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Using Student Interest Groups to Train Medical Students to Lead

Purpose: Medical student interest groups (SIG) serve as students’ introduction to medical specialties. The student leaders of these groups are driven and demonstrate leadership ability early in their careers. Connecting these student leaders with young physicians can improve specialty matriculation, leadership among new residents, and foster mentorship in the organization.

 

Background: The American College of Obstetrics and Gynecology (ACOG) has leadership positions for residents, however, less for medical students, who are encouraged to participate in meetings rather than engage.  SIG leaders have not been a focus of recruitment for ACOG, however, these students are primed to become leaders in ACOG upon completion of medical school. 

 

Methods: Prior to the 2017 ACOG’s Annual Clinical and Scientific Meeting, we contacted medical students registered for the meeting to identify any SIG leaders. A meeting was arranged for student leaders to meet with several national representatives. The group of 17 students was introduced to the structure and benefits of the organization and given training for optimizing SIG function and efficacy. Through our survey, all students appreciated the information about ACOG, ideas on how to improve their SIG, and resources available through ACOG, rating it as just the right of information or stated they would like to hear more.

 

Results: Sixty four percent were planning on establishing a generic SIG email to improve communication with ACOG while 23% already had one. When asked if they felt prepared to take the information back to their SIGs, all students answered positively. Only three of the 17 students had read a leadership book and all students said they would love to participate in a more formal leadership training. 

 

Discussions: Medical student leadership represents a natural group to become future ACOG leaders. Given the barrier of contacting the SIG leaders, we recommended establishing a generic email address for groups (eg OBGYNSIG@***). All students wanted leadership training and to be involved in ACOG. In conclusion, medical SIG leaders are an enthusiastic and untapped resource who will become our colleagues. Connecting with student leaders at organizational meetings secures future leadership and continued engagement after medical student graduation. 

Topics: CREOG & APGO Annual Meeting, 2019, Student, Faculty, Clerkship Director, Clerkship Coordinator, Professionalism, Systems-Based Practice & Improvement, GME, Independent Study,

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The Residency Buddy System\': A Better Way to Encourage Laparoscopy Simulation Training?

 

Purpose: To determine if a “buddy-system” compared to independent training increases laparoscopic simulation time amongst residents.

 

Background: Based on prior research, laparoscopic box-trainers improve proficiency on surgical skills, however voluntary simulation time by residents is traditionally low. We propose that a buddy system approach to simulation will increase laparoscopic training time, and further improve skills.

 

Methods: Thirty-two residents at a single obstetric and gynecology residency program were consented for the study.  Each buddy pair was composed of a junior and senior resident. During the first half of the 20-week study, 12 residents were randomly assigned a buddy while 20 remained solo.  During the second half, solo-trainers were assigned buddies and conversely buddies were made solo. Residents recorded check-in and -out times electronically. (Assignments were provided via email at the beginning and mid-way points; no other contact was made.) At the conclusion of the study period a survey link was distributed.

 

Results: Six of the 32 residents (18.8%) attended simulation in the 20-weeks, with an average time of 2 hours 14 minutes. In the solo-trainer group, 1 resident checked in 3 times and 2 residents once. In the buddy group, 1 pair checked in together and 1 person checked in alone.  Fifteen residents (46.9%) completed the survey.  Thirteen (86.7%) agreed they accurately reported times; 1 was neutral and 1 never attended. All communicated with their buddy monthly or less frequently, while 10 of them never communicated.

 

Discussions: Residents’ laparoscopic simulation time was dismal at our program in this study. Dedicated mandatory simulation time may increase participation.

Topics: CREOG & APGO Annual Meeting, 2019, Faculty, Residency Director, Medical Knowledge, CME, Independent Study, Minimally Invasive Surgery,

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Removing the Shelf Cutoff to Achieve Honors in the Clerkship Does Not Change Test Scores

Purpose: Purpose: To identify students’ performance on the NBME subject examination changes when a minimum score requirement for Honors is removed.

 

Background: Background: The NBME subject examination is used in many obstetrics and gynecology clerkships as an objective measure of knowledge. The exam score may be included in the calculation of a student’s final grade, with a requirement to achieve a certain minimum score to be eligible for a grade of Honors. At our institution, this cutoff was removed from the obstetrics and gynecology clerkship in 2017.

 

Methods: Methods: Scores for the Obstetrics and Gynecology subject examination at the University of Pennsylvania were compared between 2016 (the most recent year in which a cutoff was used) and 2017 (the first year in which the cutoff was removed). Comparative statistical analyses were performed, including mean, standard deviation, and Student’s T-test.

 

Results: Results: In 2016, 161 students took the NBME subject examination, during which time a minimum score of 81 was required to be eligible for a final grade of Honors. The mean score was 80.58 (range 61-93, standard deviation 6.34). In 2017, the minimum cutoff requirement was removed, and 163 students took the exam. The mean score was 80.42 (range 53-94, standard deviation 6.38). The T-test result for comparison between the two means was 0.41.

 

Discussions: Discussion: At this academic institution, the mean NBME subject examination score did not change between the two years. Students continue to study for the final exam when the minimum cutoff is removed.

Topics: CREOG & APGO Annual Meeting, 2019, Faculty, Clerkship Director, Medical Knowledge, UME, Assessment, Independent Study,

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Perioperative Complications Curriculum for the OB/GYN Resident: A Pilot Study

Purpose: To develop and implement a perioperative complications curriculum.

 

Background: ACGME program requirements and milestones include recognizing and managing perioperative complications.

 

Methods: Residents, Fellows, and Faculty were sent a needs assessment survey, addressing satisfaction with baseline perioperative complications curriculum and preferences for development of new curricula.  Additionally, Residents completed a knowledge pretest.  Over four weeks, Residents received weekly emails through the Qualtrics software program linking to topic-specific materials, including interactive, online case-based modules.  A post-implementation survey was distributed to assess Resident satisfaction with programming and to retest knowledge. 

 

Results: With 75% (21/28) of Residents and 47% (40/86) Fellows/Faculty completing the needs assessment survey, 95% (20/21) of Residents and 90% (36/40) Fellows/Faculty reported dissatisfaction with baseline curriculum.

The Resident pretest mean score was 72% (40-90%, SD = 15).

 

Interactive, online case-based modules were developed for topics including ureteral injury, bowel injury, vaginal cuff dehiscence, and bladder injury.  Curriculum materials were successfully distributed on a weekly basis to all Resident learners, as confirmed through the web-based software program.

Resident module completion rates were 50%, 36%, 29%, and 18% for weeks 1-4, respectively.

Eighteen percent of Residents completed the post-implementation survey, with 100% reporting satisfaction with the online case-based modular curriculum.  Knowledge post-test mean score was 84% (SD = 15).

 

Discussions: A needs assessment confirmed poor satisfaction with baseline perioperative complications curriculum.  Web-based materials were developed and distributed weekly to all Residents who successfully accessed the 4 developed modules.  While post-survey responses were few, 100% of responders reported satisfaction with the developed curriculum.

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Professionalism, Practice-Based Learning & Improvement, GME, Assessment, Independent Study, Problem-Based Learning, General Ob-Gyn,

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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.

 

1 Krupat E et al. Patient orientations of physicians and patients: the effect of doctor-patient congruence of satisfaction. Patient Educ Couns 2000; 39:49-59.  

Topics: 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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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 employment preparedness.

 

Background: Many 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.

 

Methods: We 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 malpractice insurance.

 

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.

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Residency Coordinator, Professionalism, GME, CME, Lecture, Independent Study,

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Jazzy Tracking Curriculum Provides Music to the Ears of Innovative Educators in OB/GYN

 

Purpose: Share outcomes from an innovative curricular approach to improving the training and skill of OB/GYN physicians in an environment of decreased training hours

 

Background: Residency programs across the US are searching for ways to improve surgical experiences in OB/GYN residencies with decreased training hours. In response, we developed the first OB/GYN program to offer an innovative, flexible curriculum referred to as “tracking.”   

 

Methods: A modified-Delphi method was initially used to develop the program and gain faculty consensus for innovative curriculum change. Evaluation of the outcomes of our 15 graduates between 2016-2018 includes job/fellowship placement, subjective data and achievement of minimum requirements based on procedure logs.

 

Results: Tracking is consistently noted as a reason that candidates interview at our program. Our residents have consistently exceeded minimal surgical requirements. Examples are 2018 graduates had an average of 395 of 200 required SDEL (331-461,) 272 of 145 required CDEL (211-333,) and 61 of 20 required LHYST (41-100.)  2019 class had only AHYST and ISPF yet left to achieve at the beginning of year 4. Of our 15 graduates, 9 (60%) have entered fellowship. All 6 of our PGY-4 class are interviewing for fellowship.

 

Discussions: Flexible curricula, such as tracking, offer an innovative approach to a changing climate of medicine. The ability to offer flexible, focused training will produce graduates who excel in all areas of OB/GYN while sharpening skills specific to their areas of interest.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Osteopathic Faculty, Residency Director, Residency Coordinator, Medical Knowledge, Professionalism, Interpersonal & Communication Skills, GME, Assessment, Independent Study,

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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 delivery.

 

Background: Residents express discomfort managing menopause. Didactic teaching of this topic can be tailored to learning style, which may influence retention and improve discomfort.

 

Methods: Prospective 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.

 

Results: Thirty-three 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).

 

Discussions: Immediately 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.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Medical Knowledge, GME, Assessment, Lecture, Independent Study, General Ob-Gyn,

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ADAPT: A Novel On-line Simulation Game That Promotes Knowledge of Maternal and Fetal Physiology Among Medical Students

Purpose: To evaluate participation, satisfaction and knowledge acquisition with ADAPT, a novel on-line simulation game designed to teach maternal and fetal physiology to medical students.

 

Background: Gaming is a useful tool for engaging learners in subjects that prove time intensive, contain unique concepts, terminology, or are difficult to recall, such as anatomy and physiology. Gaming in medical education is in its infancy and data regarding its effectiveness are lacking.

Results: A total of 27 (28%) 2nd year medical students participated and completed pre/post-game surveys.  Average knowledge score significantly increased after game play (pre 76% +/- 13%; post 87% +/- 9%; p=0.001).  Students also subjectively felt their knowledge improved with 70% reporting improved knowledge and 33% improved ability to manage pre-eclampsia.  The majority (82%) would recommend this method of learning to a colleague.

 

Discussions: The addition of ADAPT to traditional lecture both objectively and subjectively improved knowledge of pregnancy physiology.  Although the majority felt it improved knowledge and learning, the low levels of voluntary participation suggest that this format may be less familiar or immediately appealing to students. 

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Residency Director, GME, Independent Study, Problem-Based Learning, General Ob-Gyn,

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A Randomized Trial to Improve Clinical Estimation of Fetal Weight Through Self-evaluations via Text Messages

Purpose: To evaluate if weekly text messages with self-evaluations improve the accuracy of clinical fetal weigth estimation in OB GYN interns.

 

Background: Estimation of fetal weight by palpation is a basic and very important skill that can influence the mode of delivery in laboring patients. Research in this area has focused almost exclusively on clinical factors that influence the accuracy of  this method but little is known about ways to improve this important skill. The purpose of this study is to improve the accuracy of this estimation in OB GYN interns with a simple and inexpensive intervention.

 

Methods: We randomized the incoming intern class to either an intervention group that received weekly text messages with self-evaluations of their weight estimations or a control group that received self-evaluations of unrelated aspects of their performance. The primary outcome was accuracy of weight estimates within 10% of the actual birth weight. A sample of 100 estimates for each group was calculated in order to find a 20% (40 to 60%) difference. Chi-square was used to determine difference in proportions of this outcome between the study groups. 

 

Results: Clinical factors that could influence fetal weight estimation by palpation (Age, BMI, cervical dilation, fetal weight distribution, parity, and recent ultrasound) were similar between the groups (P>.05). Accuracy in the intervention group was 63%  vs 42% in the control group (p<.05)

 

Discussions: The accuracy of clinical fetal weight estimates by OBGYN interns can be significatively improved by reminding them to self-evaluate the progression of their skills through text messages. 

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Residency Director, Patient Care, GME, Assessment, Independent Study, General Ob-Gyn,

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A Novel Approach to Improve Resident Research

Purpose: To improve the quality of resident research.

 

Background: Over the past decade, scholarly activity has become more defined and outcomes-based. For years, residents have completed research projects that did not always fulfill the ACGME defined categories of publications (with PubMed IDs) or abstracts/presentations/posters (given at international, national, or regional meetings.) After assessing barriers to meaningful research, a formal strategy was developed to tackle obstacles to productive research; perceived lack of support, knowledge and motivation.

 

Methods: Residents began their research projects in their PGY2 year and received support and guidance from a medical editor and 2 faculty mentors. A formal program consisting of both a didactic curriculum (6 lectures) on research/statistical techniques and scheduled, bimonthly, mandatory meetings to assist with study design, IRB submission and presentations was developed. Throughout the research projects, a clear expectation of submission of the abstracts to selected national/regional meetings was made, and if accepted, residents were rewarded with financial subsidy to attend the conference.

 

Results: In 2016, 50% of resident research projects (3 of 6 projects) were accepted at national and regional meetings and in 2017, 70% (7 of 10 projects) were accepted. After instituting a comprehensive didactic, support and reward program, the number of research projects that were presented at meetings increased by 133%. 

 

Discussions: Implementing a scholarly activity approach that addresses issues of support, motivation and knowledge shows promise to improve quality of research. Further study is needed to make scholarly activity a more rewarding and productive part of residency.

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Medical Knowledge, Professionalism, GME, Independent Study,

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“I’d Like to Thank the Academy”…Reflections on Our Inaugural Fellows Academy

Purpose: To create a department-wide Fellows Academy to provide senior trainees with an inclusive educational forum, inter-divisional mentorship, networking opportunities and wellness activities.

 

Background: Fellows in the final stages of training can often become siloed within divisons as they narrow their scope of practice.  We created a Fellows Academy to bring together fellows across sub-specialties to discuss common issues as they prepare for independent practice and to enhance a broader sense of community within our department.  

 

Methods: We conducted an initial needs assessment survey to determine interest, meeting frequency, and topics of interest.  In response, we planned three talks for the year - one on malpractice and one about preparing for a job interview - both requested by 80% of respondents.  We also included a joint wellness session with residents about writing a condolence letter to a patient or her family.  Fellows evaluated each individual session as well as the overall program.

 

Results: \"48% of fellows completed the needs assessment. 70% felt that a Fellows Academy would be beneficial to their training and 30% were unsure.  Evaluations of the individual events were extremely positive.  All three sessions received a mean rating 5.0 out of 5.0.  Representative comments included, “thanks for organizing - this was a great and under-addressed topic” and “moving

 

Discussions: helpful exercise”.  At the conclusion of the academic year, 100% of respondents felt that the Fellows Academy should be continued. \"

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Residency Director, Residency Coordinator, Patient Care, Professionalism, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, Independent Study,

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Spicing up Scholarly Productivity: Impact of a Structured Resident Research Program

Purpose: To evaluate whether implementation of a structured resident research program improved scholarly productivity at an academic obstetrics and gynecology (OB-GYN) program.

 

Background: The Accreditation Council for Graduate Medical Education requires resident participation in scholarly activity.  Since the 1970s, OB-GYN residents at University of Colorado (CU) have been required to complete a research project.  Starting with the graduating class of 2016, the CU OB-GYN program appointed two Assistant Program Directors of Resident Research who instituted a formalized research program including didactics, timelines, detailed protocol review, an expectation of manuscript submission, and an internal grant funding mechanism.

 

Methods: We compared scholarly productivity related to the required resident research projects for the graduating classes of 2012-2014 (before program implementation) and 2016-2018 (after implementation).  Two investigators independently searched for abstracts presented at national meetings, grants received, and publications using PubMed and Google search engines.  We also confirmed with the resident or mentor.  We compared the proportion of residents who had an accepted abstract or manuscript for their research projects using Fisher’s exact test.

 

Results: Fifty-four residents were included; 27 before and 27 after program implementation. The proportion of residents who had oral presentations at a national meeting remained the same (11%), whereas those with an accepted poster presentation increased from 44% to 89% (p=0.001).  The proportion who had manuscript publication increased from 26% to 59% (p=0.03). 

 

Discussions: A formalized, structured research curriculum resulted in improved scholarly productivity.  Our experience can guide other programs faced with the challenge of improving resident scholarly activity and output. 

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Systems-Based Practice & Improvement, GME, Independent Study,

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Video Curriculum for Gynecologic Surgery

Purpose: To evaluate the efficacy of a surgical video curriculum versus standard learning throughout the rotation.

 

Background: With decreasing surgical volume, training time restrictions, and more routes to approach individual cases, efficient and effective tools for surgical learning are essential.  We developed several videos teaching pelvic anatomy and steps of common gynecologic procedures.

 

Methods: The video curriculum was presented to alternating groups of students completing their OBGYN clinical rotation compared with standard rotation exposure. Participants knowledge of relevant anatomy and surgical steps was assessed at baseline, the rotation end, and immediately after exposure in the video group. Mean score assessment scores, overall impressions, and learning preferences were evaluated.

 

Results: All 42 participants had similar training, case exposure, and baseline scores.  At the end of the rotation, the mean rotation-end scores were 34% and 46% for control and video groups (p=0.005), and the difference remained significant when corrected for baseline score (p=0.012). The mean post-test score rose to 49% compared to a baseline mean of 25% (p<0.001). Seventy-four percent of participants preferred video over text, 86% reported the series was a useful educational tool, 90% would use the videos for case preparation, and 55% felt more engaged during surgery.

 

Discussions: The video series improved students’ performance on assessment of anatomy and surgical steps. Overall impressions of the video series were positive and most students reported they preferred video to text format.  Moving forward, videos like these can be used and examined as adjunctive tools for acquisition of specific surgical knowledge and skills.

Topics: CREOG & APGO Annual Meeting, 2018, Student, Resident, Faculty, Clerkship Director, Medical Knowledge, GME, UME, Independent Study, Minimally Invasive Surgery,

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Improvement in CREOG Scores Through Focused Review Sessions

Purpose: To 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 <0.05.

 

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. 

 

Discussions: Our findings support the hypothesis that focused review sessions improved resident comprehension as reflected by CREOG scores.

Topics: 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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Improved Strategies for Teaching Surgical Skills to Medical Students: Simulation and Beyond

Purpose: Develop a curriculum to optimize surgical skills and to increase operating room (OR) opportunities for medical students.

 

Background: Simulation-based strategies for teaching surgical skills are evolving. Using an innovative task trainer, we compared one-on-one deliberate practice to video-based self-guidance in the performance of two-handed knot tying and subcuticular suturing during the OBGYN clerkship.

 

Methods: A randomized prospective trial compared two groups of third year medical students in the same clerkship rotations. Group A received one-on-one deliberate practice undergoing three sessions with an instructor and Group B received unlimited access to video-based self-guided practice over six weeks. At the end of the clerkship, surgical performance was assessed using the validated checklist. Self-reported data regarding OR experience was collected using a specifically designed phone application.

 

Results: Fifty-nine students participated in the study. Group A demonstrated a statistically significant improvement in two-handed knot tying and subcuticular suturing in pre-post assessments (knot-tying +4.34, p<0.001; suturing +19.4, p<0.001). Group B demonstrated a statistically significant improvement (knot-tying +6.03, p<0.001; suturing +22.3, p<0.001). No significant differences were found between groups in overall knot-tying (p=0.13), suturing (p=0.14), hours practiced (p=0.90), or number of OR cases (p=0.49).

 

Discussions: The use of simulation significantly improved surgical skills for all students from baseline. No differences were found between one-on-one deliberate practice and video-based self-guided practice. Both instructional strategies provided equal efficacy in teaching surgical skills and optimizing surgical performance for students during the OBGYN clerkship.

 

Topics: CREOG & APGO Annual Meeting, 2018, Student, Resident, Faculty, Clerkship Director, Patient Care, GME, Simulation, Independent Study, General Ob-Gyn,

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“On-the-Go” Training: Downloadable Modules to Educate Students in Care for Sexual Assault Survivors

Purpose: An innovative approach to train students to provide trauma-informed care for survivors of sexual assault (SA) through independent learning.

 

Background: All medical providers encounter patients who have experienced SA, and can have significant impact on survivors; long-term health. Training medical students to provide appropriate, trauma-informed care is lacking in most medical school sexual health curricula. Appealing to the millennial learner, we developed three downloadable video/podcast-style modules for on-the-go use.

 

Methods: We worked with interdisciplinary experts in trauma-informed care to develop modules on interviewing patients with recent and distant history of SA and acute medical management. The study group was a cohort of interested medical students. Students completed pre- and post-tests assessing knowledge, and a paired t-test evaluated overall change in knowledge test scores. Students responded to a Lichert-style question on self-reported comfort caring for this population, and responses were analyzed with a chi-square test.

 

Results: Thirty-two medical students spanning all years beta-tested the modules and 97% completed the study. Overall, student knowledge scores improved 20% (95% CI=16%-23%, p<0.0001). After completing the curriculum, students reported a significantly improved comfort level (p=0.0250). Students enjoyed the learning format and reported the modules enhanced their education (72-88%) and were appropriate for their education level (69-97%). 

 

Discussions: Following completion of modules, students demonstrated improved knowledge and reported increased confidence in caring for this patient population. These modules seek to empower students to step beyond screening in their care for patients with sexual trauma history. Future directions include publication of existing modules and expansion of the module library.

Topics: CREOG & APGO Annual Meeting, 2018, Student, Clerkship Director, Clerkship Coordinator, Patient Care, Medical Knowledge, Professionalism, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, UME, Lecture, Independent Study, Standardized Patient, Advocacy, General Ob-Gyn, Sexuality,

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Surfing the Curriculum by Flipping the Classroom

This round table will discuss how flipping the classroom can maximize

student-learning outcomes. Specifically, this curriculum design has been found to improve

knowledge procurement and learner satisfaction in the clinical experiences (Morgan 2014, Belfi

2015). The facilitator will discuss how the Ob/Gyn clerkship curriculum can be flipped to

maximize the medical student time spent with faculty educators. Attendees will discuss how

they can design a flipped lesson that incorporates activities for both in and out of the classroom

activities. Finally, participants will receive resources to help with flipping the classroom.

Topics: Faculty Development Seminar, 2019, Clerkship Director, Residency Director, Medical Knowledge, UME, Independent Study,

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Finding Tomorrow’s Sunshine: Developing the next generation of medical educators

Objective/Background

Near-peer teaching (NPT) is commonly used in medical education for pre-clinical didactics, large

and small group sessions and clinical skills. Junior learners consistently report NPT contributes

to a supportive learning environment, better quality feedback and mentoring. Traditional NPT

programs assume natural teaching ability, and limit tutor involvement to direct teaching roles

with little instruction as educators via formal instruction in educational theory, teaching

techniques, or other aspects of pedagogy. Teaching experiences are usually short-term and may

not contribute to students’ development as educators.

Providing students with a longitudinal course in medical education may help to develop future

medical educators. Additionally, observed teaching experiences with a longitudinal preceptor

may help students to hone their teaching skills.

Workshop Agenda

Participants will engage in exercises to develop longitudinal near-peer teaching programs for

their home institutions. We will explore opportunities and challenges from the perspective of

junior learners, near-peer tutors, and faculty. Participants will be able to identify and discuss

the needs of NPT’s for pedagogical development.

Icebreaker (5 min)

Introductions

Share Best/Worst Peer teaching experiences

Review of Literature (7 min)

Activity 1: Design a NPT experience (12 min)

Participants will design a NPT for one of several types of learning scenarios: procedures, case based learning, ambulatory and clinical learning

Report out (7 min)

Activity 2: Curricula for NPT (12 min)

Participants will discuss what elements of education theory, curriculum development and other

aspects of medical education are most valuable to NPTs

Report out (5 min)

Activity 3: Pitfalls (12 min)

Participants will troubleshoot potential difficulties inexperienced teachers face and how to

prepare new teachers for difficult situations.

Report out (7 min)

Discussion of Toolbox Resources (10 min)

Interactive Component

Small group discussions of challenges and opportunities of NPT.

Take home Product

Participants will receive a curriculum outline for a longitudinal medical education course

for their home institution.

Keywords: Near-peer teaching; longitudinal medical education; curriculum development;

mentoring

Topics: Faculty Development Seminar, 2019, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Professionalism, Interpersonal & Communication Skills, UME, Independent Study, Team-Based Learning,

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Hacking Health Education: An Open Source Makeover for the Healthcare Curriculum

As medical educators seek out innovative ways to engage learners, there are increasing
electronic resources available – videos, podcasts, presentation slide sets, and journal articles. As one
busy educator creates new content, another may be inadvertently doing the same thing at a different
institution. Such duplicated effort can be both frustrating and limiting.
Leveraging lessons learned in other industries, we can encourage educational collaboration across
institutional and regional boundaries. In this workshop, we will apply open-source principles in medical
education using readily available web-based tools. Participants will convert their own slide set
presentation into an online module complete with references, attachments, and optional audio and
video that can be accessed anywhere.

Topics: Team-Based Learning, Problem-Based Learning, Independent Study, UME, CME, GME, Interpersonal & Communication Skills, Systems-Based Practice & Improvement, Residency Director, Osteopathic Faculty, Clerkship Director, Faculty, 2018, Faculty Development Seminar,

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