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Decision making among residents in training of obstetrics and gynecology: A qualitative exploration in Pakistani context.

ABSTRACT: Medical decision-making is critical and the decisions are made under uncertain, complex, and dynamic conditions. In this regard, practitioners' experiences and perceptions may provide a bottom-up knowledge of the issues, as well as a corresponding support system that assists them in learning to make decisions in critical situations. The current study aimed to examine these experiences in the Pakistani context. We interviewed 14 trainee residents (aged 26 to 34 years) from tertiary care hospitals. Using inductive thematic analysis, we explored a participant-centered perspective on the support system and decision-making process. Findings reveal that the major challenges to decision-making include uncertain and complex situations, hospital-related constraints, and sociocultural context. Both non-critical and critical case management are used in individual and group decision-making processes. The residents use knowledge-based, emotional, and instrumental support to make decisions. The study gave practitioners and academics a transdisciplinary platform to explore the cognitive, social, and behavioral aspects of decision-making in the healthcare industry.

SUBMITTER: Younas S

PROVIDER: S-EPMC10621809 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Decision making among residents in training of obstetrics and gynecology: A qualitative exploration in Pakistani context.

Younas Sana S Khanum Saeeda S Qamar Azher Hameed AH

PloS one 20231102 11

Medical decision-making is critical and the decisions are made under uncertain, complex, and dynamic conditions. In this regard, practitioners' experiences and perceptions may provide a bottom-up knowledge of the issues, as well as a corresponding support system that assists them in learning to make decisions in critical situations. The current study aimed to examine these experiences in the Pakistani context. We interviewed 14 trainee residents (aged 26 to 34 years) from tertiary care hospitals ...[more]

PMID: 37917601

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Project description:Background: The course "Psychosomatic Primary Care" has been part of the training curriculum of obstetrics and gynecology in Germany since 2003. The aim of the course is to train up physicians, whose prior training primarily focussed on somatic care, to enable them to offer care also taking into account biopsychosocial aspects. Taking the guidelines for psychotherapy as a template, the aim of psychosomatic primary care is to recognize the etiological links between psychological and somatic factors which contribute to diseases. The necessity for a compulsory course as part of training in gynecology was recently critically discussed. Major points discussed included the question whether the current forms of teaching, consisting of courses, are outdated and whether the required skills should be part of regular daily training. Method: A 3-part online questionnaire consisting of 30 items was developed and sent to 2431 residents in the period from September to December 2012 through the online mailing list of the DGGG. Results: The 540 residents who responded to the questionnaire were predominantly female (83.3 %) with an average age of 30 years; 50.3 % were in their 1st to their 4th year of training. Over the longer term, the majority of respondents (56.1 %) hoped to continue working in a hospital and regularly (84.6 %) attended teaching courses voluntarily. 70.9 % of them had already attended the course "Psychosomatic Primary Care". Of the group who had completed the course, 29.4 % were satisfied with the offer. The main criticism directed against the course was its scope which 24.1 % considered completely inadequate. 24.5 % considered the course to be an important part of training, while 16.5 % would have preferred that the course be abolished. 18 % of respondents reported that psychosomatic medicine did not feature regularly in their daily clinical routine. Perspective: Because of the huge gap between what is currently offered and the experiences reported by the respondents, the Young Forum of the DGGG and the DGPFG have expanded the program of courses offered by the DGPFG, which will offer practice-oriented courses to future gynecologists across Germany in cooperation with the DAGG. The first courses are held in Heidelberg and Erlangen in 2014.

Project description:BackgroundTo ensure optimal patient care, physicians must establish effective patient-physician relationships and thoughtfully incorporate their patients' perspectives into their counseling. Historically, these skills are acquired with increasing clinical experience. However, given increasing work-hour restrictions, OB/GYN residents have fewer opportunities to develop these skills. Therefore, the objective of this study was to determine if an interactive learning method is an effective tool by which to teach OB/GYN residents how to communicate with complicated patients.MethodsAn experiential simulation model was developed to teach OB/GYN residents effective communication skills for dealing with patients experiencing a pregnancy-related complication. A simulated patient interaction was designed for first-year residents. Specific scenarios were constructed based on challenging clinical scenarios identified by second-year residents. Non-judgmental communication, culture competency awareness and reflective listening were key skills that were taught as part of the clinical scenarios. Both acceptability and utility of the exercise with the first-years was assessed by a follow-up survey.ResultsSeven first-year residents participated in the education session consisting of four physician-patient interactions with specific learning objectives for each. These first-year residents all indicated that they would employ the skills practiced during the intervention into their future practice of medicine, and that their comfort level in caring for complex obstetric patients had increased. Moreover, all first-year residents endorsed that this educational strategy was potentially applicable to other aspects of their training.ConclusionsSimulated patient exercises can be utilized in multiple arenas to teach OB/GYN residents communication skills, while simultaneously addressing their clinical knowledge deficits. Early implementation of such a curriculum in an OB/GYN residency will lay the foundation for the development of empathetic and culturally competent physicians.

Dataset Information

Decision making among residents in training of obstetrics and gynecology: A qualitative exploration in Pakistani context.

Publications

Decision making among residents in training of obstetrics and gynecology: A qualitative exploration in Pakistani context.

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