How Capable Are Ob/Gyn Residents in Counseling Patients at Risk for Periviable Delivery? [4O

Abstract

INTRODUCTION: To understand the current state of resident education in periviability counseling and assess Ob/Gyn resident capacity to counsel patients at risk for periviable delivery. METHODS: A cross-sectional, web-based survey developed at the University of Chicago was deployed to Ob/Gyn residents from 13 ACGME accredited residency programs across the US. The survey included questions about program/resident demographics, periviability education content/format, and periviability counseling. Descriptive statistics were used to analyze responses, and Chi-square or Fischer's Exact tests were used to analyze categorical variables. RESULTS: Of 374 eligible Ob/Gyn residents, 151 (40.3%) completed the survey. Most respondents came from university-based programs (85.3%), larger residency programs (68.5%), and non-religiously affiliated hospitals (86.7%). Most respondents (n=123, 83.6%) identified spending 0-5 hours annually on periviability education. 63% of respondents felt somewhat capable (SC) or very capable (VC) in counseling patients at risk for periviable delivery regarding neonatal outcomes, with 14 (9.3%) feeling VC. A greater proportion of PGY-4 compared to PGY-1 respondents (86.1% vs. 51.5%; p=0.0018) and those trained in a community vs. university based hospital (90.5% vs.57.9%; p=0.003) reported feeling SC or VC in counseling patients regarding neonatal outcomes. The majority of respondents had never used/were not aware of the NICHD Extremely Preterm Birth Calculator (52.1%). No respondent correctly identified the 5 predictive characteristics that form the framework for the NICHD calculator. CONCLUSION: The majority of residents do not feel capable of counseling patients at risk for periviable delivery. These findings point to targeted areas to improve Ob/Gyn resident education and patient care during the periviable period.