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Grommets and glue guns: standardization of a pfannenstiel model for low-fidelity obstetrics-gynecology education.

ABSTRACT: OBJECTIVE: To validate standardized instructions for the creation, implementation, and performance assessment of a low-fidelity model for Pfannenstiel incision. STUDY DESIGN: The Pfannenstiel model used at the University of Florida-Jacksonville was broken down into composite steps and constructed by obstetrics-gynecology faculty from across the country. The model was then utilized at participants' home institutions and evaluated with respect to realism of the model, ability to replicate the simulation, appropriateness of the skills checklists, and perceived utility of a publication of similarly catalogued simulation modules for use in obstetrics-gynecology training programs. RESULTS: The model was correctly constructed by 94.7% (18 of 19) participants and 72.2% (13 of 18) completed a post construction/post simulation survey indicating a high degree of perceived educational utility, feasibility of construction, and desire for additional catalogued modules. CONCLUSIONS: A low-fidelity simulation model was developed, successfully reproduced using inexpensive materials, and implemented across multiple training programs. This model can serve as a template for developing, standardizing and cataloging other low-fidelity simulations for use in resident education. As discussions among medical educators continue regarding further restrictions on duty hours, it is highly likely that more programs will be looking for guidance in establishing quick, inexpensive, and reliable means of developing and assessing surgical skills in their learners. Furthermore, the Accreditation Council for Graduate Medical Education (ACGME) has well-defined goals of programs developing better and more reproducible tools for all of their assessments. For programs with limited resources, preparing and disseminating reproducible, validated tools could be invaluable in complying with future ACGME mandates.

SUBMITTER: Best KA

PROVIDER: S-EPMC2931257 | biostudies-other | 2009 Dec

REPOSITORIES: biostudies-other

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Project description:Simulation and Objective Structured Clinical Examination assessment of learners can teach clinical skills proficiency in a safe environment without risk to patients. Interprofessional simulation-based education (IPSE) contributes to a transformation in students' understanding of teamwork and professional roles. Long term outcomes for stimulation and IPSE sessions, are less well studied. We hypothesized that a progressive interprofessional education simulation program incorporating both faculty and interprofessional student collaboration would improve medical students' knowledge retention, comfort with procedural skills, positive teamwork and respectful interaction between students.An Obstetrics and Gynecology IPSE for medical and nursing students (NS) was developed in collaboration between a school of medicine and a school of nursing from 2014 to 2017. By 2017, content includedFrom 2014 to 2016, medical students completed attitude, knowledge, and perception surveys both pre and immediately post simulation, at 4 months, and 8 months. In 2017; all students completed self-assessments and received faculty-assessments.The program trained 443 medical and 136 NS. Medical students' knowledge, comfort, and interest increased significantly post simulation. Outcome scores decreased but were still significantly improved at 4 months but nearly dissipated by 8 months. There were no significant differences between medical and NS self-assessment or faculty-assessment scores regarding IUD insertion, cervical examination, or contraception quiz scores. Medical students' birth simulation self-assessment versus faculty-assessment scores were 8.6 vs 8.9, P < .001.Simulation improved students' short-term medical knowledge, comfort, and perception with some long-term persistence at 4-8 months. Medical and NS learned obstetrics and gynecology skills in a collaborative environment and in role-specific situations. Medical students had the opportunity to learn from NS. Positive teamwork and respectful interaction occurred between the students.

Project description:BackgroundIn the United States (US), many obstetrics & gynecology (OB-GYN) trainees feel unprepared to care for lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) individuals, but interest in this topic is rising. Residency program websites are one way that directors can advertise whether this training is offered within their program. We aimed to describe the extent to which LGBTQI content is currently featured on OB-GYN residency websites across the country.MethodsWe identified all OB-GYN residency programs in the United States using a publicly available database. We systematically searched for select LGBTQI keywords on program websites. We collected data on mentions of LGBTQI didactics and rotations. We also searched whether LGTBQI keywords were included in diversity, equity, and inclusion (DEI) statements. We used multivariable logistic regression to compare the characteristics of programs that do and do not include this content. We used STATA SE Version 16.0 for all analyses and set the level of significance at 5%.ResultsWe included 287/295 US OB-GYN residency programs in our analysis (97.3%) and excluded 8 that did not have websites. We identified any LGBTQI content on 50 program websites (17.4%), and specific mention of didactics or rotations on 8 websites (2.8%). On multivariable analysis, programs in the West were more likely to include any LGBTQI content compared to programs in the South (OR 2.81, 95%CI 1.04-7.63), as were programs with 1 or 2 fellowships (OR 3.41, 95%CI 1.43-8.14) or 3 or more fellowships (OR 4.85, 95%CI 2.03-11.57) compared to those without fellowships. Programs in departments led by female chairs were also more likely to include LBTQI content (OR 3.18, 95%CI 1.55-6.51).ConclusionsAcademic programs, West Coast programs, and those with departments led by female chairs are more likely to mention LGBTQI keywords on their websites. Given the increasing interest in LGBTQI education for OB-GYN trainees, program directors should consider providing training opportunities and including this content on their websites.

Project description:Although there have been previous publications on curriculum innovations in teaching O&G to medical students, especially utilizing simulation-based education, there have been none, as far as we know, incorporating and evaluating the outcomes using cognitive load theory. The aim of this article was to describe the introduction, implementation, and evaluation of an innovative teaching program in O&G, incorporating simulation-based education, underpinned by cognitive load theory. Cognitive load is defined as the amount of information a working memory can hold at any one time and incorporates three types of cognitive load-intrinsic, extraneous, and germane. To optimize learning, educators are encouraged to manage intrinsic cognitive load, minimize extraneous cognitive load, and promote germane cognitive load. In these sessions, students were encouraged to prepare in advance of each session with recommended reading materials; to limit intrinsic cognitive load and promote germane cognitive load, faculty were advised ahead of each session to manage intrinsic cognitive load, an open-book MCQ practice session aimed to reduce anxiety, promote psychological safety, and minimize extraneous cognitive load. For the simulation sessions, the faculty initially demonstrated the role-play situation or clinical skill first, to manage intrinsic cognitive load and reduce extraneous cognitive load. The results of the evaluation showed that the students perceived that they invested relatively low mental effort in understanding the topics, theories, concepts, and definitions discussed during the sessions. There was a low extraneous cognitive load. Measures of germane cognitive load or self-perceived learning were high. The primary message is that we believe this teaching program is a model that other medical schools globally might want to consider adopting, to evaluate and justify innovations in the teaching of O&G to medical students. The secondary message is that evaluation of innovations to teaching and facilitation of learning using cognitive load theory is one way to contribute to the high-quality training of competent future healthcare workers required to provide the highest standard of care to women who are crucial to the overall health and wellbeing of a nation.

Project description:BackgroundPatient education materials (PEMs) can be vital sources of information for the general population. However, despite American Medical Association (AMA) and National Institutes of Health (NIH) recommendations to make PEMs easier to read for patients with low health literacy, they often do not adhere to these recommendations. The readability of online PEMs in the obstetrics and gynecology (OB/GYN) field, in particular, has not been thoroughly investigated.ObjectiveThe study sampled online OB/GYN PEMs and aimed to examine (1) agreeability across traditional readability measures (TRMs), (2) adherence of online PEMs to AMA and NIH recommendations, and (3) whether the readability level of online PEMs varied by web-based source and medical topic. This study is not a scoping review, rather, it focused on scoring the readability of OB/GYN PEMs using the traditional measures to add empirical evidence to the literature.MethodsA total of 1576 online OB/GYN PEMs were collected via 3 major search engines. In total 93 were excluded due to shorter content (less than 100 words), yielding 1483 PEMs for analysis. Each PEM was scored by 4 TRMs, including Flesch-Kincaid grade level, Gunning fog index, Simple Measure of Gobbledygook, and the Dale-Chall. The PEMs were categorized based on publication source and medical topic by 2 research team members. The readability scores of the categories were compared statistically.ResultsResults indicated that the 4 TRMs did not agree with each other, leading to the use of an averaged readability (composite) score for comparison. The composite scores across all online PEMs were not normally distributed and had a median at the 11th grade. Governmental PEMs were the easiest to read amongst source categorizations and PEMs about menstruation were the most difficult to read. However, the differences in the readability scores among the sources and the topics were small.ConclusionsThis study found that online OB/GYN PEMs did not meet the AMA and NIH readability recommendations and would be difficult to read and comprehend for patients with low health literacy. Both findings connected well to the literature. This study highlights the need to improve the readability of OB/GYN PEMs to help patients make informed decisions. Research has been done to create more sophisticated readability measures for medical and health documents. Once validated, these tools need to be used by web-based content creators of health education materials.

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Grommets and glue guns: standardization of a pfannenstiel model for low-fidelity obstetrics-gynecology education.

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