Home > Educational Resources > Abstract Catalog

Search/Filter

Search

Title    Abstract Content
Topics
+
Meeting
+
Year
+
Intended Audience
+
Competencies Addressed
+
Educational Continuum
+
Educational Focus
+
Clinical Focus
Results : 169 Page : 1
Sort by :  

Trends in Off-Service Rotations in Ob/Gyn Residencies Before and After Duty Hour Restrictions

Purpose: To establish trends in off-service rotations in OB/GYN residencies before and after duty hour restrictions.

 

Background: As co-morbidities in our patient population increases, the skills required of OB/GYNs are changing, we sought to determine the characteristics of off service rotations.

 

Methods: We searched websites of ACGME accredited OB/GYN residency programs. We collected data on off service rotations: services, number of rotations, and PGY year of rotations. Surveys were emailed to programs regarding off service rotations in 2018 and before duty hour changes in 2003.

 

Results: 92% (n=259) of programs had information available on off-service rotations, of these, 24% (n=62) had no off-service rotations, 26% (n=67) had 1, 25% (n=66) had 2, 13% (n=34) had 3, 12% (n=30) had 4 or more. The majority (84%) of rotations were in PGY1. The most common rotations were ER (47%, n=122), SICU (24%, n=62), IM (25%, n=66), MICU (9%, n=23). We received 53 responses to the survey (19% response rate). Of those who responded, the most common rotations for 2018 and before 2003 were ER & SICU. The number of programs with SICU rotations remained stable from 2003 to 2018 (43% vs 47%) compared to 1.4 fold decrease in programs with ER rotations. The number of programs with IM rotations decreased 2.5 fold from before 2003 to 2018.

 

Discussions: Duty hour restrictions have affected off-service rotations. A quarter of all programs have no off-service rotations, with a decrease in ER and IM exposure during residency. This does not reflect the breadth of knowledge required of OB/GYNs today.

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Residency Director, Residency Coordinator, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME, Quality & Safety, General Ob-Gyn, CREOG & APGO Annual Meeting, 2019, Student, Resident, Clerkship Director, Residency Director, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, UME, Team-Based Learning,

Read more »

Too Many Learners? Do Students Belong in Resident Continuity Clinics?

Purpose: Determine the prevalence of medical students in OBGYN resident continuity clinics and describe effects on the learning environment when students and residents work together in this setting.

 

Background: Patient continuity is an ACGME requirement often fulfilled through a resident run continuity clinic. It’s unknown how frequently students rotate in these clinics, or how multiple levels of learners influence each other.
 

 

Methods: We surveyed OBGYN program managers using a national listserv. Resident and student surveys were based on a Likert scale and sent to all OBGYN residents and students that rotated at our institution from 2016-2018.

 

Results: Program managers responded from 45 programs and 75.6% scheduled students in resident continuity clinics. Our response rates were 79/116(68.1%) for students and 21/24(87.5%) for residents. A one-sample Wilcoxon signed rank test was used to test the hypothesis that the typical response on the five-level Likert scale was \"Agree\" or \"Strongly Agree.\" Of medical students, 88.6% stated that they agreed or strongly agreed they enjoyed working with residents (p<0.001) and 60.8% stated they agreed or strongly agreed residents were effective teachers (p<0.001). Among residents, 52.4% agreed or strongly agreed that they enjoyed working with students (p<0.001). However, 61.9% said they agreed or strongly agreed they were too busy to be effective teachers (p<0.001).

 

Discussions: Many institutions have students rotate in resident continuity clinics. Residents and students have positive views regarding their interactions. Although students were satisfied, residents expressed concerns about their ability to be effective teachers given clinical demands. Our results highlight the importance of developing resident teaching skills.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME, CME, UME, Assessment, Problem-Based Learning, Team-Based Learning, General Ob-Gyn,

Read more »

Testosterone Supplementation in Women with Diminished Ovarian Reserve

Purpose: To evaluate the efficacy of transdermal testosterone as an adjuvant to the standard IVF protocol to improve outcomes in women with diminished ovarian reserve (DOR). 

 

Background: Women with DOR have extremely low pregnancy rates after IVF cycles, and there are currently few treatment options available. Testosterone supplementation may improve ovarian response to stimulation via enhanced folliculogenesis. 

 

Methods: This retrospective cohort study analyzed 83 IVF cycles based on inclusion criteria of age < 42 and diagnosis of DOR (basal FSH > 10, AMH < 1, antral follicle count < 6, or history of poor response [< 4 follicles]). Cycles in the control group were carried out using the standard IVF protocol while cycles in the treatment group involved the addition of transdermal testosterone prior to ovarian stimulation. Four primary outcomes were evaluated: total number of oocytes retrieved, number of mature oocytes retrieved, number of embryos generated, and pregnancy potential of the embryos.  

 

Results: Pretreatment with transdermal testosterone had no impact on the total number of eggs retrieved after ovarian stimulation. Testosterone had a negative impact of the number of mature oocytes retrieved, but had no impact on the number of embryos generated from those oocytes. Pregnancy rates between the treatment and control groups were no different per embryo transfer, but were lower per cycle initiation with testosterone therapy.

 

Discussions: Within this study population, retrospective analysis of testosterone therapy revealed no improvement in IVF outcomes. A randomized controlled trial is recommended to further investigate this association. 

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Patient Care, Medical Knowledge, GME, CME, Problem-Based Learning, Team-Based Learning, Reproductive Endocrinology & Infertility,

Read more »

Students Stuck in a Swamp? Scripting Promotes Medical Student Involvement in Obstetric & Gynecologic Care

Purpose: Characterize the effect of staff scripting on medical student acceptance in outpatient ob-gyn clinic visits.

 

Background: Direct patient care is a major tributary in the river of medical education. When patients refuse medical student involvement in their care, students are stranded in stagnant quagmire. Review of the literature shows that medical student refusal is a national issue not limited solely to obstetrics and gynecology (ob-gyn) clerkships (Chang, et al, 2010; Mavis, et al, 2006; Hartz & Beale, 2000). Written and video messages about medical student training have been effective in furthering medical student acceptance in clinical encounters (Buck & Littleton, 2016). Open the floodgates!

 

Methods: A literature review using search terms “medical student AND refusal” was conducted to guide script composition. Medical assistant and nursing staff implemented the script in an outpatient ob-gyn resident clinic. The script was revised halfway through the clerkship year based on patient and staff feedback. All ob-gyn medical students were surveyed regarding their involvement in patient visits prior to and after script implementation.

 

Results: After script implementation, the percent of medical students refused from at least one patient interaction decreased from 92% to 86%. 66% percent of our students perceived scripting as a supportive measure for medical students, and 61% percent witnessed staff, residents, and faculty utilizing scripting.

 

Discussions: Data from our institution suggest that scripting improves medical student involvement in ob-gyn patient care. Involving staff, students, and patients on scripting revision helped foster a learning environment rich as the Mississippi delta in which medical students can thrive.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Patient Care, Professionalism, Interpersonal & Communication Skills, UME, Team-Based Learning, Advocacy,

Read more »

Service-learning Wellness Initiative in the Harvard Medical School Clerkship Curriculum

Purpose: The first aim was to assess if incorporation of a service-based initiative into the curriculum results in professional fulfillment, principally: improved medical student feelings of compassion, contribution, wellness, understanding of community need, and team-building of the student class. The second aim is to report the development of this curriculum project.

 

Background: Service-learning increases student awareness of community resources, promotes service to the community, team-building through cooperation rather than competition, broadens cultural awareness, and fosters wellness through hands-on contribution.

 

Methods: The entire class of second year clerkship students volunteered at a local non-profit organization. Students were divided into small groups to work at various team tasks.  Following, the entire group reconvened for teaching reflection. They were asked a value-based qualifier of the experience. They were also asked to provide feedback as an open response. Quantitative data were analyzed using summary statistics, Wilcoxon rank sum and Fischer’s exact test. Content analysis was used to determine themes from the open-ended responses.

 

Results: 47 students participated, 48.9% of whom were male. Average satisfaction with the intervention was high (mean 4.26 on a 5-point Likert scale), with no difference in satisfaction noted by gender. Positive themes included feelings of contribution, wellness, and team-building, with 9 respondents requesting to repeat the event at regular intervals.

 

Discussions: It is crucial to investigate different types of wellness interventions throughout UME. Service-based interventions are not adequately studied and may be an important addition to the wellness program as they are a way for students to feel connected to the community they are serving.  

Topics: CREOG & APGO Annual Meeting, 2019, Faculty, Clerkship Director, Residency Director, Professionalism, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, UME, Team-Based Learning, Public Health, General Ob-Gyn,

Read more »

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 stress.

 

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.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Osteopathic Faculty, Residency Director, Residency Coordinator, Professionalism, Interpersonal & Communication Skills, GME, CME, Assessment, Team-Based Learning,

Read more »

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,

Read more »

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 performed.

 

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 effective.

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Residency Coordinator, Patient Care, Professionalism, GME, CME, Team-Based Learning,

Read more »

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 issues.

 

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 issues. 

 

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.

Topics: 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,

Read more »

Magnesium Toxicity and Medical Errors: A Multidisciplinary Simulation for Debriefing an Obstetric Emergency

Purpose: To create a simulation that improves communication during obstetric emergency and promotes a safe learning environment to debrief and evaluate medical errors.

 

Background: Simulation is known to improve communication and comfort in obstetric emergency. Little data exist regarding simulation for enhancing expertise in debriefing and evaluating system errors.

 

Methods: The simulation highlights an unresponsive patient shortly following a preterm delivery at 30 weeks gestation. The team discovers an accidental bolus of intravenous magnesium was given instead of postpartum oxytocin. Following conclusion of the simulation, participants were asked to lead a debrief session. Surveys were performed to assess participant comfort with magnesium toxicity, debriefing, evaluating a medical error, and communication during an emergency. 

 

Results: Participants felt the simulation was (1) a realistic scenario that allowed practice debriefing a medical error within a large multidisciplinary team, (2) a place to practice high acuity care and communication, and (3) a safe place to receive and provide feedback. On average, residents reported an increase in comfort with management of magnesium toxicity from little comfort(2/5) tomoderate comfort(4/5). In general, participants (90%; N=10) felt like they learned advanced management of acute magnesium toxicity. All participants (100%; N=10) reported they would recommend this simulation to others in their profession. 

 

Discussions: We have designed a simple model that highlights the importance of (1) communication during an obstetric emergency and (2) debriefing and evaluating errors from systems perspective. This model increased participant knowledge and comfort with magnesium toxicity and promoted a safe culture to discuss medical errors and practice debriefing.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Residency Director, Patient Care, Medical Knowledge, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, CME, Simulation, Quality & Safety, Team-Based Learning,

Read more »

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.

 

Results: Eighteen 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.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Clerkship Director, Residency Director, Practice-Based Learning & Improvement, GME, UME, Team-Based Learning,

Read more »

Inter-professional OSCE Based Simulation Collaboration to Teach Obstetrics & Gynecology to Second Year Medical Students and Nursing Students

Purpose: To describe an inter-professional workshop (IPE) utilizing simulation, OSCE and flipped classroom to introduce 2nd year medical and nursing students to OBGYN concepts

 

Background: IPE has been shown to facilitate improved patient-centered care

 

Methods: In November 2017; students studied an online fetal heart rate (FHR) lecture; at workshop worked in groups on clinical FHR scenarios, and presented findings for group learning and discussions. Students rotated through three stations each for 45 minutes as follows: 1) MFM faculty taught students on cervical dilation using “blinded” and “open” cervical models. Students had hands-on with obstetrical procedures such as B-Lynch Suture. 2) Students performed a simulated vaginal delivery supervised by MFM fellow; nursing students resuscitated newborn and gave SBAR report to medical students. 3) MFM fellow and gynecologist faculty taught students on contraception methods while a technician taught students IUD insertion. Students self-assessed and were assessed by faculty using OSCE; knowledge quizzes were completed for contraception and cervical examination accuracy.

 

Results: The program trained 116 (73%) medical and 51(22%) nursing students. There were no significant differences between medical students and nursing students scores which were respectively: IUD insertion self-assessment = 8.84 vs. 8.43; IUD insertion faculty-assessment= 9 vs. 8; cervical examination accuracy = 13.1 vs. 12.7;  contraception   quiz = 9.1 vs. 9.3. Medical students birth simulation self-assessment vs. faculty-assessment scores were 8.6 vs. 8.9, p <0.001.

 

Discussions: Medical and nursing students learned OBGYN skills equally, nursing students had the opportunity to teach medical students.  Medical students were more critical of their learning than faculty.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Medical Knowledge, Professionalism, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, UME, Simulation, Team-Based Learning, Contraception or Family Planning, General Ob-Gyn,

Read more »

Improved Team Climate and Increased Student Involvement with Interprofessional Learning on Labor and Delivery

Purpose: To evaluate the impact of an obstetrical interprofessional learning experience for medical students on team climate and medical student clinical involvement.

 

Background: Students often express difficulty integrating into the obstetrical team and a desire more clinical involvement on the unit.  We hypothesized that an obstetrical nurse-shadowing experience for students could increase student understanding of the team’s function and that nurses who worked with students would be more willing to advocate for student involvement in deliveries. We planned to use the Team Climate Inventory to assess students’ inclusion in the team, and to use the percentage of students playing a hands-on role in a vaginal delivery to assess student clinical involvement.

 

Methods: A baseline Team Climate Inventory was administered to students in 2015.  The nurse-shadowing day was introduced in 2016-2017 and these students also completed the Team Climate Inventory; student T test used for analysis.  The percentages of students assisting in a vaginal delivery before and after the intervention were compared using Fisher’s Exact Test.

Results: Survey response rates were 38% for control group and 42% for intervention group. Significant improvement (p<0.05) was noted on all axes assessed by the Team Climate Inventory following the intervention with the largest change in Participative Safety. 64.25% of control group students assisted in a vaginal delivery; this increased significantly to 84.65% in the intervention group (p=0.009).

 

Discussions: The introduction of an interprofessional learning exercise on Labor and Delivery was associated with improvement in medical student assessment of team climate and with increased involvement of students in vaginal deliveries.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Faculty, Clerkship Director, Professionalism, Systems-Based Practice & Improvement, UME, Team-Based Learning, General Ob-Gyn,

Read more »

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

 

Background:

·       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 sessions

Methods:

·       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

Results:

·       Positive correlation in resident teaching and satisfaction scores

·       Positive correlation in NBME scores and satisfaction scores

 

Discussions:

·       Student experience and satisfaction  may vary by location based on clinical exposure and opportunity

·       No standardized resident-lectures amongst all locations

·       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.

Topics: 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,

Read more »

Group Prenatal Care in OB/GYN Residencies

Purpose: To assess exposure to group prenatal care (GPNC) in Obstetrics and Gynecology (OB/GYN) residencies, and resident and program director (PD) perceptions of GPNC.

 

Background: Group prenatal care is a model of prenatal care that has been growing in popularity for several decades, especially among midwives. However, the state of GPNC in OB/GYN residencies nationally is unknown.

 

Methods: An electronic survey was sent to all OB/GYN PDs; subsequent similar surveys were sent to OB/GYN residents through responding PDs as well as program coordinators. The authors also encouraged PDs to complete the online survey in person during the APGO/CREOG 2018 meeting. Descriptive statistics and logistic regression were used for data analysis.

 

Results: 96/254 (38%) of OB/GYN PDs responded with a geographically balanced response rate.  Most had a positive perception of GPNC (71%), 82% believe that residencies should include GPNC training, but only 44% had been exposed themselves previously. 467/4956 (9%) of all OB/GYN residents nationwide responded.  Again, most residents had a positive perception of GPNC (70%), while 87% said they would like to learn more during residency but only 33% reported exposure during residency.  No demographic factor was associated with a positive perception of GPNC.

 

Discussions: Most OB/GYN  PD and resident respondents have positive perceptions of GPNC ,are interested in learning more and including  training in GPNC in the residency curriculum, yet very few are exposed to GPNC.  GPNC is not commonly included in OB/GYN residency training despite a widespread interest in this model of prenatal care.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Patient Care, Practice-Based Learning & Improvement, GME, Assessment, Team-Based Learning, General Ob-Gyn,

Read more »

Faculty Perceptions of Team Based Learning

Purpose: Team Based Learning (TBL) is an active learning strategy which replaced most of the traditional didactic lectures in the Ob/Gyn Clerkship at the University of Kansas Medical Center (KUMC) in 2015. Our aim of this study was to survey Ob/Gyn faculty about their perceptions surrounding their experience. We hypothesized faculty prefer facilitating TBL over other didactic lectures and perceive students as more engaged during active learning activities.

 

Background: We recently concluded an evaluation of our TBL experience with student test scores, knowledge retention, and learner satisfaction. We received multiple queries regarding faculty perceptions and satisfaction. The current research on TBL focuses on student experience, little has been published on observations of faculty. This survey sought to characterize and clarify the faculty experience.

 

Methods: A cross-sectional, anonymous survey about faculty experiences and satisfaction with TBL sessions versus traditional lectures was completed by 13 Ob/Gyn faculty.

 

Results: Faculty prefer teaching TBL sessions over traditional lectures (8.4 vs 7.3, on scale of 1-10, p=<0.05), TBL sessions require less preparation time (115 vs 26 minutes, p=<0.001). Faculty either strongly agreed or agreed to noticing increased learner engagement, with one respondent stating “I think they are excellent for education and being present (not online or on phone) during didactics.”

 

Discussions: Faculty consider TBL a viable and valuable learning strategy and responded they wish more teaching sessions were in this format. Continued implementation of TBL is likely to improve learner engagement and performance in addition to increasing faculty satisfaction and engagement in medical student education.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Faculty, Clerkship Director, Clerkship Coordinator, Medical Knowledge, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, UME, Team-Based Learning,

Read more »

Effect of Simulation Exercises on Medical Student Satisfaction and Performance in the Ob/Gyn Clerkship

Purpose: To evaluate the use of structured resident-led simulation exercises in improving medical student interest in Ob/Gyn as a specialty, satisfaction with their rotation experience, and improvement on NBME exam sores at the end of the rotation.

 

Background: Medical students persistently rank their obstetrics and gynecology (Ob/Gyn) clerkship experience below that of other surgical specialties, in addition to also raking the clerkship lowest for the ability of residents to provide effective teaching. Current research shows that clinical simulation during the Ob/Gyn clerkship leads to increased confidence and has been shown to increase medical students\' end of rotation oral and written examination scores.

 

Methods: Prospective cohort study from July 2016-June 2017 involving medical students enrolled at the McGovern Medical School- Memorial Hermann Hospital campus for their Ob/Gyn clerkship.  Rotations were randomized by alternating intervention with non-intervention,  the intervention consisted of weekly resident-led simulation exercises.  All students were given anonymous pre-rotation and post-rotation surveys that used a Liekart scale to analyze their opinions of their clerkship experience.  The surveys and NBME grades were then analyzed between the two groups.

 

Results: Overall population was 71, with 38 students in the control group and 33 in the intervention group with survey response rates of 94% and 97% respectively.  The responses of the pre and post-rotation surveys were then analyzed using the Wilcoxon ranked sum test comparing the median response.  Overall, the intervention group had a higher median score regarding preparedness in the clerkship (p .052) and scored better on the NBME (P .2679).  The intervention group had a lower median response to questions regarding importance of residents’ involvement in their clerkship, which was statistically significant (p .008). 

 

Discussions: Results indicate that resident-led simulation exercises may increase NBME scores and help students to feel more prepared within the clerkship.  However, this increase in performance and preparedness does not correlate with student satisfaction or in the student’s choice of obstetrics and gynecology as their future specialty of choice.

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Medical Knowledge, Practice-Based Learning & Improvement, GME, Simulation, Team-Based Learning,

Read more »

Does Participation in Ob-gyn Subspecialties Improve Clerkship Clinical Scores, NBME Exam Scores, or Final Grades?

Purpose: The primary objective is to determine if participation in subspecialty rotations during Ob/Gyn core clerkships improves student performance as measured by National Board of Medical Examiners (NBME) scores, clinical evaluations and final clerkship summative grade when compared to students without focused subspecialty time.

 

Background: There is limited research evaluating the effect of subspecialty rotation experience during Ob/Gyn clerkships on student performance, however similar research in general surgery indicates adequate medical student competency and improvements in medical knowledge.


Results: Complete data was identified for 474 students during this study period. There was no significant difference in NMBE scores or final clerkship summative grade when comparing general track students to the subspecialty track. There was a significant difference in the clinical evaluation scores between general track and sub-specialty track students (p<0.002).  45 of the 474 students pursued an Ob/Gyn residency, 75% of whom participated in a subspecialty track.

 

Discussions: Exposure to subspecialty fields is not uniform during core clerkships. Our study indicates that using core clerkship time for early subspecialty exposure does not negatively impact student outcomes, and potentially improves clinical evaluations.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Clerkship Director, Clerkship Coordinator, Medical Knowledge, UME, Team-Based Learning, Gynecologic Oncology, Maternal-Fetal Medicine, General Ob-Gyn,

Read more »

Can I Get a Suggestion? Improv Training to Teach Empathy in Ob/Gyn Residents

Purpose: To examine improvisation training on Ob/Gyn resident empathy

 

Background: Physician 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 over time.
 

 

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.

 

Results: 22 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.   

Topics: 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,

Read more »

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.

 

Methods: A 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 PPBTLs.

 

Results: Fifty-one 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%.

 

Discussions: Targeted 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.

Topics: 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,

Read more »

1 2 3 4 5 6 7 8 9

CONTACT US

2130 Priest Bridge Drive, Suite 7,
Crofton, MD 21114
(P) 410-451-9560 | (F) 410-451-9568

DONATE

Learn more about the programs
supported by your dues and donations.

JOIN US

APGO offers several membership and subscriber options to give you the support and resources you need to be successful.