Morbidity and mortality conference in obstetrics and gynecology: a tool for addressing the 6 core competencies.
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ABSTRACT:
SUBMITTER: Bevis KS
PROVIDER: S-EPMC3186274 | biostudies-other | 2011 Mar
REPOSITORIES: biostudies-other
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Project description:Background Core outcome sets (COSs) are the minimum outcomes which should be measured and reported by researchers investigating a specific condition. The definition of standards of COSs vary across different health-related areas. This investigated the characteristics of COSs regarding obstetrics and gynecology (OG) and examined the reports and designs of standards of OG COSs. Methods A comprehensive search was conduced on the COMET database on December 20, 2019 to identify systematic reviews on COSs. Two reviewers independently evaluated whether the reported OG COS met the reporting requirements as stipulated in the Core Outcome Set-STAndards for Reporting (COS-STAR) statement checklist and the minimum design recommendations as outlined in the Core Outcome Set-STAndards for Development (COS-STAD) checklist. Results Forty-four OG COSs related to 26 topics were identified. None of them met all the 25 standards of COS-STAR statement which representing 18 items considered essential for transparent and complete reporting list for all COS studies (range: 6.0-24.0, median: 14.0). The compliance rates to 16 standards of methods and result sections ranged from 27.3%–68.2%. Total COS-STAR compliance items for OG COSs with the prior protocol was significantly higher than without prior protocol (MD = 3.846, 95% CI: 0.835–6.858, P = 0.012). None of the OG COSs met all the 12 criteria in the COS-STAD minimum standards (range: 3.0-11.0, median: 5.0). The compliance rates for all three standards of stakeholders involved and all four standards of the consensus process were lower than 60%. Conclusions Methodological and reporting standards of OG COSs should be improved.
| S-EPMC8551850 | biostudies-literature
Project description:IntroductionAlthough menopause is a common condition, trainees still express high levels of discomfort with managing climacteric symptoms. Trainees also receive little preparation for conducting telemedicine visits, which have become increasingly important in clinical care. We present a formative standardized patient (SP) encounter to introduce medical students to the diagnosis and treatment of menopausal symptoms and the process of conducting a telemedicine visit.MethodsWe designed a virtual telemedicine encounter with an SP for medical students. Students received feedback via a post-encounter note on history taking, differential diagnosis, and diagnostics/management and an SP debrief. We collected student input on the experience at the midpoint and end of clerkship and analyzed it for recurring themes. We calculated summary statistics from student post-encounter notes.ResultsThirty-two OB/GYN students completed the menopause telemedicine SP encounter between April and June 2020. Students scored a median of 20 out of 45 (interquartile range: 18, 22) on the post-encounter note. All students correctly provided a diagnosis of perimenopause/menopause; however, 50% did not offer any strategy for counseling or managing menopausal symptoms. Students expressed discomfort with using a telehealth format (78%) but found it a useful skill to practice (47%). A majority (66%) found the educational encounter to be of excellent or above-average educational value.DiscussionWhile medical students demonstrated discomfort with both managing menopause and utilizing a telemedicine format, this SP case provided an opportunity for them to practice both skills in a safe learning environment. The majority of participants rated the learning experience highly.
| S-EPMC8079425 | biostudies-literature
Project description:IntroductionPatient handoffs, the communications required for the safe transfer of patient care, are known to be a common source of medical errors. Simulation exercises are effective techniques for teaching the procedures and patient interaction skills involved in a handoff. We developed a teaching tool that allows students to individually interact with a simulated patient, develop a treatment plan, and practice a handoff to another provider.MethodsThe curriculum is a flexible instructional tool to teach patient handoffs in the context of a simulated obstetric emergency for learners at the clerkship through first-year obstetrics and gynecology resident levels. The curriculum secondarily teaches management of first-trimester bleeding with acute blood loss and can be adapted to allow advanced learners to practice obtaining informed consent. To evaluate this simulation for educational effectiveness, we developed a faculty observation assessment tool.ResultsThe simulation assessments for history taking, fund of knowledge, and interpersonal skills were predictive of subsequent clerkship clinical grades. Eighty percent of students agreed the exercise was realistic, 95% agreed it was relevant to the clinical curriculum, 90% agreed the simulation taught handoff skills, and 73% agreed the simulation increased confidence in handoff skills. Students uniformly found the curriculum to be relevant, realistic, and effective at teaching handoff skills.DiscussionUse of this curriculum has the potential to improve students' communication skills, handoff performance, and confidence during an obstetrics and gynecology clerkship. The assessment tool may allow early identification of students in need of improvement in communication skills.
| S-EPMC6440488 | biostudies-literature
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.
| S-EPMC10642032 | biostudies-literature
Project description:OBJECTIVES:To assess whether a journal club model could improve comprehension and written and spoken medical English in a population of Chinese medical professionals. SETTING AND PARTICIPANTS:The study population consisted of 52 medical professionals who were residents or postgraduate master or PhD students in the Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, China. INTERVENTION:After a three-part baseline examination to assess medical English comprehension, participants were randomised to either (1) an intensive journal club treatment arm or (2) a self-study group. At the conclusion of the 8-week intervention participants (n=52) were re-tested with new questions. OUTCOME MEASURES:The primary outcome was the change in score on a multiple choice examination. Secondary outcomes included change in scores on written and oral examinations which were modelled on the Test of English as a Foreign Language (TOEFL). RESULTS:Both groups had improved scores on the multiple choice examination without a statistically significant difference between them (90% power). However, there was a statistically significant difference between the groups in mean improvement in scores for both written (95% CI 1.1 to 5.0; p=0.003) and spoken English (95% CI 0.06 to 3.7; p=0.04) favouring the journal club intervention. CONCLUSIONS:Interacting with colleagues and an English-speaking facilitator in a journal club improved both written and spoken medical English in Chinese medical professionals. Journal clubs may be suitable for use as a self-sustainable teaching model to improve fluency in medical English in foreign medical professionals. TRIAL REGISTRATION NUMBER:NCT01844609.
| S-EPMC4735128 | biostudies-literature
Project description:BackgroundTravel restrictions amidst the COVID-19 pandemic reshaped interviewing for fellowships into a predominantly virtual process. How this impacts Obstetrics and Gynecology (OB/GYN) resident approaches to fellowship application and Match navigation is largely unknown.MethodsWe performed a cross-sectional survey study of fourth year OB/GYN residents in the United States who participated in at least one virtual fellowship interview in 2020. We collected information regarding demographics, application strategy, perceived strengths and weaknesses of virtual interviews, and confidence with rank list creation. Descriptive statistics were used for categorical variables and responses pre- and post-Match were compared using Fisher's exact test.ResultsSeventy-five out of an estimated 490 applicants (~ 15% response rate) completed the survey. Of the respondents, 65.3% felt they interviewed at more programs virtually than they would anticipate completing in person, but perceived less confidence in having the necessary information (n = 45, 60%) or understanding the culture of programs (n = 59, 78.7%) to create a rank list. Cost savings were the main benefit of virtual interviews (n = 50, 66.7%), and inability to get a true "feel" for a program was the biggest limitation (n = 43, 57.3%). A majority (46.7%) advocate for a future hybrid interview process.ConclusionsOB/GYN residents pursuing fellowship reported interviewing at more programs during the virtual season, but had less confidence with rank list creation. Cost savings benefits are weighed against difficulty getting a "feel" for programs virtually. Most would advocate for a future hybrid interview process.
| S-EPMC8789205 | biostudies-literature
Project description:IntroductionOperating room experience alone is insufficient for surgical training. In the current era of graduate medical education, work hour restrictions and the expectations of patients and the public limit residents' ability to participate in surgical cases. We aimed to create a laparoscopy curriculum for gynecology residents that teaches the fundamentals of laparoscopy utilizing self-learning modules complemented by skill-focused and faculty-guided laboratories to maximize learning time outside of the operating room.MethodsThe curriculum consists of five electronic modules on the basics of laparoscopy. Residents are expected to complete these on their own. In addition, quarterly simulation labs are taught by faculty and allow residents to practice, with guidance, key skills as derived from a previously published laparoscopic surgery skills curriculum. Residents are then evaluated using an objective structured assessment of technical skill comprised of the Global Rating Scale of Operative Performance and time metrics for each skill. We also evaluate resident confidence and satisfaction.ResultsIn our initial year, residents' confidence regarding laparoscopy ability and satisfaction in training did demonstrate improvement. With concentrated practice, residents' observed skills also showed advancement. Furthermore, the implementation of the curriculum was feasible with reasonable cost and limited resident and faculty time.DiscussionWhile simulation is well accepted as a modality for teaching surgery, its implementation is often limited due to concerns for time and money. Our experience illustrates that simulation is an effective teaching tool for residents without becoming a burden on a department.
| S-EPMC6464452 | biostudies-literature
Project description:BackgroundThe evolving landscape of application processes for obstetrics and gynecology residency applicants poses many challenges for applicants and advisors. The lack of data coordination among national groups creates crucial gaps in information for stakeholder groups.ObjectiveThis study aimed to identify the current state of the advising milieu for obstetrics and gynecology residency applicants and their career advisors, the annual Association of Professors of Gynecology and Obstetrics survey focused on US clerkship directors' experiences advising students through these processes.Study designA 23-item anonymous survey was developed that asked respondents about demographics and outcomes for the students that they advised through the 2021 application process and their experiences with dual applicants and students not matching. The survey was sent electronically to all obstetrics and gynecology clerkship directors with active Association of Professors of Gynecology and Obstetrics memberships in April 2021.ResultsOf 224 total clerkship directors, 143 (63.8%) responded to the survey, Of the 143 respondents, almost all (136 [95.1%]) served as career advisors, and 50 (35.0%) were aware of students dual applying. Furthermore, obstetrics and gynecology was rarely the backup to a more competitive specialty. For the 2021 application cycle, 79 of 143 respondents (55.2%) reported having students not successfully match into obstetrics and gynecology, with "academic concerns" followed by "poor communication skills" as the primary reasons cited for students not matching.ConclusionThis snapshot of clerkship directors' experiences advising students in the residency application process reveals notably high rates of dual applicants and students not matching into obstetrics and gynecology. This work fills key gaps in our knowledge of current processes and highlights the importance of career advising at multiple points during the application process.
| S-EPMC10585629 | biostudies-literature
Project description:Background:Physician empathy is associated with improved patient outcomes. No studies have examined the outcomes of medical improvisational (improv) training on empathy. Objective:Our aims were to determine whether an improv workshop is an effective tool to deliver empathy training for obstetrics and gynecology (OB-GYN) residents, and whether that effect is sustained over time. Methods:We conducted a prospective cohort study of OB-GYN residents undergoing empathy training through 4 improv games in a 1-hour session. Empathy surveys (score range 20-140) with validity evidence were administered 2 weeks prior to empathy training, immediately after, and 1, 3, and 6 months later. Fisher's exact test, Student's t test, and Wilcoxon rank sum test were used to compare statistical differences at each post-intervention assessment. Results:All 22 invited residents participated in empathy training. Empathy scores improved immediately after (120.0 ± 9.8 versus 113.1 ± 10.6, P = .026), though they regressed toward baseline through 6 months (116.3 ± 11.0 versus 113.1 ± 10.6, P = .43). When asked on a scale of 1-5 how much the workshop would impact their work, there was an increase in scores both immediately after (mean 3.5 versus 4.6, P < .001) and 1 month later (mean 3.5 versus 4.1, P = .039), but this difference disappeared at 6 months. Conclusions:Using improv comedy to deliver empathy training is associated with a minor improvement in empathy scores in OB-GYN residents, which decreased at 6 months. Residents found the activity to be acceptable and reported the training would impact their clinical practice.
| S-EPMC6795330 | biostudies-literature
Project description:This article, from the “To the Point” series that is prepared by the Association of Professors of Gynecology and Obstetrics (APGO) Undergraduate Medical Education Committee, is a review of issues to consider when integrating obstetrics and gynecology into a Longitudinal Integrated Clerkship (LIC) model. The background, objectives, and outcomes related to LIC are discussed. Specific challenges and solutions for structuring an LIC in the context of obstetrics and gynecology are examined, which include student/faculty issues as well as process matters such as general infrastructure and specific curriculum concerns.
| S-EPMC7556763 | biostudies-literature