Abstract
BackgroundObstetrician cognitive and affective traits have been identified to have relationships with their patients’ perinatal outcomes. The objective was to identify relationships between obstetrician demographic and practice characteristics and physician coping, self-efficacy, anxiety and ambiguity tolerance.MethodsObstetricians at a single institution were surveyed using 5 validated scales measuring coping skills, tolerance for ambiguity, cognitive engagement and trait anxiety. Demographics and practice characteristics were assessed. Chi-square tests, t-tests, ANOVA and linear regression were used to assess relationships between physician characteristics and cognitive traits.ResultsNinety-four physicians participated. Women expressed greater proactive coping than men (p = 0.03) on the Proactive Coping scale. Providers with greater delivery volume expressed lower engagement in cognitive efforts (p = 0.03) on the Need for Cognition scale. Maternal-fetal medicine physicians demonstrated greater ambiguity tolerance (p < 0.01) and cognitive engagement (p = 0.012) than general obstetricians. Differences by specialty persisted after adjustment for potentially confounding factors.ConclusionsPractice type and specialty appeared to be related to several cognitive characteristics. It remains uncertain whether these differences are a cause or a consequence of specialty training and whether they result in differences in obstetric outcomes.
Highlights
Obstetrician cognitive and affective traits have been identified to have relationships with their patients’ perinatal outcomes
Since we are beginning to understand that there are relationships between physician cognitive and affective traits and their patients’ obstetrical outcomes, we propose that an important step is to understand the provider demographic and practice characteristics that are associated with these cognitive traits
Using multivariable regression to assess the independent association of subspecialty and scores on each scale, adjusting for physician gender and number of deliveries per year, we found the Multiple Stimulus Types Tolerance of Ambiguity (MSTAT) and Need for Cognition (NFC) scores remained significantly higher for Maternal-fetal medicine (MFM) physicians
Summary
Obstetrician cognitive and affective traits have been identified to have relationships with their patients’ perinatal outcomes. The objective was to identify relationships between obstetrician demographic and practice characteristics and physician coping, self-efficacy, anxiety and ambiguity tolerance. Clinical reasoning and complex medical decision making require the use of important cognitive skills. Medical educators recognize that trainee and physician cognitive traits, including coping skills and affect, contribute to the culture of safety and the quality of clinical care [1,2,3,4,5]. Our group’s work has investigated the associations between obstetrician cognitive and affective skills and their patients' delivery outcomes. We have demonstrated that nulliparous patients delivered by physicians with better coping skills were less likely to experience an operative vaginal delivery, whereas other “adaptive” cognitive features were associated with
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