Teaching the Unteachable: Educating Obstetrics and Gynecology Residents About the Patient Experience of Stillbirth

Abstract

BACKGROUND: Annually, approximately 24,000 fetuses in the United States are stillborn, and parents often feel alone in their grief. Obstetric providers may not be adequately trained to manage the medical and emotional aspects of stillbirth; therefore, we implemented a didactic for OB/GYN residents to address this need. METHODS: A 2-hour resident didactic including an overview of medical management and a panel of patients and families who had experienced stillbirth was offered in 2013 and 2015. Prior to each session, OB/GYN residents received an electronic 26-question survey about previous training and comfort with caring for patients with stillbirth. Following the didactic, residents were sent a follow-up survey to evaluate and reflect on the content. RESULTS: Of 47 residents, 41 responded to the pre-didactic survey (85%). Residents disagreed that the management of stillbirth was adequately covered in medical school (100%) or residency (90%). Forty-one percent agreed that they were unsure of how much personal emotion to express to patients. In qualitative comments following the session, residents felt more comfortable and confident caring for these patients throughout their experience. Residents felt that the session was “incredibly important,” “powerful and memorable,” “hard to attend…so much emotion, so many memories of so many patients.” DISCUSSION: Our experience suggests that residents feel unprepared to medically and emotionally care for families with stillbirth. Incorporating a didactic on stillbirth that includes a patient panel can improve resident knowledge and comfort.