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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,

General Information

Resident,Residency Director,
Patient Care,
Assessment,Independent Study,
Clinical Focus
General Ob-Gyn,

Author Information

Pedro Morales, MD, UMKC School of Medicine / Truman Medical Center; Avery Legg, DO; Emma Connelly, MS

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