The 7E Teaching Model in Emergency Obstetrics and Gynecology Training: Enhancing Clinical Competency in Residency Education.

Obstetric and gynecologic emergencies are time-sensitive conditions encountered in emergency departments and may result in substantial maternal morbidity and mortality if not promptly recognized and managed. Emergency physicians are frequently the first clinicians to evaluate pregnant patients presenting with acute complications, yet exposure to obstetric emergencies and related procedural training may be limited. This study assessed the confidence of emergency physicians in Saudi Arabia in managing obstetric and gynecologic emergencies and identified factors associated with higher confidence. We conducted a cross-sectional survey of emergency physicians practicing in Saudi Arabia between January and March 2026. A structured electronic questionnaire assessed demographic characteristics, training background, clinical exposure to obstetric emergencies, and self-reported confidence in managing specific obstetric conditions and procedures. Confidence was measured using a 5-point Likert scale (1 (not confident) to 5 (very confident)). High confidence was defined as a mean score of ≥4. Descriptive statistics were used to summarize responses, and univariable logistic regression was performed to identify factors associated with high confidence. A total of 214 emergency physicians participated. Most respondents were male (143 of 214, 66.8%) and aged 25-35 years (153 of 214, 71.5%). Formal training in obstetric emergencies during residency was reported by 132 physicians (132 of 214, 61.7%). Participants reported relatively higher confidence in managing hyperemesis gravidarum (mean score: 4.1±0.8) and first-trimester vaginal bleeding (3.9±0.9), whereas lower confidence was reported for shoulder dystocia (2.7±1.2) and emergency delivery in the emergency department (2.8±1.2). Procedural confidence was highest for neonatal resuscitation (3.8±0.9) and pelvic examination (3.6±1.0) and lowest for episiotomy and repair (2.3±1.2). Overall, 76 physicians (76 of 214, 35.5%) met the criteria for high confidence. Factors associated with higher confidence included more than five years of emergency medicine experience (odds ratio (OR): 2.41; 95% CI: 1.45-4.02), formal obstetric emergency training (OR: 2.87; 95% CI: 1.70-4.84), frequent exposure to obstetric emergencies (OR: 3.14; 95% CI: 1.82-5.43), neonatal resuscitation certification (OR: 1.68; 95% CI: 1.01-2.80), and consultant-level practice (OR: 3.56; 95% CI: 1.72-7.35). Emergency physicians in Saudi Arabia reported variable confidence in managing obstetric and gynecologic emergencies, with lower confidence in complex obstetric conditions and delivery-related procedures. Greater clinical experience, formal training, and more frequent exposure to obstetric emergencies were associated with higher confidence. Targeted educational strategies, including structured obstetric emergency training and simulation-based learning, may help strengthen preparedness for time-critical obstetric emergencies in the emergency department.

Integrating assistive technology (AT) into occupational therapy (OT) education is critical to educating students to utilize AT to enhance individual independence. This study aims to describe the development of a science, technology, engineering, arts, and mathematics (STEAM)-based AT curriculum in OT and evaluate its effectiveness using the Kirkpatrick model. An 18-week STEAM-based AT curriculum was created with lectures, hands-on activities, and a simulation exam. A one-group pretest-posttest observational study was undertaken with 40 undergraduate students to gauge its effectiveness. Their professionalism was evaluated using a multidimensional checklist, whereas a satisfaction survey gathered their feedback on the curriculum experience. Level 1: Participants reported high satisfaction (mean = 4.61, SD = 0.36), with a 97.5% agreement. Level 2: 95% (n = 38) passed the AT curriculum exam. Level 3: Therapists and patients expressed satisfaction with participants' AT skills (therapists: t(39) = 12.22, p < 0.001; patients: t(39) = 8.84, p < 0.001). Level 4: Participants showed significant improvement in professionalism (t(39) = 16.45, p < 0.001). Lastly, using the Kirkpatrick model, the STEAM-based AT curriculum passed the evaluation. The STEAM-based AT curriculum in OT enhances professionalism and potentially boosts patient satisfaction with AT services provision.

Objective To explore the value of ultrasonography in the diagnosis and identification of Obstetrics and Gynecology in accident and emergency. Methods A retrospective method was taken to 80 cases of obstetrics and gynecology emergency patients with ultrasound diagnosis data analysis in the hospital from June 2014 to June 2015, and compared to surgical and pathological diagnosis, to observe the ultrasonic diagnosis value. Results The correct rate of the ultrasound diagnosis of ectopic pregnancy, ovarian cyst torsion, inevitable abortion, threatened abortion, corpus luteum rupture, trophoblastic disease, and acute pelvic inflammatory disease was 90.9%, 94.1%, 100.0%, 100.0%, 85.7% , 75.0%, and 100.0%, and the overall diagnostic accuracy was 93.8%. Conclusions The Emergency Department of obstetrics and gynecology patients used ultrasound has a better diagnosis effect, and high diagnostic accuracy. At the same time, the ultrasound examination is gynecology and obstetrics emergency check the preferred way, strong repeatability, and better observed lesions, high application value. Key words: Ultrasonography; Emergencies; Genital diseases, female/US; Pregnancy complications/US; Diagnosis, differential

Background: Obstetric and gynecological emergencies demand rapid, high-stakes decision-making, where delays or inaccuracies can lead to serious maternal and fetal outcomes. Artificial intelligence (AI)-powered decision support tools are emerging as promising adjuncts to aid clinicians under such critical conditions. Despite increasing interest, the clinical utility, accuracy, and safety of these technologies in emergency women’s health care remain underexplored and unstandardized, warranting a comprehensive synthesis of current evidence. Objective: This systematic review aims to evaluate the effectiveness, safety, and real-time decision-making accuracy of AI-powered decision support tools in the management of gynecological and obstetric emergencies. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Comprehensive searches were performed across PubMed, Cochrane Library, Scopus, and Web of Science from database inception to 2024. Inclusion criteria encompassed randomized controlled trials, feasibility studies, qualitative research, and developmental studies evaluating AI applications in obstetric and gynecological emergencies. Data were extracted using a standardized form and assessed for bias using the Cochrane Risk of Bias tool and Newcastle-Ottawa Scale, depending on study design. Due to heterogeneity, a qualitative synthesis was performed. Results: Eight studies were included, encompassing feasibility, qualitative, and developmental research. AI tools demonstrated high concordance with clinician decisions in simulated obstetric emergencies, improved triage classification, and enhanced workflow efficiency. Clinicians highlighted the importance of transparency, personalization, and ethical considerations in AI adoption. However, most studies were small-scale or simulation-based, limiting generalizability. Conclusion: AI-based decision support systems show encouraging potential in obstetric emergency care by enhancing diagnostic accuracy and clinical efficiency. Nonetheless, the current evidence base is preliminary. Rigorous, real-world validation and ethical integration are essential for safe and effective implementation in clinical practice.

This study aimed to evaluate an internship programme for preservice teachers. The program evaluation model uses the Kirkpatrick Model which consists of four levels: reaction, learning, behaviour, and outcome. This model is suitable for evaluating internship programmes in reviewing the development of preservice teachers from the initial level to the completion of the internship programme targets. This study involved prospective teachers (n=205) in Economics and Business at the Universitas Negeri Medan. Data were collected online using a Google Forms questionnaire over two months in 2022. Data analysis used quantitative description to explore the programme achievements at each level in depth. The findings showed that the mean of reaction (5.05), learning (5.20), behaviour (4.96), and outcome (5.03) were above the ideal mean of 3.50. Internship programme participants have met the average achievement target of Kirkpatrick's four-level model, where learning evaluation is more meaningful for student teachers when participating in the internship programme compared to other levels. Overall, with this research, it is hoped that internship programme managers can design more targeted and measurable programmes to improve the experience of prospective teachers. Keywords: internship program, preservice teacher, evaluation, Kirkpatrick four-level

The development of artificial intelligence (AI) provides new opportunities for improving teachers' professional competencies, particularly in the development of digital learning tools. However, the implementation of AI-based training in coastal schools still faces obstacles, mainly related to infrastructure limitations and digital literacy. This study aims to evaluate the effectiveness of the Teacher Capacity Building Programme in the Use of AI for the development of learning tools at SMA Negeri 2 Bintan Pesisir, Riau Islands Province. The evaluation was conducted using Kirkpatrick's four-level model, which includes reaction, learning, behaviour, and results. This study used a mixed methods approach with data collection through questionnaires, pretest–posttest tests, and observation. The results showed that the training programme obtained an overall average score of 84.3, which is in the good to very good category. Specifically, the participants' reaction level scored 86.8, learning level 84.4, behavioural change 80.3, and final results 85.7. Correlation analysis between levels showed a coefficient of 0.87, indicating a strong linear relationship between evaluation components. These findings indicate that AI-based training contributes positively to improving teachers' ability to design digital learning tools, although its implementation is still influenced by contextual factors in schools. Theoretically, this study reinforces the relevance of the Kirkpatrick model in evaluating digital training. Practically, the results of this study can be used as a reference in designing technology-based teacher training programmes, especially in coastal areas and regions with digital limitations.

As e-training has shown great promise, Microsoft (China) and the Ministry of Education of China (MOE) have launched e-training for in-service teachers in order to improve teachers' instructional skills. 16,264 primary and secondary school teachers participated in this e-training. This study aims to evaluate the effectiveness of the e-training using the Kirkpatrick's four-level model. Discourse data, testing scores, homework scores, and final passing rate were collected and analyzed. The results indicated that the e-training indeed improved trainees' instructional skills. The final passing rate of e-training was over 80%. The results also indicated that it was appropriate to use the Kirkpatrick's four-level model to evaluate the e-training.

To evaluate the effectiveness of an obstetrical and gynecologic (Ob/Gyn) Boot Camp simulation training on perceived technical competency, confidence in a leadership role, and stress hardiness of resident training. We conducted a prospective pilot study on the effectiveness of an Ob/Gyn Boot Camp on resident training. Residents participated in an intensive immersion in clinical simulation of common obstetrical emergencies including shoulder dystocia, neonatal resuscitation, postpartum hemorrhage, and ruptured ectopic pregnancy. After the training, residents completed a Web-based survey on their perceptions of how the Ob/Gyn Boot Camp affected their 1) technical competency in the assessment and management of their patients, 2) confidence in taking a leadership role, and 3) stress hardiness. Residents rated their perceptions on a Likert scale of 1 to 5, 1 = poor to 5 = excellent. Twenty-three (14 Ob/Gyn and 9 family medicine) residents participated in this pilot study. Eighteen (78%) residents completed the online survey; 4 Ob/Gyn and 1 family medicine resident did not complete the survey. The residents reported that the simulation training stimulated an interest in learning key skills for obstetrical and gynecologic emergencies. Ob/Gyn residents reported significant improvement in their perceived technical competence and stress hardiness after the Boot Camp. However both Ob/Gyn and family medicine residents reported no significant improvement of confidence in their leadership abilities during obstetrical emergencies after the Boot Camp. Boot Camp simulation training early in the curriculum has the potential for enhancing residents' self-assessments of confidence, competency, and stress hardiness in managing obstetrical emergencies.

To understand the perceptions of residents and Fellows in obstetrics and gynecology about the impacts of race or ethnicity, gender, and mentorship experiences on pursuing careers in academic medicine. Two surveys were administered: one to a sample of 2,000 Fellows of the American College of Obstetricians and Gynecologists, and one to the 4,814 obstetrics and gynecology residents taking the 1998 in-training examination. The questionnaires asked about demographics, perceptions about careers in academic medicine, and residents' experiences with mentorship. Response rates were 96.8% for residents and 40.6% for FELLOWS: Of the residents, 26.1% indicated they would not consider a career in academic medicine. First-year women residents were more inclined to pursue careers in academic medicine than were first-year men (p =.042), but their interest declined during residency. Women residents (43%)-especially minorities-felt that men were mentored and recruited more for faculty positions, while men (38%) felt that women were mentored and recruited more. Fellows' reports of recruitment did not differ by gender. Most white residents did not perceive racial or ethnic bias in mentoring or recruiting, while most non-white residents did. Almost one third of non-white women residents felt that supervisors were more likely to condescend to women and minority individuals. It is likely that neither men nor women residents in obstetrics and gynecology receive adequate mentorship for careers in academic medicine. Perceptions of bias are a serious barrier to developing racial, ethnic, and gender diversity in leadership positions.

Medical students face high levels of psychological distress but often hesitate to seek formal support. Peer support programmes offer a student-centred approach to fostering well-being and resilience. This study examines the educational impact of the Ramathibodi Peer Support Programme (Rama PSP), a student-led initiative in Thailand, with a focus on the development of peer supporters. Thirty-seven medical students across all six years participated in a 10-week training programme. A mixed-methods design was employed, guided by Kirkpatrick’s Four-Level Model of Training Evaluation. Quantitative data were collected using the mid- and end-course assessments, Rama PSP aptitude assessment, PHQ-9 and GAD-7. Qualitative data were obtained through post-training interviews and analysed using content analysis. Peer supporters demonstrated self-reported significant improvements in key competencies, including clarifying questions, referrals and boundary-setting. No significant changes were observed in PHQ-9 and GAD-7 levels, consistent with the programme’s educational–not therapeutic–focus. Qualitative findings revealed substantial growth in self-awareness (96.2%), self-esteem, self-management and social awareness. Peer supporters reported applying their skills in both formal and informal peer interactions. Rama PSP suggests that structured peer support training may be associated with perceived improvements in interpersonal competencies and developmental outcomes among medical students. By focusing on peer supporters, the programme may support professional identity formation and complement traditional curricula. Integrating such training could help foster empathy, resilience and a supportive learning environment; however, further research using objective measures is needed.

Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency's Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum. Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick's four-level model to evaluate effectiveness of training was used to frame design and analysis of learner, faculty, and community partner evaluations. Twenty residents have completed the year-one curriculum, 8 residents the year-two curriculum, and 8 residents the year-two and year-three elective. Community partners, residents, faculty, and leadership all were satisfied with the curriculum, particularly regarding relationship building and mentorship. Overall satisfaction with the rotation, quantitatively and qualitatively, was positive. Competency milestone ratings improved within each year of training: first-year residents by 0.6 (3.0 for 2015-2016 and 3.6 for 2016-2017) and second-year residents by 0.1 (5.2 vs 5.3). The CHAMP curriculum uniquely a) spans all three years of residency; b) combines block mandatory rotations with a longitudinal elective experience; and c) integrates community health, advocacy, and managing populations to meet accreditation requirements and prepare residents to address health disparities and SDH.

Background: A sound understanding of pelvic anatomy is essential for training in obstetrics and gynaecology (OBGYN) and for practising in the field post-qualification. There is a growing concern that surgery residents have an inadequate knowledge of anatomy and little confidence in their approach to the subject. Objective: This study aims to explain the use of an anatomy workshop to deliver a unique and self-designed innovative instruction method that employs cutting-edge resources to enhance OBGYN residents’ comprehension of clinical anatomy and to discuss why this approach works. Methodology: The workshop emphasised the clinical and surgical anatomy of the female pelvis using 3-D virtual dissections, relevant plastinated specimens and also bony pelvic models that had been developed in house. Anatomists and OBGYN consultants facilitated the workshop. The students’ knowledge of anatomy and their perceptions of the subject were evaluated by pre- and post-tests and a five-point Likert scale, respectively. A mixed methods analysis was applied. Results: Of the 42 participants, 26 (61.9%) completed both the pre- and post-test. The overall difference (mean percentage) between the pre- and post-test performance was 25.41%. There was a significant difference in the residents’ knowledge of anatomy between the pre- and post-workshop ( p&lt;0.05). Participants ( n=10) provided positive feedback on the workshop content, teaching tools, learning activities and educators. They recommended that the workshop should be held at least once a year (70%), and particularly during the first year of residency (90%). Conclusion: The active learning workshop enabled by multidisciplinary teaching and the innovative tools employed resulted in improved outcomes in knowledge of anatomy, confidence and learning satisfaction. Reintroduction of anatomy concepts during OBGYN residency training is needed to improve surgical training and patient care.

Education and training interventions can be evaluated through the success of learning outcomes. Kirkpatrick's four-level model is a widely accepted and highly popular evaluation tool. However, some criticise the model's shortcomings. This article will examine the extent to which the four-level model can evaluate design and technology students' learning about aesthetics after an intervention by reporting our use of an augmented version of the four-level model. We examine the results in terms of students' reaction to the intervention, their long-term learning and their behaviour changes by studying their visual analyses and drawings through segment codes. We found that, in order to uncover the obscurities imbedded in aesthetics and to explicate the complexities, we could not use the four-level-model on its own, but had to revert to a more augmented version.

Donald Kirkpatrick developed the basis of his four-level model in 1954, which he published in four articles for the first time in 1959. It is today one of the most acknowledged models for evaluating training programmes. The levels are: reaction (participant satisfaction), learning (learning success), behaviour (learning transfer) and results (business success). Kirkpatrick assume causal linkages between the four levels. Since the 1960s, these assumptions were tested with little evidence. In the presented study, 43 training courses with altogether 335 participants were evaluated on the levels (1) reaction, (2) learning and (3) behaviour. The data show no correlation between reaction and learning and also no correlation between reaction and behaviour. In view of this result, the practice of evaluating professional trainings based on participant satisfaction requires further development.

BackgroundThis study aimed to evaluate the compliance with guidelines, clinical safety, and applicability of ChatGPT-5 responses in obstetric and gynecological emergency scenarios. With the increasing role of AI-powered large language models (LLMs) in healthcare, there is a need to examine their performance in obstetric emergencies systematically.MethodsThis study was designed as a prospective, scenario-based, double-blind study. A total of 15 obstetric and gynecologic emergency scenarios were created based on the literature and current international guidelines (ACOG, RCOG, WHO). Five standard questions were posed to ChatGPT-5 for each scenario: (1) Most likely diagnosis, (2) Investigations to confirm the diagnosis, (3) Hemodynamic stability assessment, (4) Initial treatment approach, and (5) Advanced management options. The same scenarios were independently answered by two obstetricians, an emergency medicine specialist, and an anesthesiologist, and were considered the “gold standard.” Responses were scored for guideline compliance, patient safety, and critical information gaps. In addition, quality and understandability were evaluated with modified DISCERN (mDISCERN), Global Quality Score (GQS), and readability indexes [Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), Coleman–Liau Index (CLI)].ResultsA total of 75 responses were reviewed. High agreement (5/5) was observed in 5 scenarios (33.3%), moderate agreement (4/5) in 7 scenarios (46.7%), and low agreement (≤ 3/5) in 3 scenarios (20.0%). High agreement was particularly evident for well-defined guideline algorithms, such as postpartum hemorrhage, eclampsia, HELLP syndrome, shoulder dystocia, and ruptured ectopic pregnancy. Deficiencies in moderate agreement scenarios included insufficient emphasis on mortality risk, omission of scoring systems, incomplete steps in sepsis management, and inadequate specification of fertility-sparing approaches. Low agreement scenarios included severe vaginal hemorrhage, acute bleeding due to malignancy, and traumatic gynecologic emergencies. The mean mDISCERN score of the responses was 4.0 ± 0.7, and the mean GQS was 4.1 ± 0.7. Readability analyses showed that responses contained a moderate amount of technical language (FRES score = 40.5 ± 2.5; FKGL score = 11.6 ± 1.2; SMOG score = 10.9 ± 0.8; and CLI score = 10.9 ± 0.8). The mean lexical density was 0.63.ConclusionsChatGPT-5 generally produced moderate to good guideline-compliant and confident responses in obstetric and gynecological emergency scenarios. However, its performance was limited in complex cases requiring a multidisciplinary approach. The findings suggest that AI-powered large language models can be a complementary tool in obstetric emergency management, but should not be used alone without expert clinician supervision. Larger, comparative, and multidisciplinary studies will provide more reliable evidence for the clinical integration of these technologies.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12873-025-01396-5.