bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results of a Multidisciplinary Workshop to Reduce Bias and Improve Health Equity for Patients With Limited English Proficiency [ID: 1375774]
Authors: Garrison Etoi , Bey Amita , Jimenez Eleazar , Li Andria , Nettles Arie 
Published: May 2023

INTRODUCTION:
Birthing people with limited English proficiency (LEP) often face systemic limitations to care and are at increased risk for disparate birth outcomes due to barriers in patient–provider communication. Patients with LEP are particularly vulnerable to biases and microaggressions that can limit timely health care delivery and the quality of services received. We developed a multidisciplinary curriculum to educate providers about 1) unconscious bias (UCB), 2) barriers to equitable health care delivery for patients with LEP, and 3) use of trained interpreter services to promote patient–provider communication.

METHODS:
We developed a 60-minute workshop for physicians/midwives/nurses (n=75). Surveys were used to assess change in knowledge. Results were evaluated by descriptive statistics, t tests for significance, and thematic analysis. Institutional review board approval was obtained.

RESULTS:
Approximately 75 participants attended the workshop. Thirty-three percent of pre-workshop survey respondents (13/39) had not received cultural competency training within the last 3 years. Approximately 1 in 5 (22%) pre-workshop respondents were unaware of their hospital's interpreter services policy. After a brief didactic presentation, participants identified common microaggressions and barriers to care for patients with LEP. They also developed 15 unique strategies to promote communication via use of trained interpreters when the patient/family initially opt for ad hoc interpretation instead. At workshop completion, 97.1% of participants reported that they will adopt or modify an existing strategy when communicating with LEP patients and families.

CONCLUSION:
Post-workshop survey results suggest that continuing education can be used to address UCB for patients with LEP and promote use of interpreter services to improve patient–provider communication.
Before and After SB8: Obstetrics and Gynecology Residency Application Patterns in Texas [ID: 1353318]
Authors: DiCenzo Natalie , Giglio Marisa 
Published: May 2023

INTRODUCTION:
In September 2021, Senate Bill 8 (SB8) banned abortion in Texas around 6 weeks of gestation. This law authorizes members of the public to sue anyone who performs or facilitates an illegal abortion. This study investigates the change in patterns of obstetrics and gynecology residency applications from the application cycle before and after the ban took effect.

METHODS:
Using publicly available data of United States obstetrics and gynecology residency applications via Association of American Medical Colleges Residency Explorer, we calculated the average number of applications submitted to residency programs in Texas before SB8 (2020 cycle) and after (2021 cycle) the law was in effect. We then compared the application patterns in the state of Texas to the average number of applications submitted to other states in the country.

RESULTS:
According to public data, the average number of applications per residency program in the United States increased from 547 to 616, or a net average increase in 69 applications per program, from 2020 to 2021. Comparatively, in the same time period, the average number of applications per program in Texas increased from 565 to 598, or a net average increase of 33. Therefore, the average rate of residency application increase in Texas was half that of the rest of the country.

CONCLUSION:
After the introduction of SB8, there was slower growth in the average number of applications to Texas obstetrics and gynecology residency programs compared to the average across the rest of the country. This could indicate a decreasing number of applicants to states with restrictive abortion laws in place in the future.
Effect of a CME Symposium on the Obstetrician–Gynecologist's Knowledge and Confidence Related to CGM Use in Pregnant Patients [ID: 1368750]
Authors: Larkin Amy , Le Anne , Schrand Julie 
Published: May 2023

INTRODUCTION:
We sought to measure the effect of a live symposium at the American College of Obstetricians and Gynecologists followed by enduring on Medscape related to real-time continuous glucose monitoring (rtCGM) use in pregnant patients.

METHODS:
Pre and post questions assessed changes in knowledge and confidence. Absolute differences were calculated for the live activity. For the enduring, completers of all pre and post questions were linked and analyzed.

RESULTS:
There were 61 live participants: 68% were physicians, 3% NPs, 3% pharmacists, and 3% nurses. There was a 21% increase in learners who recognized time in range goals for pregnant patients with diabetes, and a 26% increase in those who reported being very or somewhat confident in using rtCGM in their patients with diabetes (24% less were not confident with this concept). 100% declared the content learned will affect their practice, and 91% reported being committed/very committed to implementing practice changes. There are 3,595 enduring learners to date (October 9, 2022), and 83 completers of all questions by August 30, 2022. 16% of ob-gyn learners improved at recognizing time in range goals for pregnant patients with diabetes. Eighteen percent of ob-gyn learners improved at recognizing the benefit of rtCGM in pregnant patients with diabetes. Thirty-nine percent of ob-gyn learners had increased confidence in using rtCGM in pregnant patients with diabetes for an average confidence shift of +79% among those with increased confidence.

CONCLUSION:
The outcomes gathered in this assessment are a strong indicator that live, in-person CME symposia followed by online enduring is successful at improving knowledge and confidence related to rtCGM use in pregnant patients with diabetes, and possibly promote improvements in clinical practice.
Applicant and Program Director Perceptions Regarding Virtual Interviewing and Signaling [ID: 1373344]
Authors: Schoppen Zachary , Gabbur Nagaraj , Kaufman Leah , Miller Sarah 
Published: May 2023

INTRODUCTION:
In 2020, obstetrics and gynecology residency programs switched to a virtual interview format because of the COVID-19 pandemic. Most programs have continued to conduct virtual interviews. In 2022, program signaling was introduced to allow candidates applying to obstetrics and gynecology residencies to indicate interest in specific programs. The objective of this study is to survey medical student residency applicants and program directors about their perceptions of the process.

METHODS:
Education for All (EFA) developed a validated survey assessing student and residency program director perceptions. This survey was distributed online to all residency applicants and program directors who registered for the 2022 EFA Residency Fair.

RESULTS:
Five hundred six obstetrics and gynecology residency applicants and 33 program directors responded. 37% applicants indicated that virtual interviews would probably provide enough information to create a rank list, but 36% were not sure. 37% of students and 50% of residency programs indicated the process should continue to be virtual. Ninety-one percent of students indicated they would “definitely” use signaling, and 66% of program directors said signaling “might or might not” improve the application process. In a free-text section, many applicants expressed concern with the virtual interview process.

CONCLUSION:
Fifty percent of residency programs and the majority of residency applicants are unsure if interviews should continue to be virtual. Nearly all candidates planned to use program signaling, but the majority of program directors were unsure if this would improve the application process. Further study is necessary to determine whether program signaling and virtual interviews should be continued in the future.
Did the Initiation of ACOG Surgical Curriculum Affect Accuracy of Videos Published on YouTube for Ob-Gyn Resident Education? [ID: 1374093]
Authors: Foncham Juanita , Francis Antonia , Kayaalp Emre , Mcilvaine Jamie 
Published: May 2023

INTRODUCTION:
The purpose of this study was to assess the accuracy of open-access online obstetrics and gynecology procedural videos to the ACOG Surgical Curriculum in Obstetrics and Gynecology (SCOG) and its educational value. YouTube is commonly used as an easily accessible resource for education and surgical preparation. There is no current research that evaluates instructional videos for educational usefulness across multiple obstetric and gynecologic procedures. Given the rigorous workload of residents and the fact that they are already relying on these videos, despite the lack of known quality control, this study was designed to develop an efficient way to determine whether any given video can deliver quality information that is useful for building surgical skills.

METHODS:
The SCOG topics were entered into YouTube search queries. The resulting videos were screened with strict exclusion criteria. The percent accuracy of each video was calculated as compared to the SCOG checklist for the corresponding procedure.

RESULTS:
Three hundred six videos were analyzed and categorized into six groups: private practice/independent physicians (n=127), academic institutions (n=70), commercial companies (n=50), nonacademic institutions (n=32), international health care organizations (n=20), and other (n=7). Using the SCOG checklist, videos produced by international organizations had the highest percent accuracy at 50.6% followed by academic institutions at 45.8%.

CONCLUSION:
Using the SCOG checklist, there is a significant variance in the accuracy of educational videos depending on the associated publishing organization. Ob-gyn residents should be mindful of publishing organizations on YouTube videos to ensure they are learning from accurate content in line with SCOG.
How Are Cord Blood Units Being Utilized? Releases at a Private Newborn Stem Cell Bank in the United States [ID: 1377085]
Authors: Isley Lauren , James Jason 
Published: May 2023

INTRODUCTION:
Cord blood preservation allows individuals future access to cord blood for stem cell transplants as well as infusions via regenerative medicine clinical trials for a wide range of indications. Although many obstetric providers are involved in the collection process, there are knowledge gaps pertaining to the actual utility of a unit, including the condition being treated and autologous (self) versus allogeneic (donor) use.

METHODS:
Data on cord blood releases at a private newborn stem cell bank from 1993 to 2021 were analyzed. Releases were separated into transplant versus regenerative medicine use. Releases were then categorized by clinical indication as well as autologous versus allogeneic use.

RESULTS:
One hundred eight releases were for transplant medicine and 568 releases were related to use in an experimental regenerative medicine application. Of the units released for stem cell transplants, 48% were used for treatment of a blood disorder, followed by 42% for malignancy. For regenerative medicine, brain injuries (51%) and developmental disorders (44%) were the most common indications for release. Most transplant medicine releases were for allogeneic use (93%), whereas the opposite was true for regenerative medicine releases, with 80% being for autologous use.

CONCLUSION:
Use of a cord blood unit is determined by the treating physician and considers many factors. There are misconceptions surrounding who in the family may be able to use a sample and under what circumstances. Encouraging education on newborn stem cell preservation options and the potential future clinical utility is key to ensure patients can make an informed decision prior to birth.
A Simple Curriculum for Teaching Transfixion Stitches Using a Low-Fidelity Model and Following Gagne's Instructional Design [ID: 1377582]
Authors: Cheng Connie , ElSahwi Karim , Vurture Gregory 
Published: May 2023

INTRODUCTION:
Surgical training is often carried out through observation and practice in the clinical setting. Gagne's model of instructional design is an organized method of teaching motor skills. The purpose of the study is to evaluate the feasibility and effectiveness of using Gange's model to improve surgical knowledge on transfixation stitches used during hysterectomy on a low-fidelity pelvic model trainer.

METHODS:
A simple teaching curriculum for transfixation stitches was developed following Gange's model. A thought-provoking clinical vignette was presented and followed by clear learning objectives. Prerequisite knowledge was tested using a quiz. Stimulus material included relevant anatomy, instruments used in a hysterectomy, and steps of an abdominal hysterectomy. Learning guidance was provided in the form of diagrams and videos of various transfixation stitches. Learners practiced on low-fidelity pelvic models with supervision by faculty members. At the end, learners repeated the knowledge test and provided feedback. Comparisons were made between pretest and posttest scores using Fisher exact test and chi-square test as appropriate for nominal variables, and Mann-Whitney test for continuous variables.

RESULTS:
The simulation was performed by 18 participants (n=18). There was significant improvement in test scores after completing the simulation (59.6±21.8% versus 89.3±9.7%, P<.0001). Additionally, the number of transfixation stitches each learner was familiar with increased significantly after the simulation (0 interquartile range [IQR] [0–1] versus 4 IQR [2–4], P<.0001).

CONCLUSION:
These findings suggest that using Gagne's model of instructional design on a low-fidelity pelvic model trainer in a low-stress environment can help improve surgical skill education. Our experience demonstrates that simulation training can be organized without much time or resource and help build lasting surgical skills.
Ob-Gyn Residency Training on Caring for Incarcerated Patients: A National Survey of Programs [ID: 1379016]
Authors: Tummala Meghna , Brousseau Erin , Burrell Dayna 
Published: May 2023

INTRODUCTION:
Incarcerated individuals requiring obstetric and gynecologic care make up the fastest-growing population in U.S. carceral settings. Research suggests that these patients' reproductive health needs are complex and disparate compared to the general population because of multiple forms of structural oppression. Little is known about the current state of ob-gyn resident education on providing reproductive health care to incarcerated patients.

METHODS:
A cross-sectional survey was administered by email to program leaders at U.S. obstetrics and gynecology residency programs between August and September of 2022.

RESULTS:
Program directors or assistant program directors at 101 out of 269 contactable programs (38%) completed the survey. Among respondent programs, the majority (81%) have opportunities for residents to see incarcerated patients in a clinical setting, but only a minority (23%) of programs have mandatory didactic content on providing care to these patients. When asked about the most significant barriers to offering didactic content, 71% of respondents indicated that the lack of faculty expertise on the topic is at least moderately significant, followed by other competing curricular requirements (63%). Most respondents (82%) indicated that the inclusion of such didactic content during obstetrics and gynecology residency is at least moderately valuable.

CONCLUSION:
There is a glaring gap in formal resident education on providing obstetric–gynecologic care to incarcerated patients, even though residents are actively treating these patients. Although residency program leaders believe that training residents to care for this population is important, most programs are not equipped to do so because of the existence of various barriers.
The Competitiveness of Obstetrics and Gynecology Fellowships: A 15-Year Assessment [ID: 1380331]
Authors: Schenken Claire , Michelotti Ali , Schenken Robert , Stansbury Nicholas 
Published: May 2023

INTRODUCTION:
While subspecialty competitiveness for obstetrics and gynecology fellowships has evolved over the last 15 years, objective competitiveness is poorly understood. This study aimed to assess the competitiveness of obstetrics and gynecology fellowships using the normalized competitive index (NCI).

METHODS:
Obstetrics and gynecology subspecialty match data for gynecologic oncology (GO), maternal–fetal medicine (MFM), reproductive endocrinology and infertility (REI), and female pelvic medicine and reconstructive surgery (FPMRS) were obtained from the National Resident Matching Program from 2008 to 2022. The competitive index (CI) was determined by the percentage of positions filled divided by the match rate (matched applicants/total). The NCI was determined by the yearly CI divided by the average CI of the particular subspecialty. Statistical analyses included univariate analysis and linear regression.

RESULTS:
Comparing 2008–2015 versus 2016–2022, fellowship applicants (335.2±27.1 versus 381.4±19.9, P<.01) and positions (225.1±23.6 versus 294.3±22.6, P<.01) significantly increased. Match rate significantly increased for GO, MFM, and FPMRS (0.62±0.05 versus 0.68±0.02, P=.02; 0.67±0.08 versus 0.78±0.08, P=.03; 0.66±0.10 versus 0.79±0.06, P=.01, respectively), but did not change for REI (0.62±0.06 versus 0.69±0.08, P=.06). The NCI decreased for MFM (R2=0.43, P<.01) and FPMRS (R2=0.60, P<.01), from 2008 to 2022 indicating decreased competitiveness. The NCI for REI (R2=0.24, P=.06) and GO (R2=0.09, P=.27) did not significantly change.

CONCLUSION:
Match rate increased for three of four obstetrics and gynecology subspecialties, but the NCI for MFM and FPMRS decreased, indicating decreased competitiveness in these subspecialties. Therefore, the NCI may be a useful metric, in addition to the match rate, for obstetrics and gynecology subspecialty fellowship applicants to determine program competitiveness.
A Novel, Low-Fidelity, Low-Cost Residency “Simulation Festival” Competition: An Opportunity for Scholarly Innovation [ID: 1381241]
Authors: Boedeker David , Chatfield Lindsay , MacKinnon Rene , Owens Amanda 
Published: May 2023

INTRODUCTION:
Simulation has rapidly expanded in obstetrics and gynecology for teaching medical knowledge, surgical skills, and maintenance of certification. Low-fidelity simulations are typically lower cost to produce and have been proven beneficial for surgical training.

METHODS:
The Junior Fellows of the American College of Obstetricians and Gynecologists District X created a competition at their Annual District Meeting in October 2022. All nine residency programs submitted and showcased a low-cost, novel simulation in obstetrics and gynecology at a 1-hour event open to all attendees. After IRB exemption was obtained, a postevent survey was completed by the participants at the event.

RESULTS:
A total of 77 individuals completed our postevent survey (medical students 12.99%, residents 58.44%, staff or fellows 28.57%). The majority of respondents felt simulation is valuable to ob-gyn training (96.10%). All respondents reported they would like to see the event repeated at future Annual District Meetings. The majority of resident responders reported they would be very likely (79.07%) or likely (18.60%) to use one of the simulations presented at the festival in future teaching or training. Fifteen respondents were involved in creating a simulation for the festival. Most simulations were very easy (60.00%) or easy (33.33%) to make, and all were reported to be very reproducible (100.00%).

CONCLUSION:
This unique event for Junior Fellows was successful in fostering innovative, low-cost, low-fidelity, highly reproducible simulations in obstetrics and gynecology. Our goals are to continue this event in future years, expand to other districts, foster reproduction of simulations at residency programs and medical schools, and support the publication of novel ideas.
The Dobbs Decision and Its Geographical Effect on Future Physician Training [ID: 1380882]
Authors: Traub Ariana , Aaron Bryan , Kawwass Jennifer , King Louise , Mermin-Bunnell Kellen , Wang Kelly 
Published: May 2023

INTRODUCTION:
The United States is experiencing a physician shortage, particularly in rural and lower socioeconomic status regions. The Dobbs v Jackson Women's Health decision puts individual state health care access at the forefront of future physician's decisions on where to train and practice medicine. This study assesses how access to abortion care is changing where medical students choose to apply to residency.

METHODS:
This study surveyed third- and fourth-year U.S. medical students applying into U.S. residency programs from August 6, 2022, to October 22, 2022. Participants were selected via convenience sampling through social media and direct outreach to U.S. medical school admissions offices, medical student class presidents, and medical student organizations. 494 complete responses were analyzed.

RESULTS:
The majority (77.0%) of respondents across all medical specialties reported that access to abortion care, or lack thereof, affects the location of residency programs to which they apply. Over half (58.1%) of respondents said they are unlikely to apply to a residency program located in a state with abortion restrictions. The sample represented students applying to many specialties, with obstetrics and gynecology applicants comprising 21.6% of the sample.

CONCLUSION:
This study found that the majority of third- and fourth-year medical students' residency choices, across all specialties, are influenced by state abortion laws. Future physicians are choosing where to attend residency based on state abortion policies, indicating that access to abortion care is changing the landscape of medical practice, and has the potential to shift the geographical makeup of health care.
Perspectives on Counseling Women of Reproductive Age About Emergency Preparedness by Primary Health Care Providers: DocStyles, United States, 2021 [ID: 1364512]
Authors: Meeker Jessica , Galang Romeo , Hall Rebecca , Shapiro-Mendoza Carrie , Simeone Regina , Snead Margaret 
Published: May 2023

INTRODUCTION:
Pregnant, postpartum, and lactating women (PPLW) face unique challenges during disasters that may be mitigated by emergency preparedness. Health care providers have opportunities to counsel this population on emergency preparedness, but the extent of counseling has not been reported. Our objective is to report health care provider attitudes and practices related to counseling women of reproductive age (WRA), including PPLW, on emergency preparedness.

METHODS:
DocStyles, a web-based panel survey of a convenience sample of primary health care providers in the United States, was conducted from March 17 to May 17, 2021. Family practitioners, internists, obstetrician–gynecologists, nurse practitioners, and physician assistants were asked about importance of emergency preparedness counseling, confidence level of counseling, frequency of counseling, barriers to providing counseling, and preferred resources to support counseling among their WRA and PPLW patients. We calculated frequencies of provider attitudes and practices using R, version 4.0.3.

RESULTS:
Among 1,503 respondents, family practitioners (33%), internists (34%), obstetrician–gynecologists (17%), nurse practitioners (8%), and physician assistants (8%), 88% thought that emergency preparedness for keeping reproductive-aged patients safe, and counseling patients of reproductive age about emergency preparedness were both important. However, 45% of respondents were not confident in WRA emergency preparedness counseling, and most (70%) had never talked to PPLW about this topic. Respondents cited not having time during clinical visits (48%) and lack of preparedness knowledge (34%) as barriers. Most respondents (79%) stated they would use educational materials, especially fact sheets or brochures and patient text alerts.

CONCLUSION:
Emergency preparedness resources combined with training may improve health care provider confidence in counseling WRA and PPLW.