bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interdisciplinary Flipped Classroom: Methods and Modules
Authors: Hooks Jared , Brincat Cynthia , Wagner Sarah , Bullough Alexandra 
Published: September 2017

BACKGROUND:
To efficiently address the limitations on formal didactic time, we have developed a practical, interprofessional curriculum.

METHODS:
Following IRB exempt status, we piloted a low-fidelity, anesthesia designed module covering Anesthetic Concerns for a Surgical Pneumoperitoneum on OB/GYN residents, prior to their orientation to the robotic surgery system. One component was in lecture format, developed via power point with voice over. The second was an interactive case study. The residency director invited the residents to access the module which was accessible via a link in survey monkey and required 25 minutes to complete. A brief survey followed.

RESULTS:
Forty-seven percent (8/17) of the residents accessed the module. 87.5% of respondents agreed or strongly agreed that the video presentation assisted with learning. Seventy-five percent agreed or strongly agreed that they felt engaged with the educational material. 87.5% agreed or strongly agreed that the case portion of the didactic session allowed for application of the material, and 75% of respondents felt they could apply the knowledge learned clinically. Yet only 50% of the respondents found the self-directed learning: 1) time saving, and 2) more satisfying than traditional learning.

DISCUSSION:
Didactic topics for OB/GYN residents can be developed interprofessionally and addressed efficiently through a flipped-classroom model. While only half of the residents accessed the module, the vast majority found it helpful. But only half found the experience satisfying. Future steps will involve developing topics for anesthesia residents relevant to OB/GYN.
Making Magic With Interprofessional Education: A 3-Year Experience
Authors: Appleton Sarah 
Published: September 2017

BACKGROUND:
In the past 5 years, the American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists have urged collaborative practice and the development of interprofessional education (IPE) teams. Many barriers exist in establishing true interdisciplinary teams in training.

METHODS:
Over 3 years, all OB/GYN interns completed a rotation with the faculty CNM practice 1 day per week. The rotation included didactics, simulation, and clinical teaching with an emphasis on normal birth as well as an introduction to midwifery scope of practice and philosophy of care. Interns completed a validated attitude survey before and after the rotation, formative feedback evaluations after each shift, and a clinical reflection.

RESULTS:
Of all participating interns (n=30), 50% had never previously worked with a midwife. Topics rated most helpful included: nonpharmacologic pain control, normal labor and birth, and birth positions. Based on the attitude survey (4-point Likert scale), the most significant changes in perception at completion included: scope of care (Δ 0.5), nonmedical approach to obstetrics (Δ 0.6), and understanding credentials in midwifery (Δ 0.7). Review of the reflections revealed three main qualitative themes learned during the rotation: therapeutic use of self, birth experience, and relationship with midwives.

DISCUSSION:
An interprofessional education with faculty CNMs provided interns with an introduction to midwifery care and an opportunity to establish positive relationships with future collaborators.
Medical Students Can Improve Health Literacy: Training Students to Educate Patients About Obstetric Venous Thromboembolism Prophylaxis
Authors: Siegel Molly , Tukan Natalie , Abbott Jodi 
Published: September 2017

BACKGROUND:
Medical schools are increasingly emphasizing patient education in the clerkship year. Effective education is essential to increase patient buy-in when spearheading quality initiatives. This project was designed to train 3rd-year medical students in teach-back education while concurrently enhancing a departmental QI effort to increase obstetric VTE prophylaxis.

METHODS:
Ob-Gyn clerkship students watched a student-created instructional video on teach-back teaching and a case-based presentation on VTE prophylaxis. Students assessed three patients for VTE risk and counseled patients on interventions. Students recorded pre- and postcounseling assessments of patient knowledge and responded to a survey about their experience.

RESULTS:
During the first clerkship block, 26 students participated in counseling and 75 patients were counseled. Following student counseling, a significantly increased number of patients exhibited understanding of: definition and consequences of VTE (56.25% increase, P<.0001), VTE risk factors (212.5% increase, P<.0001) and prophylactic interventions (169% increase, P<.0001). Students agreed or strongly agreed that their participation improved: understanding of VTE prophylaxis (100%), confidence counseling patients (100%), quality of patient care (64%), and understanding of QI (93%). One hundred percent of students stated that they plan to use teach-back teaching in future patient encounters.

DISCUSSION:
Students felt that the experience was rewarding and contributed to their education, and students' assessment of patient understanding improved following counseling. This intervention demonstrates that medical students can effectively counsel patients and enhance a quality improvement intervention.
Resident Training in Hysterectomy and Patient Morbidity: Interrogating the Association
Authors: Shah Divya , Vitonis Allison , Missmer Stacey 
Published: September 2017

BACKGROUND:
Concern regarding resident inexperience as a contributing factor toward unfavorable surgical outcomes is often claimed but has been inadequately explored.

METHODS:
Data were abstracted from American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) on 33,278 benign hysterectomies performed from January 2005–December 2012. Associations between resident participation and morbidity were examined using multivariate-adjusted regression, adjusting for age, BMI, race, ethnicity, year of surgery, smoking, diabetes, hypertension, steroid use, ASA physical classification, uterine size, and postoperative diagnosis. Cases without resident involvement (63.4%) were used as the referent.

RESULTS:
Resident involvement was associated with significantly longer operative times regardless of surgical approach and year of training (all P<.0001). Odds of blood transfusion were increased with resident participation in abdominal (OR 1.74; 95% CI 1.40–2.17) and laparoscopic hysterectomy (OR 1.87; 95% CI 1.33–2.64), while odds of sepsis were increased in abdominal (OR 2.29; 95% CI 1.37–3.83) and vaginal hysterectomy (OR 2.49; 95% CI 1.24–5.00). Odds of urinary tract infections were uniformly higher with resident participation (all P<.001). When stratified by level of training, these associations only remained significant in hysterectomies involving senior residents. All associations were significantly attenuated or absent when operative time was included in the model.

DISCUSSION:
Resident involvement is associated with modest increases in the odds of blood transfusion and infectious morbidity after hysterectomy. These associations are likely driven by prolonged operative times with resident participation.
SUGAR in OB/Gyn: A Multi-Institutional Collaboration to Develop Cases for Simulation Use for Global Away Rotations (SUGAR)
Authors: Rysavy Mary , Butteris Sabrina , Pitt Michael , Anderson Cynthie 
Published: September 2017

BACKGROUND:
Simulation Use for Global Away Rotations (SUGAR) is an open source curriculum initially developed by a collaborative of pediatricians to allow residents to experience and debrief common practical and emotional challenges of working in resource-limited settings. The original curriculum included eight pediatric simulation cases with facilitators trained at more than 80 institutions. A multi-disciplinary group was formed to harness the principals of the SUGAR curriculum to provide simulation training for residents in specialties beyond pediatrics.

METHODS:
OB/Gyn collaborators were trained to facilitate SUGAR cases. New OB-Gyn simulation cases were developed, formatted, and piloted with multi-disciplinary groups of residents at our academic institution over a 3-year period.

RESULTS:
Three new OB/Gyn SUGAR cases were developed and piloted with the goal of allowing residents to experience and debrief common medical management and emotional complexities faced in resource-limited settings. The following medical topics are addressed: obstructed labor, postpartum hemorrhage, eclampsia, female genital cutting. The following negative emotional experiences/adaptive characteristics are addressed: frustration/adaptability, floundering/awareness of resources, failure/adjustment and humility. Facilitator and resident feedback is under evaluation. Collaborators agreed that the content would be made available for free for use in global health education on the training website http://sugarprep.org/.

DISCUSSION:
By creating, piloting, and open-sourcing simulation cases in OB/Gyn, the SUGAR curriculum can be expanded to fill a need of global health educators in OB/Gyn. SUGAR simulations hold promise to expand resident preparation for international electives in resource-limited settings.
Enhancing Family Planning Training at a Catholic OBGYN Residency Program
Authors: Fennimore Robin , Guiahi Maryam , Gottesfeld Marshall , Ricciotti Hope 
Published: September 2017

OBJECTIVE:
Residents in Catholic hospitals face restrictions in family planning training based on the Ethical and Religious Directives. Our objective was to create a rotation that addresses ACGME competencies in family planning and abortion training for the OBGYN residency program at Saint Joseph Hospital.

METHODS:
In July 2016, a family planning grant was awarded to the OBGYN residency program at Saint Joseph Hospital to create a family planning rotation to improve on-site family planning curricula at Saint Joseph Hospital and provide planned, off-site abortion and contraception training at a family planning clinic affiliated with a nearby academic center. All residents participated in family planning didactic sessions, simulation sessions, and annual values clarification workshop. Residents who participated in the family planning rotation were assigned readings (American College of Obstetricians and Gynecologists publications and journal articles), an e-learning curriculum (LEARN module), and trained in providing contraception and uterine evacuation procedures. Residents who chose to opt-out of performing uterine evacuation procedures were considered partial participators.

EVALUATION:
We will compare pre- and postmean test scores for LEARN modules and median number of family planning procedures before and after the family planning rotation. Participating residents will complete rotation evaluations and comments will be evaluated using thematic codes. Preliminary data suggest residents gain more experience in uterine evacuations and LARC contraception procedures after the rotation.

DISSEMINATION:
Our family planning rotation can serve as a model for other faith-based residency programs to improve training.

REFLECTIVE CRITIQUE:
The family planning rotation provides an opportunity to improve training in our Catholic hospital-based program.
Effect of Time Lapsed on Quality of Surgical Resident Intraoperative Performance Evaluation: A Systematic Review
Authors: Garduno Elizabeth , Swoboda Eva , Kenton Kimberly 
Published: September 2017

OBJECTIVE:
Several tools have been developed and validated to assess resident intraoperative performance and to provide formative feedback. The objective of this systematic review is to evaluate the effect of time since the completion of the case on the quality of the feedback gathered by the assessment tool.

DATA SOURCES:
Search English-language studies in PubMed, Cochrane, Science Direct Journals, and Ovid using keywords.

METHODS OF STUDY SELECTION:
Publications selected for review were published in a peer-reviewed journal, described a study involving intraoperative assessment of resident surgical training and reported on the timing of completion. Studies were excluded if they were an abstract or if the subject of study was simulation, medical students or nonsurgical residents. Two reviewers independently appraised the articles to extract relevant data.

RESULTS:
Three hundred sixty-one publications were identified, and three met inclusion criteria addressing the main objective. One study demonstrated that the median time to completion of evaluations was more than 11 days, with a range of 4.5–22 days. Another study demonstrated that elapsed time greater than 6 days threatened the construct validity of the assessment. The final study demonstrated the degree of item-to-item variation and the presence of formative comments were negatively affected when more than 14 days had elapsed.

CONCLUSION:
The amount of time elapsed between the observed operative performance and the performance evaluation can be lengthy and can negatively impact the quality of the data collected. Solutions must be sought to improve the timeliness of feedback to mitigate the impact of the delay.
Using Patient Feedback as a Feedback and Assessment Tool for Medical Students
Authors: Keblawi Hisham A. , Jude David C. , Jude David C. , Ricciotti Hope A. 
Published: September 2017

OBJECTIVE:
To improve the quality of feedback and assessment of medical students through a patient satisfaction questionnaire about student performance.

METHODS:
To measure student performance from the patient’s perspective, five items were adopted from the validated Patient Satisfaction Questionnaire from the American Board of Internal Medicine. This was used to assess medical student skills in communication and professionalism, which were rated on a five-point Likert scale. All 3rd-year medical students rotating through the OBGYN clerkship participated in these unsupervised patient feedback encounters. Students then were asked to anonymously respond to a two-item questionnaire on usefulness of the patients’ feedback encounter and whether this process improved feedback that faculty provided to students.

EVALUATION:
This is a survey study; 65% (53 out of 81) of students found the patient feedback encounters helpful and 51% (34 out of 67) thought that the exercise encouraged preceptors to provide useful feedback.

DISSEMINATION:
The goal is to implement this feedback tool locally in the OBGYN Clerkship as well as other clerkships in our institution. The intention is to publish the results in peer-reviewed journal for wider dissemination.

REFLECTIVE CRITIQUE:
Providing feedback and assessment is an essential element of medical education. Feedback to medical students regarding their performance is usually provided by preceptors and standardized patients in simulated encounters. Little attention has been given to feedback provided directly by actual patients. Comments provided by patients have more positive impact compared to numerical rating. Empowering patients to participate in feedback improves the quality of feedback to students.
Cultural Self-Awareness Training in OBGYN Residency
Authors: Lutz Elizabeth , Riley Rachel , Bouldin Sheila , Hueppchen Nancy 
Published: September 2017

OBJECTIVE:
Develop and implement a training session for our OBGYN department that expands knowledge of one's own culture and fosters an awareness of the cultures of colleagues.

METHODS:

Needs Assessment including review of the 2014 ACGME Annual Resident Survey, which highlighted need for improved respect in the workplace. This prompted a meeting of the Designated Institutional Officer with the faculty of the OBGYN department regarding improved communication and sensitivity. An extended cultural competency curriculum was suggested from this meeting. Discussions with the institutional Director for Inclusion and Diversity Strategy confirmed that policies of inclusion and diversity are reviewed at new resident orientation; however, there is no further formal training for residents. Focus Group conducted with graduating residents to discuss their experiences during residency regarding issues of respect in the workplace and cultural sensitivity. Developed Framework for curriculum. Workshop conducted to address the specific objectives: Increase knowledge concerning cultural awareness and cultural competency; Identify personal attitudes regarding culturally sensitive issues and biases; Develop skills for addressing culturally sensitive issues.

EVALUATION:
Pre- and posttests developed with the Office of Diversity and Inclusion to assess knowledge, attitudes, and beliefs. Twenty-one residents and faculty attended the workshop. Nineteen of 21 (90%) of participants felt more open to learning of others' cultures and beliefs after this activity, and 18/21 (86%) felt closer to their colleagues after this activity.

DISSEMINATION:
Present to local “Ed Talks” conference, which promotes Educational Scholarship across the institution. Submit to MedEdPortal.

REFLECTIVE CRITIQUE:
The workshop was very well-received by those in attendance.
“The Electronic Preceptor”—Use of Email to Provide Feedback to Students on Their Suturing Compared to Direct Observation and Direct Feedback in Third-Year Medical Students During Their OB/GYN Clerkship
Authors: Sutton Jill M. , Guyton Lisa M. , Hodson Charles , Nelson Keith H. , Learman Lee A. 
Published: September 2017

OBJECTIVE:
To assess medical students' preferred method and timing of feedback on suturing skills.

METHODS:
This study was a quasi-experimental study involving 3rd-year medical students on the OB/GYN Clerkship at East Carolina University (IRB approved exempt). Students were preassigned by the clerkship director based on prior subrotation experience to digital feedback (n=32) or direct feedback (n=35) for each cohort. Upon arrival to the clerkship, students receive instruments, suture, and access to the “Duke Suture Skills Course” video. During Simulation Day (Week 3), students received either “Direct Feedback” immediately by a resident colleague or “Digital/Indirect Feedback” from the Clerkship Director via email shortly after the session. Suturing was performed on contraceptive implant model arms. Feedback preferences were assessed using a questionnaire asking students their level of agreement with six statements regarding the effectiveness of the feedback they received (5-point Likert scale ranging from 1=strongly disagree to 5=strongly agree). Mean responses were compared using the Mann Whitney U Test and a statistical significance threshold of P<.05.

RESULTS:
Direct feedback by a resident colleague was superior to indirect/digital feedback by an expert in perceived skill acquisition (4.53 versus 3.60, P<.001), skill correction (4.50 versus 3.71, P<.001) and value to the learner (4.63 versus 4.29, P<.01). Small mean differences in skill confidence, perceived suturing independence, and the quality of the learning environment were not statistically significant.

CONCLUSION:
Immediate feedback may be valued more by medical students learning suturing skills than indirect feedback, but may not promote more skill confidence or independence.
Implementing Patient Satisfaction Surveys to Assess Resident Professionalism and Communication
Authors: Taché Véronique , Wallach Stacey , Kenton Kim 
Published: September 2017

OBJECTIVE:
To develop and implement an outpatient patient feedback measure to assess OBGYN resident professionalism and communication.

METHODS:
After obtaining institutional IRB exemption, we used four questions from inpatient Press Ganey survey assessing communication and professionalism (Did your doctor: 1) treat you with courtesy and respect; 2) listen carefully to you; 3) explain things in a way you could understand; and 4) give you time to ask questions) with the answer scale: Never, Rarely, Sometimes, Always. We administered the same questions to OBGYN residents to determine their baseline perception of their patient–physician communication and professionalism skills.

EVALUATION:
This was a longitudinal study, with collection of outpatient OBGYN patient surveys initially over 3 months. After pilot data (n=22) yielded the same answer (Always) for each question, the answer scale was changed (Yes, No, and Unsure). Data from the new questionnaire (n=34) again yielded the same answer (Yes) to each question. Resident answers showed slightly more variation. All residents (n=17) felt they treated patients with courtesy and respect and gave time for questions. Only 1/17 resident felt s/he sometimes did not listen carefully to patient concerns and 5/17 residents felt they had a hard time explaining things in a manner patients would understand.

DISSEMINATION:
This was initiated to create a template that could be used by other residency programs as part of their evaluation system.

REFLECTIVE CRITIQUE:
This is not useful in its current form. I plan to reassess the survey content, process and administration.
Resident Coaching Sessions: A Clinical Faculty Development Program to Provide Actionable and Formative Resident Feedback
Authors: Werkema Michael , Leach Richard , van de Ridder Monica , Leach Richard , Hueppchen Nancy 
Published: September 2017

OBJECTIVE:
To develop a formative evaluation instrument that will facilitate mid-rotation feedback. To educate learners and educators on formative feedback in order to facilitate coaching sessions in timely and actionable ways.

METHODS:
A mid-rotation assessment instrument was created within the New Innovations platform. The instrument focuses on EPAs relevant to the rotation, achievement of resident goals, and resident-directed action plans for improvement. It includes feedback elements that can be completed in 5 minutes. Content validity was confirmed through ACGME Milestones and critical assessment from experts in field. Reliability was confirmed through expert consensus obtained through structured interviews. Faculty and resident development sessions were created and delivered to educate on formative feedback and use of instrument. The sessions included a 15 minute presentation and instrument demonstration. Subspecialty rotations were chosen as pilots due to the limited number of faculty and residents.

EVALUATION:
Nineteen residents and six faculty were surveyed prior to implementation on quality of feedback skills. Upon completion of feedback cycles residents and faculty will be resurveyed for comparison.

DISSEMINATION:
The optimized feedback tool will be expanded to every rotation facilitating structured feedback and timely consistent reporting.

REFLECTIVE CRITIQUE:
The implementation of structured feedback training and an assessment tool that formalizes the process can optimize meaningful feedback for learners. Education on formative feedback and instrument use improves efficiency and increases timely and actionable feedback.