Gynecology Residents Research Articles

(190) Lasting Impact of a Peer-to-Peer, Longitudinal Reproductive Psychiatry Curriculum for Obstetrics and Gynecology Residents: An Update on Resident Knowledge, Attitudes, and Comfort

(190) Lasting Impact of a Peer-to-Peer, Longitudinal Reproductive Psychiatry Curriculum for Obstetrics and Gynecology Residents: An Update on Resident Knowledge, Attitudes, and Comfort

Perception and Comfort with Endometriosis Management Among OB/GYN Residents.

The diagnosis of endometriosis often takes several years, delaying appropriate care while patients suffer from pelvic pain, dysmenorrhea, and dyspareunia. Understanding whether residents in obstetrics and gynecology (OB/GYN) are being adequately exposed to and trained in the diagnosis and management of the disease is important for improving care. We conducted an online cross-sectional survey of OB/GYN residents to investigate their comfort level and familiarity with endometriosis diagnosis and management. Residency program directors and coordinators of 20 OB/GYN residency programs in California, USA were emailed to disseminate the 31-question, anonymous survey in January to February 2023. Responses were collected using Redcap and analysis was conducted using STATA. 67 residents answered at least one non-demographic question and were included. A resident response rate was not calculated because we were unable to determine how many programs distributed the survey. 84% of residents felt they could recognise symptoms of endometriosis but over 30% of senior residents were not comfortable with sonographic diagnosis of endometrioma. Approximately one third of residents felt comfortable managing hypoestrogenic symptoms, osteoporotic risks, and add-back progestin for certain hormonal therapies. Academic-hospital based residents had significantly more exposure to attendings prescribing long-acting reversible contraception, GnRH antagonists, and GnRH agonists but there were no significant differences in trainee prescribing practices or comfort. More respondents would feel comfortable medically managing endometriosis (52%) than surgically managing the disease (26%) if they were in practice today, with only 39% of PGY3-4 residents feeling comfortable surgically managing endometriosis. There is considerable room for improvement in the education of residents in the diagnosis and medical and surgical management of endometriosis.

Preliminary Survey in preparation for the implementation of ERAS at Dr Soetomo Hospital

Background
 Medical science has developed rapidly. One of them is ERAS (Enhanced Recovery After Surgery) which is a multidisciplinary team development pathway for perioperative methods that offer a variety of benefits. Some of the advantages of the ERAS method are speeding up the post-operative recovery period, economic benefits, and shortening the Length of Stay (LOS) by minimizing surgical stress so that the patient quickly returns to a normal physiological state.
 Objective
 This study aims to analyze the readiness of the team that will support the ERAS application at General Academic Hospital (RSUD) Dr Soetomo.
 Methods
 This is an observational analytic study with a cross-sectional design using a questionnaire. Patient baseline data were taken from the examination at the anesthesiology outpatient clinic. Assessment for patient understanding was carried out directly after a brief explanation of ERAS method by the researcher. The patient's level of understanding was assessed by two investigators and rated on a scale of 1 to 5. Primary data and assessment of understanding of doctors and medical personnel were filled in independently by research subjects on online forms and rated on a scale of 1 to 5. Data was collected from March 23 to April 14 2022, at RSUD Dr. Soetomo Surabaya. The analysis results are considered significant if the p-value is less than 0.05. The analysis was carried out using SPSS 19 software.
 Results 
 Most patients planned to undergo surgery in the field of urology (82.9%), followed by caesarean section (14.6), and almost all patients or their families agreed to surgery using the ERAS method (95.1%). The medical team consists of 110 doctors from 4 areas of expertise, namely specialist doctors and residents in anesthesiology, urology surgery, obstetrics and gynecology, as well as orthopedics and traumatology. The health team consists of 56 personnel, namely anesthesiologists, surgeons, recovery room nurses, nutritionists and pharmacists. The majority (61%) of health workers had heard about ERAS and stated that ERAS was ready to be implemented at RSUD Dr. Soetomo (89%). Most doctors stated that ERAS was ready to be implemented at Dr. Soetomo and its human resources and facilities are considered qualified.
 Conclusion
 The ERAS method at RSUD Dr. Soetomo is considered quite ready to start, especially the Obsgyn study program, which is supposed to have an excellent level of understanding of ERAS and is enthusiastic to begin immediately. The patient group can be said to understand and accept the ERAS method well as a perioperative method for handling their cases.

Amniocentesis learning: Use of a home-made simulator

BackgroundAmniocentesis is the most performed invasive prenatal diagnostic procedure. Learning the procedure is difficult for the learner, the teacher and the patient because of the risks inherent to this technique and the anxiety generated by the procedure. The objective of this work was to evaluate a theoretical and practical amniocentesis training workshop using a simulator. MethodsWe were inspired by Pierre Jean's precepts for the planning of a medical training. We then carried out the pedagogical session with the gynecology residents of our Regional University Hospital, a type 3 maternity hospital in France. We evaluated the theoretical learning through a questionnaire before and after the training and then the practical session on a home-made simulator. The satisfaction of the participants was assessed by a questionnaire at the end of the session. ResultsFifteen learners, from the first to the last semester of internship, participated in the training. The median score of the pre-training questionnaire (“pre-test” questionnaire) was 3.3 out of 10 (min = 1, max = 6) and that of the post-training questionnaire (“post-test” questionnaire) was 7.9 out of 10 (min = 6, max = 9). The post-training scores were significantly higher (p < 0.0007). The average score for the practical training was 30.5 out of 40 (24–36). 93 % of the learners were fully satisfied with the theoretical training and 100 % stated that they had improved their technical skills. ConclusionThe residents in our department expressed a need for training in this invasive procedure of antenatal diagnosis. The training proved to be beneficial following the evaluation of the learning but also following the feedback of the learners.

KNOWLEDGE LEVEL OF THE MANAGEMENT OF HEPATITIS B DURING PREGNANCY AMONG SPECIALIST AND RESIDENTS OF THE OBSTETRICS AND GYNECOLOGY: A SURVEY STUDY FROM TURKEY

In this study, it is aimed to assess the levels of knowledge of specialists and residents of gynecology and obstetrics in Turkey, concerning management of Hepatitis B virus (HBV)-positive pregnant women. A cross-sectional online survey study was conducted on Gynecology and Obstetrics specialists and residents between November 2019 and February 2020. Questionnaire form concerning management of HBV-positive pregnant women, which was prepared by researchers on the basis of literature, has been sent to Gynecology and Obstetrics Clinics and departments of Turkey via online means. The questionnaire form consisted of sections including socio-demographic characteristics (age group, gender, time spent as a specialist doctor/resident (years), place of work) and assessing the level of knowledge concerning the management of HBV(+) pregnant women. The questions in this section were created by the researchers based on the literature. These questions are not questions of a scale whose validity and reliability studies have been conducted. Knowledge Level Score on the management of HBV-positive pregnant women (KLS) has been calculated in a range of 0 to 18 points. Statistics Package for the Social Sciences (SPSS) version 25.0 was used for statistical analysis. A total of 215 physicians, including 50 residents (23.3%) and 165 (76.7%) specialists, have participated in the study. Since normal distribution was not observed as a result of normality evaluation, mean values are presented as median (25%-75%). Median KLS was found as 8.0 (7.0-10.0). In residents, KLS was 8.0 (6.75-9.0), and in specialists, it was 8.0 (7.0-10.0). There was no statistically significant difference between the scores of residents and specialists. The median level of knowledge of the physicians participating in the study about Hepatitis B treatment in pregnant women was 8.0 (7.0-10.0). This score was interpreted as “inadequate” out of a maximum of 18 points, by researchers. Despite limitations, this study has shown the inadequacy of level of knowledge of gynecologists and obstetricians in Turkey concerning management of Hepatitis B in pregnant women. There is a need for further studies and continuous training of Gynecologists and Obstetricians.

Anatomical knowledge retention in Obstetrics and Gynaecology residents and impact of an e-learning tool.

Anatomical knowledge of medical students and residents is insufficient and further anatomical sciences throughout medical curriculum may be necessary. The first aim of this study was to assess pelvic and perineal anatomical knowledge retention of Obstetrics and Gynaecology (Ob/Gyn) residents. The second was to assess the impact of an e-learning tool on anatomical knowledge. A survey was sent by mail to medical students and Ob/Gyn residents. After completion, Ob/Gyn residents were randomised to "e-learning" group or to "Control" group. "E-learning" group had an unlimited access to a tool about female pelvic and perineum anatomy, implemented by iMAIOS society in their online platform. A second assessment of residents' anatomical knowledge was done 2months after randomisation. Ob/Gyn residents (N = 23) had a significant lower global score than third-year medical students (N = 103) (22.1% (± 10.2) vs 43.8% (± 12.1), p < 0.0001). Two months after randomisation, residents of "control" group demonstrated no significant difference between the two questionnaires (3.6%, p = 0.31), whilst the "e-learning" group demonstrated a significant increase overall (10.6%, p = 0.09). There was no significant difference on the post-intervention questionnaire between control and "e-learning" group (25.4% vs 33% respectively, p = 0.34). Knowledge of pelvic and perineal anatomy is poor. This e-learning tool aimed at improving anatomical knowledge retention but is not sufficient. A combination of traditional approaches and innovative solutions should be proposed throughout medical school and residency to maintain anatomical knowledge.

Inequities at the Transition to Obstetrics to Gynecology Residency.

Inequities at the Transition to Obstetrics to Gynecology Residency.

The golden tickets: impact of preference signaling on obstetrics and gynecology residency applicants

With the residency selection process becoming more competitive and programs receiving unprecedented numbers of applications, some specialties have introduced preference signaling in an attempt to help applicants target programs of interest. In the 2022-2023 application cycle, obstetrics and gynecology also introduced a 2-tiered system with a limited number of gold signals (n=3) and silver signals (n=15). Given the novelty of preference signaling in the obstetrics and gynecology residency application process, this study aimed to (1) assess the effect of signals on interview offers and match and (2) discuss applicant attitudes toward this preference signaling system. This was a voluntary cross-sectional survey study conducted in April 2023 that was open to all fourth-year medical students who applied to an obstetrics and gynecology residency in the United States. Self-reported demographics, signaling, interview, and match data were collected. In addition, students were asked about attitudes toward signaling on a 5-point Likert scale. Of the 1507 applicants who entered an obstetrics and gynecology residency via match or Supplemental Offer and Acceptance Program process, 969 (64.3%) completed the survey. Moreover, an additional 22 applicants who did not match responded to the survey. More respondents used all 3 gold tokens (98.3%) and all 15 silver tokens (94.3%). The mean number of applications sent was 74.3±35.1, and the mean number of interviews received per applicant was 12.8±6.6. The interviews or token yields were 64.0%±31.5% for gold tokens, 43.8%±23.1% for silver tokens, and 9.8%±10.0% for no token. Of the survey respondents, 340/951 (35.8%) matched to a gold token program, 338/951 (35.5%) matched to a silver token program, and 244/951 (25.7%) matched to a nontoken program. Furthermore, 499/951 applicants (52.5%) reported feeling slightly positive or very positive about signaling. Most obstetrics and gynecology applicants in this survey participated in preference signaling. Gold and silver tokens were associated with high ratios of interview invitations compared with no token. However, the overall number of applications did not decrease in the 2022-2023 cycle, and only half of survey respondents reported feeling positive about the signaling process. These results can inform program directors and students about application number and strategy in upcoming cycles.

Structured Workshop for Repair of High-Grade Perineal Lacerations Among Obstetrics and Gynecology Residents, The Need for Repetition and Retraining.

The objective of this study was to evaluate the effectiveness of structured workshops in improving the knowledge and skills of obstetrics and gynecology residents for repairing high-grade perineal lacerations. This quasi-experimental multicenter study evaluated the baseline knowledge of obstetrics and gynecology residents using an online patient-management problem (PMP) tool. After the initial evaluation, a workshop was conducted using sponge models to teach the practical technique for repairing high-grade perineal lacerations, including external and internal anal sphincter repair. The residents' knowledge was reassessed by PMP exams at 3 and 6months after the workshop, and the scores were compared to the baseline statistics. Eighty residents participated in the study, including 26, 22, and 32 at the first, second, and third-year levels of residency, respectively. The total PMP scores significantly improved after three months of the workshop, with an increasing total score from 15.5 (baseline) to 31.3 (p = 0.027) (range of total score from - 63 to + 52). The senior residents performed better before and after three months of the intervention. However, in the six-month follow-up, the total PMP score of all residents decreased to 12.3 with no significant difference with pre-education scores at all levels. Similar significant results were also reported for each PMP question at all levels of residency. The study found that obstetrics and gynecology residents had substandard knowledge in repairing perineal lacerations. Although the training workshop significantly increased residents' knowledge, its effectiveness diminished over time, indicating a need for continuous or periodic training. The online version contains supplementary material available at 10.1007/s13224-023-01792-6.

Localization and removal of nonpalpable contraceptive implants: Experience from a teaching hospital in Ethiopia: Acase series.

To assess the outcome of women presenting with nonpalpable contraceptive implants to a referral center in Ethiopia. In addition, we discuss our approach and experience with localization and removal of nonpalpable contraceptive implants. We conducted a facility-based retrospective review of patients evaluated for a nonpalpable contraceptive implant between September 2019 and March 2022 at St. Paul's Hospital Millennium Medical College (SPHMMC) located in Addis Ababa, Ethiopia. SPHMMC is a tertiary teaching hospital with Obstetrics and Gynecology (OBGYN) residency as well as a Family Planning fellowship program. The present study was approved by the institutional review board of SPHMMC. Of the 68 patients reviewed, 48 were referred from other facilities. A total of 24 (35.3%) patients had at least one previous failed attempt at removal before referral. On ultrasound examination, 27 (40.3%) implants were found below the muscle fascia. Implant removal procedures were successfully done at the outpatient clinic in 65 (95.6%) patients including 40/40 (100%) suprafascial and 25/27 (92.6%) subfascial implants. Removal of subfascial implants was performed in the operating room in two patients. We failed to localize the device in one patient currently on follow-up. All removals were performed by OBGYNs with subspecialty training in family planning or current fellows supervised by subspecialists. No post-procedure complications have been documented. Our findings show that with meticulous evaluation and careful patient selection, localization and removal of nonpalpable implants in outpatient settings are successful. Initial ultrasonography minimizes delays and allows for same-day implant localization and removal.

Assessing Endoscopic Suture Performance of Gynecology and Obstetrics Residents Following Methodic Training.

To evaluate the performance of residents in gynecology and obstetrics before and after practicing laparoscopic sutures, to establish when the training shows the best results, in addition to comparing whether being in different years of residency influences this progression. A prospective cohort study involving 32 medical residents evaluated with a pretest to establish their previous knowledge in laparoscopic suture. This test consisted of knotting two wires, one made of polypropylene and the other of polyglactin, with a blocking sequence of five semi-knots. We set a 30-minute limit to complete the task. Then, the residents held four training meetings, focusing on suture, Gladiator rule, knot, and symmetries, in addition to executing blocking sequences. A second test to establish progress was performed. Regarding the time spent to make the stiches using polyglactin wire, a statistically significant time improvement (p < 0.01) was observed, with a 10.67-minute pretraining median (mean 12.24 minutes) and a 2.53-minute posttraining median (mean 3.25 minutes). Regarding the stitches with polypropylene wire, a statistically significant time improvement (p < 0.05) was also observed, with a 9.38-minute pretraining median (mean 15.43 minutes) and a 3.65-minute posttraining median (mean 4.54 minutes). A total of 64.2% of the residents had been able to make the knot with polypropylene previously. One hundred percent were able to complete the task in the posttest. Model training using the Gladiator rule for laparoscopic suture improves the knotting time with statistically similar performance, regardless of the year of residency, after systematic training.

EP02.19: Successful implementation of the four‐year AIUM obstetrics and gynecology residency curriculum

EP02.19: Successful implementation of the four‐year AIUM obstetrics and gynecology residency curriculum

Competitiveness of Obstetrics and Gynecology Residency Programs and Applicants.

Competitiveness of Obstetrics and Gynecology Residency Programs and Applicants.

Effects of the Dobbs v Jackson Women's Health Organization Decision on Obstetrics and Gynecology Graduating Residents' Practice Plans.

To explore the association of the Dobbs v Jackson Women's Health Organization ( Dobbs ) decision on future practice locations of graduating obstetrics and gynecology residents. This is a mixed-methods survey study of obstetrics and gynecology residents graduating from sites with Ryan Program abortion training programs (109 sites) between March 8, 2023, and April 25, 2023. We conducted both univariate and multivariable logistic regression analyses to identify factors that were associated with post- Dobbs change in career plans, particularly location. We also performed a thematic analysis using responses to the survey's optional, open-ended prompt, "Please describe how the Dobbs v Jackson Women's Health Organization decision impacted your professional plans." Of an estimated 724 residents graduating from residencies with Ryan Program abortion training programs, 349 participated in the survey (48.2% response rate); 17.6% of residents indicated that the Dobbs decision changed the location of intended future practice or fellowship plans. Residents who before the Dobbs decision intended to practice in abortion-restrictive states were eight times more likely to change their practice plans than those who planned to practice in protected states before the Dobbs decision (odds ratio 8.52, 95% CI 3.81-21.0). In a thematic analysis of open-ended responses, 90 residents wrote responses related to "not living in a state with abortion restrictions." Of residents pursuing fellowship, 36 indicated that they did not rank or ranked lower programs in restrictive states. These findings demonstrate reduced desire of residents in obstetrics and gynecology to practice or pursue fellowship in restrictive states after residency. This reduction in obstetrics and gynecology workforce could significantly exacerbate maternity care deserts.

Transparency around abortion training on obstetrics and gynecology residency program websites

ObjectivesThe availability of family planning and abortion training in residency is a concern for applicants, particularly following the overturning of Roe v Wade. We aimed to characterize public information on abortion training in obstetrics and gynecology residency programs in states with and without abortion bans. Study designWe abstracted residency program data using a publicly available database of obstetrics and gynecology residency programs. We performed a systematic internet search of each program’s website to identify information on abortion training. We defined states with abortion bans as those with total or near-total bans as of November 2022. Using Stata SE 16, we used Student t tests and Fisher exact tests to characterize differences between programs with public abortion training information and those without. ResultsOf 293 obstetrics and gynecology residency programs, 197 (67.2%) included online information regarding abortion training. Of 64 programs in states with abortion bans, 34 (53%) had public information regarding abortion training, compared to 163 (71%) of the 229 programs in states with legal abortion. Programs with publicly available abortion training information were more likely to be academic (49.8% vs 26%, p < 0.001) and have a higher percentage of female residents (86.6% vs 82.9%, p = 0.003). Programs in states with legal abortion were more likely to use words like “abortion” (36.2% vs 17.7%, p = 0.05). ConclusionsOnly two-thirds of obstetrics and gynecology residency programs publicize abortion training information. Almost half of all programs in states with abortion bans do not share this information, revealing a need for improved transparency to better inform residency applicant decision-making. ImplicationsDuring the 2022–2023 academic cycle, one-third of obstetrics and gynecology residency programs did not include information about family planning or abortion training online. In states with abortion bans, this number increased to almost one-half. These findings serve as a call to action for programs to clarify their commitment to abortion training.

Abortion training in U.S. obstetrics and gynecology residency programs in a post-Dobbs era

ObjectivesThe Accreditation Council for Graduate Medical Education requires all obstetrics and gynecology residents have access to abortion training. The impact of Dobbs on training remains unknown. We aimed to describe residency programs affected by abortion bans and those lacking abortion training despite permissive state policies. We considered demographic data to understand the impacts on residents under-represented in medicine. Study designWe used residency databases and websites to abstract data. We identified programs offering routine abortion training as either those with Ryan Programs or those with website or email acknowledgment of training. We defined states with abortion bans as those with either complete or 6-week bans as of December 2022. We used χ2 and Student’s t tests in descriptive analyses and performed a logistic regression to adjust for demographic and program-specific variables. ResultsOf 286 residency programs included, 140 (49%) offered routine abortion training prior to Dobbs. As of December 2022, 19 of these (14%) had lost the ability to provide routine in-state abortion training. Of 223 residency programs in states with legal abortion, 102 (46%) programs lacked routine abortion training. These sites were more likely to be community or community-university programs, with graduates more likely to practice as generalists. Resident race/ethnicity did not differ between residents in states with legal abortion vs abortion bans. ConclusionsNearly half of obstetrics and gynecology residency programs in states with legal abortion do not appear to provide routine abortion training. Further work is needed to understand this paucity of training and maximize access in legislatively permissible environments. ImplicationsFollowing Dobbs, 14% of residency programs lost in-state abortion training. Notably, in states with legal abortion, 46% of programs lack routine abortion training despite permissive legislation. This presents a window of opportunity for expansion of abortion training, particularly at community and community-university hybrid residency sites.

An online alternative: a qualitative study of virtual abortion values clarification workshops

ABSTRACT Background Following the U.S. Supreme Court Dobbs decision, access to abortion education is increasingly regionally dependent. Participation in values clarification workshops on abortion can improve abortion knowledge and reduce stigma. Traditionally, values clarification workshops occur in person, yet medical education increasingly utilizes online learning. We sought to understand how a virtual platform impacted medical students and Obstetrics and Gynecology (ObGyn) residents’ experience with a values clarification workshop on abortion. Methods We conducted values clarification workshops over Zoom with medical students and ObGyn residents at four midwestern teaching hospitals from January 2021-December 2021 during the COVID-19 pandemic. We held semi-structured interviews with participants and facilitators to learn about how the virtual format impacted their experience with the workshop. Four researchers analyzed transcripts using an inductive approach to generate codes then themes. Results We interviewed 24 medical students, 13 ObGyn residents, and five workshop facilitators. Participants and facilitators found the virtual platform to have both unique advantages and disadvantages. Four central themes were identified: 1) Screen as a barrier: participants noted obstacles to conversation and intimacy. 2) Emotional safety: participants felt comfortable discussing sensitive topics. 3) Ease of access: participants could access virtual workshops regardless of location. 4) Technology-specific features: Zoom features streamlined aspects of the workshop and allowed for anonymous contributions to discussion. Conclusions Our findings suggest that a virtual platform can be a convenient and effective way to deliver values clarification workshops on abortion, and this technology could be leveraged to expand access to this training in areas without trained facilitators.

Obstetrics and gynecology clerkship directors’ experiences advising residency applicants

The evolving landscape of application processes for obstetrics and gynecology residency applicants poses many challenges for applicants and advisors. The lack of data coordination among national groups creates crucial gaps in information for stakeholder groups. This study aimed to identify the current state of the advising milieu for obstetrics and gynecology residency applicants and their career advisors, the annual Association of Professors of Gynecology and Obstetrics survey focused on US clerkship directors' experiences advising students through these processes. A 23-item anonymous survey was developed that asked respondents about demographics and outcomes for the students that they advised through the 2021 application process and their experiences with dual applicants and students not matching. The survey was sent electronically to all obstetrics and gynecology clerkship directors with active Association of Professors of Gynecology and Obstetrics memberships in April 2021. Of 224 total clerkship directors, 143 (63.8%) responded to the survey, Of the 143 respondents, almost all (136 [95.1%]) served as career advisors, and 50 (35.0%) were aware of students dual applying. Furthermore, obstetrics and gynecology was rarely the backup to a more competitive specialty. For the 2021 application cycle, 79 of 143 respondents (55.2%) reported having students not successfully match into obstetrics and gynecology, with "academic concerns" followed by "poor communication skills" as the primary reasons cited for students not matching. This snapshot of clerkship directors' experiences advising students in the residency application process reveals notably high rates of dual applicants and students not matching into obstetrics and gynecology. This work fills key gaps in our knowledge of current processes and highlights the importance of career advising at multiple points during the application process.

Colposcopy and Loop Electrosurgical Excision Procedure: A Simulated Exercise.

Cervical intraepithelial neoplasia 3 is associated with a high degree of progression to cervical cancer. Its risk is markedly reduced after excisional treatment. Hence, it is critical that providers accurately diagnose and treat this condition. We present a simulation-based module focused on resident mastery of performance of colposcopy and loop electrosurgical excision procedure (LEEP). Learners were obstetrics and gynecology residents. Guidelines on performance of colposcopy and LEEP were presented prior to module participation. We used pelvic task trainers, kielbasa sausages, and routine equipment for performance of colposcopy and LEEP. Colposcopy and LEEP sessions each lasted 30 minutes. Learners completed questionnaires before and after regarding comfort level on aspects of colposcopy and LEEP performance and level of agreement with statements on performing procedures independently. Comfort levels and degrees of agreement were based on 5-point Likert scales (1 = very uncomfortable/strongly disagree, 3 = neither comfortable nor uncomfortable/neutral, 5 = very comfortable/strongly agree, respectively). Modules were held in November 2021 and May 2022. Thirty-four residents participated. Mean comfort scores significantly increased from 3.1 to 4.3 (p < .001) before and after the module for all steps. There was an increase in level of agreement with statements on being able to independently perform colposcopy (2.2 to 3.5, p < .01) and LEEP (2.9 to 3.6, p = .06). Simulation-based modules on performance of colposcopy and LEEP significantly increased resident learner comfort in the performance of these procedures. Comfort in performing these procedures is important in providing comprehensive gynecologic care.

The application of rapid response team in category 1 emergency caesarean section teaching for OBGYN residents in the delivery room.

Category 1 cesarean section (CS) can be a life-saving procedure when there is immediate threat to the life of the woman or fetus. However, category 1 CS is a challenge for obstetrics and gynecology residents, and it is necessary to establish an effective and straightforward teaching strategy. This study aimed to evaluate the efficiency of rapid response team (RRT) on category 1 CS teaching for obstetrics and gynecology residents in the delivery room. A total of 142 residents who underwent standardized residency training programs in the delivery room were divided into a RRT teaching group and a traditional response (TR) teaching group. In the RRT teaching group, Category 1 emergency CS teaching was started and explored by rapid response team. The training included both theoretical and practical components. After the training, decision-to-delivery interval (DDI), neonatal Apgar score, operation time and rate of postpartum hemorrhage were compared. A questionnaire on the subjective assessment of various aspects of the program was conducted at the end of the training period. The DDI in minutes in the RRT teaching group (n = 72) was significantly shorter than that of the TR teaching group (n = 70) (11.83 ± 4.16 vs 13.56 ± 5.47, P = .0364). The score of satisfaction from residents in the RRT teaching group was significantly higher than that of the TR group [7 (6, 9) vs 9 (7, 10), P = .0154]. Compared with the TR teaching group, more residents thought their clinical skills have been improved (94.29% vs 100%, P = .0396) and willing to recommend their training method to others (91.43% vs 100%, P = .0399) in the RRT teaching group. However, no significant differences were observed in the incidence of postpartum hemorrhage between the 2 groups. RRT teaching is beneficial in the standardized training and teaching of residents in the delivery room. It improves the DDI of category 1 emergency cesarean section and the degree of satisfaction.