bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of a Focused Faculty Development Program on the Written Comments Component of Resident Evaluations
Authors: Dodds Robert , Deighton-Collins Sarah , Flora Robert , Steinauer Jody 
Published: September 2017

OBJECTIVE:
Evaluate effectiveness of faculty development program combined with focused feedback on quality of written comments in resident evaluations.

METHODS:
Faculty were educated to improve quality of written comments on resident evaluations. Monthly evaluations concurrently changed, requiring comments before ratings. Quality was determined using validated CCERR (Completed Clinical Evaluation Report Rating) on de-identified evaluations, final scores representing median score from both authors. CCERR scores vary from nine to 45 correlating with quality. Baseline data were abstracted from the last half of 2015. Faculty development seminar took place May 2016. Faculty then received feedback at the monthly faculty meetings as well as individual coaching. After 9 months, a survey of faculty and residents will gauge comfort writing comments. CCERR scores were compared using nonparametric test, P<.05 defining significance.

RESULTS:
Two hundred five evaluations (50% with written comments) comprised the baseline with 22, 28, 38, 27, 28, 32 and 23 evaluations completed (May through November). The median CCERR score increased from baseline of 10–22.5, 20, 20, 21, 22, 21 and 19 (May through November, P<.0001).

CONCLUSION:
Previous studies confirm CCERR validity, eight points representing meaningful change. Educational sessions and ongoing feedback individually have been shown to increase scores, but not meaningfully. We achieved meaningful change, but our baseline was lower than previous studies. Ongoing feedback was not effective at generating further improvement. It is not clear if the improvement seen resulted from faculty development or changes in the structure of monthly evaluations requiring comments.
Breast Care 101: A Teaching Tool to Educate Ob/Gyn Students and Residents in Breast Care
Authors: Miller Jennifer Griffin , Kinney Sonja , Hueppchen Nancy 
Published: September 2017

OBJECTIVE:
To develop breast educational videos to prepare learners for educational experiences in breast care.

METHODS:
As part of a prior research study, a needs assessment was completed (presented at APGO/CREOG Meeting 2012) indicating insufficient educational resources in breast care topics for Ob/Gyn residents. For this project, three brief (6–12 minute) videos were developed in the following content areas: breast tools including physical exam, breast cancer risk assessment, and understanding breast imaging results. Resident learners were exposed to these videos in preparation for breast care educational experiences (breast clinic.) After utilizing the videos, learners were assessed on their confidence in evaluating patients with breast complaints.
In addition, the videos were presented to medical students prior to their clerkship lecture on Breast Complaints. Videos can be accessed at the present time via You Tube: Evaluation of Breast complaints at https://youtu.be/ruydjeJumag; Breast Risk Assessment at https://youtu.be/VAh71__LhL8; and Breast Imaging and Diagnosis at https://youtu.be/Cmn2KA7Kv-k.

EVALUATION:
Postintervention surveys were completed by Ob/Gyn residents who had the opportunity to the view the videos regarding satisfaction with format and confidence. Postintervention surveys were completed by M3 students after their breast lecture.

DISSEMINATION:
Plan to distribute video links directly to fellow Ob/Gyn program directors and via AAMC Med Ed Portal.

REFLECTIVE CRITIQUE:
The goal of this project is to create resources that can be utilized in different venues to support education in breast care. Access to self-directed learning to prepare for educational experiences supports the learner’s confidence, skills, and attitudes toward breast care and enhances their educational experiences. Such resources can also be used by learners at the student and resident level in a flipped classroom approach to prepare the learners for case discussion.
Development and Evaluation of an eLearning Module on the Prepubertal Exam and Vaginoscopy for Ob-Gyn Residents
Authors: Huguelet Patricia S. , Palacios-Helgeson Leslie , Guiahi Maryam , Guiahi Maryam , Learman Lee A. 
Published: September 2017

OBJECTIVE:
To develop and evaluate a self-study module for Obstetrics and Gynecology (Ob-Gyn) residents to improve knowledge and skills with prepubertal exam and vaginoscopy.

METHODS:
We developed an interactive module to teach CREOG Learning Objectives in pediatric and adolescent gynecology: prepubertal vaginal bleeding evaluation, including prepubertal exam, vaginal culture, office lavage, and vaginoscopy. After pilot-testing with chief residents and recent graduates, we held a focus group to solicit feedback resulting in modifications.

EVALUATION:
After obtaining IRB approval, we offered the revised module to all current Ob-Gyn residents (n=37). We solicited residents by e-mail communication and offered a small incentive. The evaluation tool queried satisfaction, confidence with knowledge and skill in the tested areas, and assessed knowledge of prepubertal bleeding before and after module completion. Of the 37 residents, 26 (70%) participated. Satisfaction with knowledge improved from 30.8% to 100% (P<.0001). Reported confidence in being able to independently perform a prepubertal genital exam improved from 7.7% to 53.8% (P<.001). Reported confidence in in being able to independently perform vaginoscopy did not change significantly (0%–11.5%, P=.24).

DISSEMINATION:
We will submit this module to the AAMC MedEdPORTAL. We aim to design a multi-institutional research study to assess whether the module improves knowledge and skills on this topic at institutions throughout the country.

REFLECTIVE CRITIQUE:
Although residents overall found benefits, improving their confidence with vaginoscopy performance was limited. The module may serve as an introduction to vaginoscopy, but skill acquisition may rely on actual performance.
Characterizing the Culture of a Graduate Medical Education Program
Authors: Lachance Jason A. , Han Paul , Varaklis Kalli , Varaklis Kalli , Kenton Kim 
Published: September 2017

OBJECTIVE:
To develop a methodology for exploring the factors that influence local culture in an academic community-based Graduate Medical Education program.

METHODS:
We conducted a group of six structured focus groups with 14 current residents and 15 faculty to exploring local themes that affect the shared values and key characteristics of successful OB/GYN residents and how those factors influence the culture of the residency program.

EVALUATION:
Focus groups were conducted by interviewers trained in qualitative research methodology with the purpose of identifying themes and characteristics that are desirable in both current and potential future residents. Qualitative data were collected and de-identified then analyzed with MAXQDA software to identify common themes that correlated with resident success.

DISSEMINATION:
Results will be submitted to a peer reviewed journal of higher medical education as well as shared at local home institution amongst other GME training programs for similar analysis of their respective program.

REFLECTION:
The work has been most challenging navigating the emerging field of qualitative research. We were ultimately able to successfully narrow the scope of the project, garner IRB approval, secure independent grant funding, and complete the focus groups and data analysis. Collaboration with local experts was immensely helpful and successful. I expanded my knowledge of both qualitative research as well as developed a better understanding of our residency program which has been extremely valuable as I have just begun the role of Program Director.
Ultrasound Assessment of Fetal Head Position
Authors: Morosky Christopher M. , Steinberg Adam , Steinberg Adam , Learman Lee A. 
Published: September 2017

OBJECTIVE:
We developed a 1-hour multimedia conference to educate Obstetrics and Gynecology residents on the techniques of digital and ultrasound assessment of fetal head position. We evaluated the curriculum by assessing its impact on resident performance and confidence before and after the conference.

METHODS:
The conference included a 15-minute demonstration video and a supervised skill practice using a simulation mannequin and pelvis. Participants were asked to submit digital documentation of one attempt of ultrasound assessment of fetal head position on a laboring patient.

EVALUATION:
Eleven residents (PGY-1, n=5; PGY-3, n=6) successfully completed the conference and surveys. There was a nonsignificant increase in the resident documentation of fetal head position as part of the labor cervical exam in the 3 months following the start of the conference compared to the same 3 months from the year prior (25.6% versus 20%, P=.48). Mean confidence in the ability to identify fetal head position (5.1 versus 6.9, P=.004), rotate the fetal head (3.5 versus 5.1, P=.013), safely apply a vacuum or forceps (3.9 versus 4.5, P=.054), and use ultrasonography to assist in identification of fetal head position (5.7 versus 6.4, P=.09) improved following the conference.

DISSEMINATION:
The demonstration video was accepted for presentation at the CREOG & APGO Film Festival 2017 and will be submitted to the AAMC MedEdPORTAL. The curriculum evaluation results will be submitted to the Journal of Graduate Medical Education.

REFLECTIVE CRITIQUE:
We will plan to enroll more residents into the study over the course of the next year.
Resident Practices Regarding Prenatal Contraceptive Counseling
Authors: Patel Pooja , Young Amy , Steinauer Jody 
Published: September 2017

OBJECTIVE:
Prenatal contraceptive counseling has been associated with effective postpartum contraceptive use; therefore, proper training in providing this service is paramount. The purpose of this cross-sectional study is to determine obstetrics and gynecology (ob-gyn) residents' prenatal contraceptive counseling practices.

METHODS:
Data were obtained via anonymous surveys completed by University of Texas, Medical Branch in Galveston (UTMB) ob-gyn residents.

RESULTS:
Twenty-one of 25 residents (84%) completed the survey. Five (20%) PGY-1, seven (28%) PGY-2, five (20%) PGY-3, and four (12%) PGY-4 residents participated. With regards to prenatal contraceptive counseling practices, 11 (52%) reported initiating prenatal contraceptive counseling in the third trimester or later, 20 (95%) described spending 10 minutes or less on contraceptive counseling during all prenatal care, and nine (43%) respondents reported counseling about all four major contraceptive categories (oral pills/patches/rings, injections, long-acting reversible contraceptives/IUDs/implant, and sterilization). When asked for reasons for not doing prenatal counseling, residents cited either time-constraints and simply forgetting to counsel. One-third of the residents felt that they “miss[ed] some aspects of proper counseling.” Finally, one 3rd year and one 4th year stated they had no formal training in contraceptive counseling, and only four (16%) residents reported formal didactics on contraceptive counseling specific to the prenatal period.

CONCLUSION:
Prenatal contraception counseling was inadequate in one ob-gyn residency program. Our findings suggest that further research and uniform guidelines regarding resident education on contraceptive counseling are warranted.
Impact of Cesarean Simulation on Medical Education
Authors: Snyder Lindsay , O'Reilly Meg , Friedman Elizabeth , Hawkins Allyson , Schink Julian (Skip) , Schink Julian (Skip) , Goepfert Alice , Kenton Kimberly 
Published: September 2017

OBJECTIVE:
To 1) enhance a cesarean delivery educational video and 2) determine the impact of an innovative cesarean delivery simulation model on learners' knowledge.

METHODS:
An innovative program was developed by expanding on an existing cesarean simulation video from Dr. Meg O'Reilly at Oregon Health Services University. Students and interns watched the video, then participated in a 2-hour structured experience. The simulation involved dissection and re-approximation of the abdominal wall and uterus. All participants completed a pre- and posttest immediately before and after their participation.

EVALUATION:
Data were collected from 42 participants, eight interns and 34 medical students. Significantly more questions were answered correctly in the posttest, compared to the pretest (17.3+4.1 versus 11.4+2.9, respectively; P<.001).

DISSEMINATION:
We will submit to AAMC MedEdPortal, and continue to collect data for presentation at future APGO and CREOG meetings.

REFLECTIVE CRITIQUE:
While the immediate responses are promising, the long-term results are unknown. In addition, an ongoing assessment of skill performance needs to be considered for future learners.
Simulation Training Regarding Vaginal Delivery Versus Traditional Medical Student Clinical Education
Authors: Stetzer Brad , Sarfoh Vanessa , Mercer Brian , McKenzie Margaret , Hueppchen Nancy 
Published: September 2017

OBJECTIVE:
To assess the impact of birth simulation training on medical student comfort, confidence and anxiety in performing a delivery, and knowledge of normal labor.

METHODS:
In this prospective study of 3rd-year medical students during their 4-week inpatient clinical experience, student groups were randomly assigned to “traditional” teaching versus traditional plus additional “simulation” teaching. All students were immersed in clinical experiences in the delivery room after an initial group education session regarding normal labor and delivery mechanisms and procedures. The group assigned to “simulation” underwent additional supervised simulation training for normal delivery and delivery complications. All groups underwent a pretest before training and a posttest on completion of their clinical rotation. Evaluated variables included: confidence and anxiety regarding performing a delivery; comfort controlling the head, shoulders and body during delivery; comfort in delivering a placenta; and knowledge of cardinal movements and stages of labor. Statistical analyses were accomplished using Pearson χ2 analysis and Student's T tests.

RESULTS:
Sixty students participated. Overall, both traditional teaching and simulation groups demonstrated significant improvements in their scores regarding measures of comfort, anxiety, and knowledge between the pre- and posttests (P≤0.05). However, comparison of posttest responses did not reveal those undergoing additional simulation training to have higher comfort or confidence in performing a vaginal delivery (P>.05), or have lower anxiety at being involved in a vaginal delivery (P>.05). Similarly, knowledge about the cardinal movements of labor and stages of labor at the posttest were similar between groups (P>.05).

CONCLUSION:
In the context of an inpatient clinical rotation in which student comfort, confidence, anxiety, and knowledge regarding vaginal delivery improved significantly with traditional teaching, additional simulation training was not associated with improved outcomes.
The Decline in Attitudes Toward Physician–Nurse Collaboration From Medical School to Residency
Authors: Kempner Samantha , Morgan Helen , Kobernik Emily , Brackmann Melissa 
Published: September 2017

BACKGROUND:
Interprofessional education is often part of early medical school curricula; however, as learners progress through their training, there is often less instruction in this important area. Little is known of the impact of clinical exposure on medical students' and residents' attitudes toward physician–nurse collaboration.

METHODS:
Third-year medical students and residents completed the validated Jefferson Survey of Attitudes Toward Physician–Nurse Collaboration. This instrument has 20 questions in which trainees indicate their level of agreement with statements regarding physician–nurse collaboration. All items were scored on a 4-point Likert scale (1=strongly disagree to 4=strongly agree). Student and resident scores were compared using Student's t tests.

RESULTS:
The survey was completed by 129 medical students and 260 residents. The response rate for medical students was 75% and for residents was 16.5%. Resident respondents agreed more strongly with the notion of physician as dominant authority, “the primary function of the nurse is to carry out the physician's orders” (students: 2.02±0.72 versus residents: 2.45±0.82; P=.0001) and “doctors should be the dominant authority in all health care matters” (students: 2.36±0.84 versus residents: 2.67±0.89; P=.0011).

DISCUSSION:
Resident physicians' perceptions of the physician–nurse relationship are significantly less favorable than the views of 3rd-year medical students, particularly in the area of authority. There may be some aspects of the hidden curriculum which contribute to the development of these interprofessional attitudes.
The FLAME Initiative: “Five-Minute Lectures Accelerating Medical Education” Empowering Resident Teaching
Authors: Steller Jonathan , Burns Roshan , Crosland Adam , Fitzmaurice Laura 
Published: September 2017

BACKGROUND:
The ever-increasing volume of medical knowledge and time available to acquire it are inversely proportional, creating a conundrum for resident-educators of medical students during clerkships. As learners themselves, resident teaching opportunities can be stifled by self-confidence, time, and accessibility of resources. The FLAME initiative seeks to increase the frequency and quality of teachable encounters while catalyzing resident learning through teaching.

METHODS:
FLAME seeks to create a short presentation for each APGO medical student learning objective. These can be readily accessed on www.flame.rocks and through an iPhone application. Our primary hypothesis, assessed by confidential survey before and after FLAME implementation, is that residents will be better able to meet their own teaching goals with FLAME as a resource. Secondary hypotheses include: residents will be more comfortable teaching, residents will teach medical students more frequently, students will be more satisfied with resident teaching, and student Shelf scores will improve.

RESULTS:
Of 28 residents surveyed pre-FLAME, 92% find medical student teaching important, and 88% wished they taught more. Major barriers impeding teaching are: time/clinical duties (100%), comfort with teaching (23%) and accessibility of resources (18%). The survey will be repeated in January 2017 and compared to the pre-FLAME baseline. Medical student postclerkship survey scores and Shelf scores for 12 months following FLAME introduction will be compared to the 12 months prior.

DISCUSSION:
FLAME's philosophy is simple: empower residents to teach by making relevant, efficient, and reliable teaching resources immediately accessible.
Using Interprofessional OSCE-Based Simulation Collaboration to Teach Obstetrics to Second-Year Medical Students
Authors: Berg Jordan , Ogunyemi Dotun , Venuti Judith , Ferrari Thomas 
Published: September 2017

BACKGROUND:
We have shown that it is possible to introduce an obstetric simulation program to preclinical 2nd-year medical students. In the second year of our obstetrics simulation curriculum for 2nd-year medical students, we introduced OSCE assessment in collaboration with the nursing school educator with the program occurring in the nursing school simulation center in November 2015.

METHODS:
Students rotated through three stations: 1) simulated vaginal delivery demonstrated by nurse educator and OBGYN resident; 2) MFM faculty gave interactive presentation on fetal heart rate (FHR), a student nurse then role played with students and they were assessed by OSCE format; and 3) OBGYN resident and faculty taught and assessed students on cervical dilation using cervical models. Students completed surveys on attitude, knowledge before, after and 7 months postcurriculum.

RESULTS:
Of 95 students, mean scores for the FHR OSCE were: identifies FHR baseline=0.97, identifies FHR variability=0.92, provides accurate identification of periodic pattern=0.73, identifies FHR category=0.67 and orders appropriate medical interventions=0.93. For the cervical station OSCE, the mean score on cervical examination skills after training was 75%. For the knowledge questions on obstetrics and fetal heart rate monitoring, students obtained a mean prescore of 2.57±0.09, postsimulation the mean score increased to 3.24±0.11 (P=.12). Presimulation; students scored their comfort level with obstetric procedures as 12.2±0.63, after simulation the mean score increased to 28±0.63 (P<.001).

DISCUSSION:
We have demonstrated the feasibility of an OSCE-based inter-professional educational curriculum utilizing nursing, physician and resident faculty instructing medical students and nursing students jointly. For FHR teaching, the concept of FHR category was the most challenging for the students to grasp. The course improved students' short-term knowledge but had dropped back to baseline by 7 months. Students' comfort level increased immediately posttraining and decreased but was still higher than baseline at 7 months. Further curriculum development is undergoing on increasing long term knowledge gain.
Willing and Able: A New Model for Resident Research
Authors: Doyle Nora , Gardner Michael 
Published: September 2017

BACKGROUND:
OB/GYN programs rely on resident research projects for the ACGME scholarly requirements. Recently, ACGME has shifted to requesting better definitions/additional curriculums. This obligation shift represents a major change for residencies. The Six-Source Model of Influence (SSM) is a well-studied model for change based on Motivation and Ability of three forces: Personal, Social, and Structural. We established a team-based resident research program using SSM. We then evaluated the success of our program.

METHODS:
We developed a resident research program over a 7-year period in an OB/GYN resident program on probation in part due to lack of scholarly activities. Using SSM we identified personal motivation/ability, social motivation/ability, and structural motivation/ability factors for intervention. Personal motivation—research required for graduation. Personal ability-supported by monthly learning sessions. Learning topics included types of research studies, statistics, research design, and abstract/manuscript writing. Social motivation and social ability were obtained by using a team research approach. Each team was comprised of a PGY-1, -2, -3, and -4. Roles were delegated by year, with team interaction and support. Structural motivation—monetary rewards for project presentation and free trips if abstracts were accepted. Structural ability—designated research program director and support staff for statistics/project completion. Monthly sessions were built into the academic schedule for group research. A designated resident research office was created.

RESULTS:
All 28 residents completed their projects on schedule. Eight of 28 residents went on to fellowship programs. Eight of 28 obtained positions in academic departments. Eight residents presented posters at national OB/GYN meetings, including the Association of Professors of Gynecology and Obstetrics, the American College of Obstetricians and Gynecologists (the College), the Central Association of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine. Four of 28 residents gave oral presentations at one of these meetings. One resident was awarded the national College prize for best resident research project.

DISCUSSION:
Resident research requirements are changing. Accepting that people do things for two reasons: motivation—because they want to, and ability—because they can, provides the basis for SSM. By applying these two reasons to the three forces of personal, social, and structural; a sound resident research model can be constructed. Our research presentations support SSM can produce positive, productive, and sustainable change.