compared with that of male and
Results: Between 1977 and 2017, the number of full-time faculty
increased from 1,628 to 6,347, mostly as clinician educators (from 345 to
4,607; 13.4-fold increase) than as being either tenured (from 457 to 587) or on
tenure-track (366 to 514). The proportion of clinician educators increased from
21.2% to 69.4%. The availability of tenure positions remained constant (92.7%
of all schools); however, the proportions of tenured and tenure-track faculty
declined steadily from 28.1% and 22.5%, respectively to 8.2-9.1% for each
group. The proportions of male and female faculty who were tenured or on
tenure track declined from 52.9% and 37.1% respectively to 23.3% and 13.6%. The
proportion who were tenured or on tenure-track declined similarly for URM (from
55.3% to 13.4%) and non-URM (from 50.2% to 18.0%) faculty.
Discussions: The substantial rise in ob-gyn faculty is largely among those
who pursued careers as clinician educators. This finding confirms the essential
need and protected time for educator development programs at all schools to
more effectively teach medical students and resident physicians.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Professionalism, CME, Lecture,
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Medical Students’ Perceptions of Teaching on the Obstetrics and Gynecology Clerkship
Purpose: Assess medical students’ perceptions of the learning quality
in their OBGYN clerkship.
Background: OBGYN uniquely synthesizes primary, subspecialty, and
surgical care. Accordingly, medical student teaching must reflect the breadth
of our field. Many teaching modalities are employed within the clerkship, such
as patient interactions in the clinic setting and wards, intraoperative
instruction, non-traditional case-based conferences, and written texts. While
overall learning and students’ decisions about specialty selection are known to
be contingent on effective education, it is not known which modalities students
perceive as most efficacious.
Methods: An eighteen-item electronic questionnaire was
distributed to consenting third year students at the completion of their six-week
clerkship at the University of Florida’s two campuses over a twelve-month
Results: Students receive approximately 6 hours of group and
individual instruction weekly and felt this was appropriate. Satisfaction was
high for resident and attending instruction, opportunities to demonstrate
clinical knowledge, and meaningfulness of students’ roles in patient care. The
ability to practice procedures and receive feedback were ranked lowest. Among
key topics in OBGYN, the highest scores included preeclampsia and abnormal
uterine bleeding, with relatively lower scores for pelvic floor dysfunction.
Labor and Delivery board rounds was perceived as the most effective mode of
instruction. Roles in the outpatient setting were perceived as primarily observational,
while perceived responsibilities in the OR varied.
Discussions: Potential areas of growth include incorporating more
procedural training and providing more effective feedback. Limitations to our
study included survey format, single academic year, and limitation to two
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, Lecture,
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Management of Postoperative Issues in Gynecology and Gynecologic Oncology: A New Method for Teaching Residents
Purpose: This project sought to develop and assess a curriculum to
improve resident knowledge of and comfort in managing common post operative
Background: Junior obstetrics/gynecology residents enter training
with varied experience in post-operative management. They are often the first
contact for surgical patients with little formal education on post-operative
Methods: Eleven common post-operative issues were identified
based on literature review, resident experience and gynecology/gynecologic
oncology faculty input. Topic based curriculum included: example case,
pathophysiology, differential diagnosis, next steps, and useful resources. It
was presented at two educational sessions, involving lectures and small-group
simulations. Residents completed a pre and post-assessment questionnaire
assessing comfort level in managing (10-point Likert scale) and baseline
knowledge about (content-specific questions) the topics.
Results: Twenty-three residents participated.Seventeen
completed one or both pre-assessment surveys (nine junior residents). Ten
completed one or both post-assessment surveys (five junior residents). All
post-assessment respondents reported improved knowledge of issues covered.
Average self-rated comfort level increased for ten of eleven topics amongst
junior residents (average increase 1.6 points (range 0.5 – 3.2; p = 0.02)).
Largest increase in score was for hypoxia and low urine output. Average scores
maintained or improved for 80% of the content questions (not significant).
Residents had no preference for lecture versus small group format.
Discussions: As a result of directed teaching, resident knowledge of
post-operative issues showed measurable improvement. Resident comfort level in
management increased significantly for 90% of topics covered, most noticeably
amongst junior residents. A systematic, resident-led curriculum on
post-operative management can improve resident knowledge and patient care.
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Patient Care, Medical Knowledge, GME, Simulation, Lecture, Problem-Based Learning, Team-Based Learning, Gynecologic Oncology, Minimally Invasive Surgery, Female Pelvic Medicine & Reconstructive Surgery, General Ob-Gyn,
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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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Let the Good Grades Roll: Optimizing Shelf Exam Performance with a Novel Peer-led Comprehensive Review Session
Purpose: To create a
comprehensive review for third year medical students at Brody School of Medicine
in preparation for the end of clerkship national board shelf examination in
Background: With the
increasing availability of resources in preparation for clinical clerkships,
medical students struggle to identify high-yield topics in review for end of
clerkship shelf examinations. This dilemma is further exacerbated by having
educational objectives published by both the National Board of Medical
Examinations (NBME) and the Association of Professors of Gynecology and
Obstetrics (APGO). Although though it was proven that the NBME exam
appropriately tests students on the information that APGO deemed “essential,”
there still isn’t a timely and comprehensive review resource available for
students focusing on these specific topics. Due to this, a comprehensive
high-yield review was created using the student educational objectives in
OB/GYN published by the APGO.
two-hour comprehensive review presentation was created for students who were
rotating on the OB/GYN clerkship at the Brody School of Medicine using the APGO
objectives. The presentation was created in a question and answer format to
allow students to use the information presented as both a study tool and as a
self-assessment of knowledge. This review was created using the follow
resources: U-World, Step-Up to Obstetrics and Gynecology, and Pre-Test OB/GYN.
post-presentation survey revealed that participants found the review to be
educational, high yield, and extremely useful for studying for the NBME shelf
examination. An additional survey was also sent to students after taking the
NBME shelf examination to assess the quality of the information presented.
Overall the students who attended the review session and used the presentation
as a study tool reported positive impacts on shelf examination scores and
overall understanding of high-yield concepts in OB/GYN.
Discussions: With the positive
feedback from students who attended the review session and used the
presentation as a study-tool for the NBME shelf examination, we hope that
comprehensive reviews such as this will be created for additional clerkships to
help students prepare for other NBME examinations.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Medical Knowledge, GME, CME, UME, Lecture, General Ob-Gyn,
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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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amming with Podcasting: Make Education Swing for Medical Students!
Purpose: Take five to explore
the podcast format as a smooth way to teach medical students intimate
partner violence (IPV) screening and history-taking.
USPSTF recommends IPV screening as routine health maintenance.2 Research has
found that perceived preparedness and comfort level are barriers to screening
and intervention.1,3 There were only crickets regarding IPV screening in our
own curriculum. As a result we sought to harmonize the instruction of students
with an accessible and memorable educational format.
Methods: We laid
down a brief introductory lecture about IPV followed by a 22 minute podcast
about screening and addressing IPV disclosures for first-year medical students.
They completed pre- and post- surveys assessing general knowledge and perceived
pre-survey “opener” showed 52% of respondents had no prior experience nor
training in IPV screening. Initially, 64% of respondents hit a sour
note feeling either “somewhat not confident” or “not confident at all.” In a
smooth turn-around, the post-survey showed that listening to the smokin’
podcast increased students’ confidence. When asked about addressing a positive
disclosure of IPV, the post-survey again showed an increase in confidence.
The objective section of the post-survey demo’ed an increase in correct
answers for every knowledge question.
Discussions: This curricular
intervention employs a hot form of information sharing. Initial data
suggested that a majority of students did not feel confident screening for IPV
nor addressing a positive disclosure. After a paired lecture/podcast on
this topic, students demonstrated increased general knowledge about IPV as well
as a measureable crescendo of confidence.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Patient Care, Medical Knowledge, Interpersonal & Communication Skills, UME, Lecture,
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Improving Tetanus, Diphtheria, Pertussis Vaccination Rates in an Academic Center Through Resident-driven Education
Purpose: To improve rates of
prenatal Tetanus, Diphtheria, Pertussis (Tdap) vaccination for clinic patients
in an academic training center.
United States is experiencing a resurgence of pertussis, which can cause
serious complications for infants, especially within the first six months of
life. To maximize maternal antibody response to Tdap and antibody transfer to
the newborn, vaccination between 27-36 weeks of gestation is recommended.
pre-post survey study design was used to evaluate OBGYN residents at the
University of Tennessee during the 2017-2018 academic year. The primary outcome
was Tdap vaccination rate. Secondary outcomes were resident-reported Tdap
counseling and resident understanding of the appropriate gestational age for
administration. The following educational methods were utilized: resident-lead
lecture, provider handouts, English and Spanish patient education posters
throughout the clinic. Direct comparison of pre and post-surveys was used to
Tdap vaccinations were given in the four months prior to pre-survey
administration (0.33 vaccines/resident). Following the Tdap educational
program, forty-three vaccinations were given in four months (2.86
vaccines/resident). Pre-surveys indicated eleven residents (73%) provided Tdap
counseling, while post-surveys revealed fifteen residents (100%) provided
counseling. On pre-surveys, the majority of residents (33%) incorrectly
answered that Tdap was indicated between 27 weeks gestation until delivery. In
post-surveys, thirteen residents (87%) correctly answered that Tdap was
indicated between 27-36 weeks gestation.
Discussions: Tdap vaccination rate
increased by 767% after implementation of the educational tools. Additionally,
resident-driven counseling about Tdap increased by 36% and resident
understanding of appropriate gestational age for vaccine administration
improved by 225%.
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Patient Care, Medical Knowledge, GME, Lecture, Quality & Safety, Public Health, Advocacy,
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Impact of Resident Led Didactics on OBGYN Clerkship Shelf Scores and Student Satisfaction
Purpose: Compare NBME shelf
scores prior to and after implementation of the Wednesday lecture
series.Compare satisfaction scores of students prior to and post implementation
of Wednesday lecture series. Scores would be obtained from the Aesculapian
Society who evaluates students’ overall perceptions of clerkships
· The ACGME and LCME has designated teaching as an
accreditation standard with numerous competencies. Residents serve as clinical
teachers for medical students with studies indicating that residents spend up
to 20% of their time teaching medical students.
· In a national survey 60% of students reported that
they received their teaching from residents and fellows during their obstetrics
and gynecology clerkships.
· In 2015-2016, the department of Obstetrics &
Gynecology at Louisiana State University School of Medicine-New Orleans
implemented a new lecture series for 3rd year medical students.
· Wednesday Lectures: High yield OB/GYN topics
delivered by chief resident.
· Lectures designed to complement Team-Based Learning
· Shelf exam scores from 2011-2017 were reviewed and
compared across the training sites.
· Control Group: Baton Rouge and Lafayette based
students who do not receive the same lectures.
· Aesculapian Society Evaluations.Scores before and
after implementation were examined
· Positive correlation in resident teaching and
· Positive correlation in NBME scores and satisfaction
· Student experience and satisfaction may vary by
location based on clinical exposure and opportunity
· No standardized resident-lectures amongst all
· Future Implications: Standardized implementation
of resident led didactics. Our goal is to Implement ACGME recommended
‘Resident-as-teachers program as already established in other institutions and
improve shelf scores over the next 5 years.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Medical Knowledge, Professionalism, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, CME, Assessment, Lecture, Team-Based Learning, CREOG & APGO Annual Meeting, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Medical Knowledge, Professionalism, UME, Assessment, General Ob-Gyn,
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Immediate Post-placental IUD Insertion: Evaluation of Clinician Knowledge and Views
Purpose: To increase
practitioner knowledge and comfort performing immediate post-placental IUD
insertion with a session including lecture and simulation.
post-placental (within 10 minutes of placental delivery) insertion of an
intrauterine device (IUD) has been shown to be both safe and effective
contraception. Post-placental IUD insertion removes barriers (loss of
insurance, loss to follow up, etc.) in the prevention of unplanned pregnancies.
In order to increase practitioner knowledge and comfort performing immediate
post-placental IUD insertion, this project developed and administered education
and procedural simulation sessions.
session consisted of a 10 minute pretest, 15 minute scripted powerpoint
presentation, 15 minute procedure simulation, and 10 minute post-test. The primary
outcome of knowledge score was calculated as the sum of all knowledge
questions. The change in knowledge score and comfort levels were assessed by
paired T-tests. Participants were asked to rate their comfort level on
performing post-placental IUD insertion on a scale of 1-5 (1=not comfortable at
all; 5=completely comfortable).
obstetrical providers attended the sessions. The average knowledge score
pre-training was 11.4 (95% CI 10.6-12.2) as compared to 15.5 (14.5-16.5)
post-training (p<0.01). Pre-training, participants were less comfortable
with immediate post-placental IUD insertion (mean 2.82; 95% CI 2.4-3.2) as
compared to post-training (mean 3.96; 95% CI 3.7-4.2), (p<0.01).
Discussions: Education and
procedural simulation sessions are an effective method to improving knowledge
and procedural comfort of post-placental IUD insertion. A curriculum dedicated
to improving knowledge and comfort of post-placental IUD insertion should be
integrated into obstetrical training.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Patient Care, Medical Knowledge, Practice-Based Learning & Improvement, GME, Simulation, Lecture, Contraception or Family Planning,
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Evaluation of Knowledge Retention 3 Months After Completion of a Resident Menopause Curriculum
Purpose: Evaluate residents’
retention of menopause-based knowledge 3 months after completion of
self-administered modules that varied by menopause-related topic and format of
express discomfort managing menopause. Didactic teaching of this topic can be
tailored to learning style, which may influence retention and improve
cross-over study of Obstetrics and Gynecology and Family Medicine residents at
one institution over the 2017-2018 academic year. Residents were randomized to
a series of 3 PowerPoints, each < 30 slides, administered during protected
learning time. Each series contained 3 different subjects (Menopause Basics
(MB), Hormone Replacement Therapy (HRT), Genitourinary Syndrome of Menopause
(GSM)) delivered through 3 different presentation styles (typical presentation
(typical), pictures and a narration (pictures), and interactive to reveal
information (interactive)). Knowledge and comfort were assessed through
baseline, immediate post-exposure, and 3-month follow-up surveys containing 24
knowledge questions (multiple choice) and 10 comfort and satisfaction questions
(5-point Likert scale and multiple choice). Statistical tests were applied with
a p< 0.05 considered significant.
residents completed 3-month follow-up. Immediately post-exposure, knowledge and
comfort increased from baseline for all topics (p< 0.05). On 3-month
follow-up, the HRT topic demonstrated a sustained increase in knowledge
(p=0.047). The typical format of the GSM topic had significantly better retention
than the picture format (p=0.027). All formats were associated with a
significant increase in comfort (all p< 0.01).
post-exposure knowledge and comfort were universally improved by topic,
however, on 3-month follow-up retention varied by format and topic. Comfort in
managing menopause remained increased on follow-up.
CREOG & APGO Annual Meeting, 2019, Student, Resident, Medical Knowledge, GME, Assessment, Lecture, Independent Study, General Ob-Gyn,
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Development of a Novel Method for OBGYN Resident Recruitment
Purpose: We aimed to improve our
resident recruitment method to promote individualized, holistic admissions and
decrease applicant stress.
Background: The AAMC
is promoting processes that utilize holistic, individualized resident applicant
criteria and methods that reduce candidate stress.
applicants were divided among six experienced faculty who selected candidates
based on objective scoring of academic records. Selected applicants were
emailed to rank interview date preferences within 72-hours, and then received
an email with interview placement. Following interviews, applicants were
surveyed about the process.
Three ranks lists were generated and compared:
a behavioral-based composite rank list (BBC); a BBC with pre-interview scores
included; and a traditional list. In the BBC method, faculty were blinded to
pre-interview scores, and applicants were evaluated on professionalism,
leadership, trainability, and fit. The traditional rank list was generated via
open discussion with interviewers. The three rank lists were compared to
determine concordance between methods.
were 78 applicants interviewed. There was 62.8% concordance between the BBC and
traditional rank list, which dropped to 32.1% concordance when pre-interview
scores were combined with BBC scores. Applicant post-invitation survey response
rate was 67%; with 93.3% reporting the interview invitation process was more
equitable, less stressful (82.7%), and better than other institutions (86.6%).
All faculty involved in the candidate prescreen preferred the new
Discussions: There was concordance
between the BBC and standard rank lists, but not when pre-interview scores was
combined with the BBC. Candidates were satisfied with the new method
of invitation and faculty found the standardized pre-interview scoring method
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Residency Director, Residency Coordinator, Professionalism, Interpersonal & Communication Skills, CME, Assessment, Lecture,
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Can I Get a Suggestion? Improv Training to Teach Empathy in Ob/Gyn Residents
Purpose: To examine
improvisation training on Ob/Gyn resident empathy
empathy is associated with improved patient outcomes. Empathy training is
effective in physicians, and many models exist. However, no studies have
examined whether the improvements are sustained over time. Our primary aim is
to determine whether an improv workshop is an effective tool to deliver empathy
training. Our secondary aim is to determine whether that effect is sustained
Methods: This is
a prospective study of Ob/Gyn residents. Validated empathy surveys were
administered 1 week prior to empathy training, immediately after training and 1
month later. Improv games were used in conjunction with empathy training during
the intervention. Paired t-tests and McNemar’s were used to compare statistical
differences at each post-intervention assessment compared to pre-intervention.
residents participated. Empathy scores increased immediately after training
(mean=113 vs 120, p=0.03), but were not sustained 1 month later (mean=113
vs 117, p=0.11). Residents reported that the workshop positively impacted
their delivery of care both immediately (mean=3.5 vs 4.6, p <0.001) and 1
month later (mean=3.5 vs 4.1, p=0.04).
Discussions: Using improv comedy to
delivery empathy training is associated with improved empathy scores in Ob/Gyn
residents, but this improvement gravitates back to baseline over time.
Residents report that the improv workshop was effective at improving empathy,
even up to one month later.
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Interpersonal & Communication Skills, GME, Simulation, Team-Based Learning, CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Patient Care, Medical Knowledge, Professionalism, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME, Assessment, Lecture, Maternal-Fetal Medicine, General Ob-Gyn,
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Bringing Basic Science to the Ob/Gyn Clerkship: Perspective from Our Learners
Purpose: To evaluate medical
student perceptions on whether basic science concepts were taught during
patient care delivery in an Obstetrics-Gynecology clinical clerkship.
school curriculums are moving towards competency-based curricula, with an
emphasis on early introduction to clinical training. These changes condense the
traditional basic science curriculum, yet basic science remains critical to
clinical medicine. Students who learn basic science explanations for clinical
correlates have improved retention. The goal is to embed basic sciences within
Methods: At the
end of each required clinical clerkship at the University of Michigan, students
on their rotations were asked to evaluate their overall clerkship experiences
from December 2017 to July 2018. The survey included the statement “Basic
science concepts were taught during patient care delivery” with a too-little to
too-much five level scale, with a score of three being “just right”.
Descriptive statistics were used to analyze the results.
Results: For the
OB/gyn clerkship, 102 students completed the survey. The mean score was 2.37
with a standard deviation of 0.7. Other clerkships were blinded. The same
statement in other clerkships resulted in a score of 2.39 (0.69), 2.73 (0.68),
2.88 (0.56), 2.68 (0.64), 2.65 (0.63), 2.45 (0.73), and 2.66 (0.59).
Discussions: While basic science
concepts are taught in the OB/gyn clerkship, there is significant room for
improvement. All clerkships fell below what students considered optimal basic
science teaching. Teaching scripts, basic science videos, and didactics with
purposeful integration of basic science principles could be an effective,
efficient method of integrating basic science content within the
CREOG & APGO Annual Meeting, 2019, Student, Faculty, Clerkship Director, Medical Knowledge, Practice-Based Learning & Improvement, Lecture, Problem-Based Learning, General Ob-Gyn,
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An Effective Vaginal Delivery Simulation and Lecture Combination for the Medical Student Learner
Purpose: To evaluate the
effectiveness of a normal spontaneous vaginal delivery (NSVD) simulation and
lecture combination on medical student education.
obstetrical training, simulation significantly improves learner knowledge and
confidence. However, time and space constraints may hinder routine integration
of simulation into medical student education. Findings regarding effectiveness
of a concise and easy-to-implement medical student education program consisting
of an NSVD simulation and lecture are presented.
on-campus outpatient space was used for an educational program aimed at third
year medical students. This program occurred at the start of the obstetrics and
gynecology clerkship and consisted of: (1) lecture on NSVD of fetus and
placenta, stages of labor and identification of lacerations and fetal
presentation, station and position and (2) simulation of an NSVD on a portable
birthing mannequin. No more than 9 students participated during the 45-minute
program. 15 to 20 minutes were used for lecture; 25 to 30 minutes for
simulation. Medical students completed questionnaires before and after the
program regarding confidence (based on a 1-5 Likert scale, 5 being very
confident) and knowledge on NSVD and associated aspects (total possible score
Results: Total of
33 medical students participated. Mean confidence and knowledge scores
significantly increased from 1.9 to 3.9 (p < 0.001) and from 8.8 to 14.3 (p
< 0.001) before and after the program, respectively.
Discussions: A concise and
easy-to-implement educational program consisting of an NSVD simulation and
lecture significantly improves medical student confidence and knowledge.
CREOG & APGO Annual Meeting, 2019, Student, Faculty, Clerkship Director, Clerkship Coordinator, Patient Care, Medical Knowledge, UME, Simulation, Lecture, General Ob-Gyn,
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Increasing Access to Emergency Contraception, Non-emergent Contraception, and LARC Referrals in the Emergency Room: A Resident-based Educational Intervention
Purpose: The aim of this study is to determine whether an educational
intervention improves emergency medicine residents\' knowledge of and personal
comfort with prescribing EC, offering non-emergent contraception, and referring
patients for LARCs.
Background: Approximately 50% of pregnancies in the United States
are unintended. Increasing access to emergency contraception (EC), non-emergent
contraception, and long-acting reversible contraception methods (LARCs) is one
way of decreasing unintended pregnancies. Emergency rooms enable physicians to
assess a woman\'s risk of unintended pregnancy and afford an opportunity to
intervene, if appropriate. Previous studies have found that emergency medicine
physicians do not always offer EC, even in cases of sexual assault. Barriers to
prescribing EC have been identified and include time constraints, lack of
clinical resources, concern about discouraging regular birth control, and
concern about birth defects.
Methods: Emergency medicine residents were given an interactive
lecture on contraception with emphasis on EC. They were also given a pocketbook
on contraception to keep. Pre- and post-lecture surveys were given in person,
along with another 6 months later. The surveys assessed knowledge, comfort
level, and prescribing/referring practices with both quantitative data and
qualitative data. Data will also be extracted from the electronic medical
record to assess if there was an increase in prescriptions for contraception
and/or referrals to family planning.
Results: The preliminary data analysis is currently being
conducted. Twenty-three emergency medicine residents completed the pre- and
post-test surveys. Additional information from prescriptions and referrals will
provide objective data to assess whether the educational intervention changed
Discussions: There are two hypotheses for this study. First, it is
hypothesized that an educational intervention will increase emergency medicine
residents\' knowledge of and comfort with EC, non-emergent contraception, and
LARCs. Second, there will be a significant increase in prescriptions for EC,
non-emergent contraception, and referrals for LARCs one year after the
educational intervention takes place. If the hypotheses are correct, residency
programs and hospitals should consider developing educational strategies and
policies to improve access to contraception in the emergency room and prevent
CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Systems-Based Practice & Improvement, GME, CME, Assessment, Lecture, Quality & Safety, Contraception or Family Planning,
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Ultrasound Training in Obstetrics and Gynecology Residency: A National Portrait
understand current training in obstetric and gynecologic ultrasound.
Background: Modern obstetrics and gynecology practice requires the frequent use of
ultrasound (US) and therefore US training has become an important part of
resident education. We sought to understand how residents are currently being
trained in obstetric and gynecologic US by surveying residency program
Methods: We developed a 36 item self-administered questionnaire targeted for
residency program directors (PD). PD from all 261 accredited programs were
invited to participate. We inquired about US curriculums, time spent in US
training, types of US taught, learning environments and instructors, feedback
regarding resident competence and resident input of the learning experience.
IRB approval was obtained prior to study onset.
Results: We received 108 completed responses.PD from all geographical US areas and
Canada responded. PD self-described their programs as 52% university based, 28%
community based, 18% combination of university/community based and 2% military.
Over 65% reported US education was built into the curriculum as a distinct
rotation. Of the US rotations >50% were described as a one month separate
block. 40% stated 1 – 4 hours week devoted to US education. 99% said supervised
instruction was the norm with the majority of teachers being MFM
physicians/sonographers. A mixture of observational and hands-on ultrasound
experience is the norm for most programs. Over 76% PD gave residents US reading
assignments and have formal lectures, mostly by MFM and REI faculty. Less than
20% of programs supported any experience with ultrasound simulator training.
90% of PD give formal feedback to the residents about their skills. Only 69%
state that their residents can evaluate the learning experience.
recount details of the current status of US education in OB/Gyn residency
programs as reported by PD across the country. Our questions were designed to
understand the amount of time actually committed to ultrasound education. With
the inception of widespread US need in the daily life of obstetrics and
gynecology the challenge of ensuring adequate resident training exists. More structure
and protected learning time may assist in resident training. Simulator training for US education seems
CREOG & APGO Annual Meeting, 2018, Resident, Faculty, Residency Director, Medical Knowledge, GME, Assessment, Simulation, Lecture, General Ob-Gyn,
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There Is an APP for That: Vaginal Hysterectomy
create an instructional app which includes medical knowledge, procedural steps
and assessments based on the ACOG curriculum for vaginal hysterectomy.
Background: Vaginal hysterectomy is the evidence based medicine route of choice when
feasible. Significant challenges exist
in teaching this procedure due to lack of simulation training, proper
assessment of specific techniques and timely instruction prior to performing
the procedure. There is also
considerable variation in how cases are tracked and assessments of technique
Methods: Key features/contents of the application include: 1) ACOG curriculum for vaginal hysterectomy,
2) a complete step by step live and simulated surgical video tutorial, 3) a
procedural step by step assessment (10 steps-- 0-10 score), 4) a global
surgical rating scale (7 metrics), and 5) a knowledge based assessment (4
metrics, 0-4 scale).
Results: The data captured on the app can be accessed via IPAD and iPhone mobile
devices and is verified by Apple. The
evaluations can be directly emailed to any database.
comprehensive instructional surgery app coupled with real time assessment will
provide greater learning efficiency and will more effectively improve surgical
skills. This app has the potential to
standardize surgical evaluation in the operating room and provide a more
efficient method to track surgeon competency using ACOG guidelines. The assessment is currently employed by the
ACOG Simulation Consortium Working group during vaginal hysterectomy simulation
and is part of a surgical simulation course which certified by the ABOG for MOC
CREOG & APGO Annual Meeting, 2018, Resident, Faculty, Clerkship Director, Osteopathic Faculty, Residency Director, Residency Coordinator, Medical Knowledge, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME, Assessment, Simulation, Lecture, Minimally Invasive Surgery,
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Teaching Lesbian, Gay, Bisexual, Transgendered, and Queer Family Building in a Third Year OBGYN Clerkship
explore third year medical students’ fund of knowledge and attitudes about
LGBTQ family building and third party reproduction.
Background: Medical student knowledge and attitudes about family building for LGBTQ
families and third party reproduction (TPR) varies based on student prior
experience and pre-clinical teaching.
The OBGYN clerkship is a unique opportunity for students to learn
medical knowledge and reflect on attitudes about this subject.
Methods: A quantitative study of knowledge and attitude among third year medical
students done after IRB approval. The intervention consisted of a one hour
lecture on TPR and participating in a group discussion about LGBTQ family
building. Students (231) completed a survey asking about their knowledge and
attitudes prior to starting the rotation and 178 completed the survey following
the intervention. Survey respondents rated items using a Likert scale and
completed a knowledge assessmented. Changes in knowledge scores were investigated
Results: Survey respondents were 51% female, 48% male, 1% gender non-conforming;
heterosexual 93%; and partnered 59%. Comfort with same sex couples was endorsed
by 92%. 56% of students felt that opting out of assisting a patient with family
building was not an option. Fertility knowledge increased from after
intervention significantly (p<0.0001). Some students, 29%, thought that infertility was hard to discuss,
but 67% felt it would be hard to discuss for same sex couples.
students’ fund of knowledge was increased with lecture and small group
discussion about TPR and LGBTQ patients. Students report being comfortable with
TPR and LGBTQ families but have some discomfort with varied pathways to
parenthood. Most feel that opting out of care for LGBTQ families is not an
CREOG & APGO Annual Meeting, 2018, Student, Faculty, Clerkship Director, Medical Knowledge, Professionalism, Interpersonal & Communication Skills, UME, Lecture, Advocacy, Reproductive Endocrinology & Infertility, Sexuality,
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Improvement in CREOG Scores Through Focused Review Sessions
determine if focused review sessions lead to improvement in CREOG scores.
Background: In 2013, faculty at the University of Kentucky developed a Gynecologic
Oncology (GYO) review aimed at improving resident scores.
Methods: Each year, residents voluntarily participated in five review sessions on
major topics in GYO. Sessions consisted
of a pre-test (approximately 15 questions) followed by a discussion that
emphasized the key concepts for that subject. From 2014-2017, GYO scores were
compared between residents who attended (A) over 50% of the sessions and those
who did not (NA). Scores from 2010-2013 were collected as a control group (C).
SAS (9.4) was used to analyze the data via ANOVA with repeated measures and
least square difference pairwise comparisons. Significance was defined as p
Results: Data was collected on 153 tests from 55 residents (80 from 2010-13 and 73 from
2014-17). The mean scores for GYO and overall test increased with each resident
year (p<0.0001). Attendance revealed a statistically significant improvement
on GYO scores when compared to NA (p=0.0001) and C (p=0.0008). There was
no difference between C and NA (p=0.3875). Those who attended also scored
significantly higher on overall test scores compared to NA (p=0.0002). There
was no difference between A and C (p=0.1747). For those residents who attended
multiple years of review sessions, there was no significant improvement in GYO
or overall scores compared to less frequent attendees.
findings support the hypothesis that focused review sessions improved resident
comprehension as reflected by CREOG scores.
CREOG & APGO Annual Meeting, 2018, Resident, Faculty, Residency Director, Medical Knowledge, GME, Assessment, Lecture, Independent Study, Gynecologic Oncology, General Ob-Gyn, CREOG & APGO Annual Meeting, 2018, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Medical Knowledge, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, Advocacy, General Ob-Gyn,
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