Gynecology Residents Research Articles

Obstetrics and Gynecology residency training in transgender care: a national survey of residents and program directors

Aim: Obstetricians and gynecologists (OB-GYN) routinely care for transgender patients though most OB-GYN practitioners do not have any transgender care-specific training. The pervasive lack of training and education leads to dire health consequences for transgender patients. Residents and program directors within U.S. OB-GYN residency programs have been surveyed separately. To our knowledge, this is the first study that compares responses from residents and program directors related to their training. Our study aims to assess OB-GYN residents’ and program directors’ levels of comfort, preparedness, and knowledge in caring for transgender patients. Methods: Electronic surveys were sent to 183 OB-GYN residency programs. Resident and program director surveys consisted of questions regarding experiences with transgender care, perceptions about current transgender care training, and levels of comfort, preparedness, and knowledge in caring for transgender patients. Data were collected via Qualtrics and analyzed using IBM SPSS Statistics. Results: Responses were collected from 37 program directors and 94 residents across five regions defined by the Council on Resident Education in Obstetrics and Gynecology (CREOG). Over 67% of program directors reported not having an established transgender care training curriculum in their program. Among those without an established curriculum, 89% of program directors reported plans to implement one within the next year. Average levels of comfort, preparedness, and knowledge in caring for transgender patients was low for both groups, with residents scoring lower on these variables. Most program directors (89%) were amenable to using standardized training materials as part of their transgender care curriculum, if available. Conclusion: While a majority of U.S. OBGYN residency programs do not have an established transgender care training curriculum, most would use standardized training materials to implement one. This is important given that the current knowledge of transgender care amongst both program directors and residents is low. This study contributes to the limited pool of data that aims to support the development of curricula within OB-GYN residency programs to improve care and reduce health inequities for transgender patients.

Program evaluation of postgraduate obstetrics and gynecology training in Lao people’s democratic republic - using the CIPP model

BackgroundThe obstetrics and gynaecology (OB-GYN) residency training program in Lao People’s Democratic Republic (PDR) began in 2003 based on the Millennium Development Goals (MDGs) and ‘Reproductive, maternal, newborn, and child health interventions (RMNCH) strategies and action plan’. However, the training program had not been properly evaluated previously. The purpose of this study is to evaluate the current postgraduate OB-GYN residency training program in Lao PDR by using CIPP model to identify the current problems (the strengths and weaknesses) and suggest a future plan to promote continuous improvement.MethodThe context, input, process, and product classification (CIPP) model was used to develop criteria and indicators. A mixed-methods approach was used for this study. To capture instructional material for quantitative analysis, a Google survey with 38 items and a t-test were used to determine a significant difference in responses between residents and lecturers (N = 120). Based on qualitative analysis, an in-depth interview was done (four questions based on study outcomes, including satisfaction, strengths and weaknesses, and future opportunities), and six interviews provided different viewpoints on the course. The SPSS software program was used to measure validity, with p-values = 0.05.ResultsThe overall average response rate was 97.5%. Two significant differences in program perspectives were revealed between lecturers and residents, difficulties in maintaining the course (professors 3.66 ± 1.03 and residents 3.27 ± 0.98, p = 0.04) and learning outcomes achieved (professors 3.57 ± 0.85 and residents 3.14 ± 0.95, p = 0.01 The overall average for the context part of the questionnaire was under 3.00, with the lowest scores for overlapped learning outcomes and difficulties in maintaining the course. The input part, lack of the classroom, skills lab and staff; the process part, lecturer to collect student opinions and the product part on learning outcomes.ConclusionCurriculum improvement based on the program evaluation results, including regular evaluation and feedback, will advance the residency training program based on the RMNCH strategy and contribute to the promotion of maternal health in the Lao PDR.

Resident training to optimize patient-focused menopause management: a multispecialty menopause curriculum to enhance knowledge and preparedness.

Surveys of residents in obstetrics and gynecology, internal medicine, and family medicine have demonstrated low levels of knowledge and comfort in treating patients with menopausal symptoms, suggesting a need for improved training during residency. To address this problem, we used a flipped classroom design to deliver a novel menopause curriculum for medical residents. The curriculum included six podcast episodes followed by an interactive case-based classroom session. We then assessed effects of the curriculum on the residents' knowledge and preparedness to manage menopause symptoms. We targeted 200 residents (43 obstetrics and gynecology, 86 internal medicine, and 71 family medicine) from six residency programs from 2019 to 2020. Of these, 115 (58%) completed both pre- and postcurriculum assessments, including a 15-item knowledge test and self-ratings of their knowledge, comfort, and preparedness to manage menopause. Following the curriculum, the proportion of correctly answered knowledge questions rose from 60.8% to 79.1% (+18.3%; 95% confidence interval, 15.4-21.2; Cohen's d = 1.2). Improvement did not significantly differ by specialty or year of residency. There were higher gains for residents who listened to the entirety of all six podcast episodes ( b = 11.4, P < 0.001) and who attended the classroom session ( b = 11.6, P = 0.003). Residents' self-ratings of knowledge, comfort, and preparedness also improved following the curriculum across all medical specialties (Cohen's d = 0.47-1.2). Residents rated the podcast format as convenient (73%) and effective (65%) compared with an equivalent amount of reading. Pairing a podcast with a classroom discussion was found to be an effective combination for improving menopause knowledge.

Social media trends in obstetrics and gynecology residency programs on Instagram and X (Twitter).

During the COVID pandemic, residency program's social media presence increased to aid in residency recruitment by attempting to increase engagement and readily available information for applicants across specialties. However, little information exists on what characteristics and content on obstetrics and gynecology (OBGYN) residency program accounts attract more followers or engagement. To identify social media trends in OBGYN residencies and determine which aspects of programs influence the number of followers and interaction with content posted. We performed a retrospective review of ACGME accredited OBGYN programs and determined their presence on Instagram and X in the fall of 2021. Content from the thirty programs with the most followers was analyzed independently by two authors. Multivariate analysis and a linear mixed model were used to characterize and evaluate content on Instagram and X. Most programs utilized Instagram (88.5%, N = 262/296) and were managed solely by residents (84.4%, N = 108/128). Number of followers on Instagram positively correlated with features such as program size, Instagram profile duration, and Doximity rankings (p < 0.0x01). Programs on X had more followers if their profile had a longer duration, followed more individuals, or were ranked higher on Doximity. The most posted Instagram content was biographical and social in nature. Instagram posts with the highest engagement were awards and/or the Match. Understanding what social media content attracts more followers and increases engagement is crucial as it likely impacts OBGYN resident recruitment. Professional groups should establish guidelines for social media use in recruitment for the protection of both residents and applicants.

Creation of a Novel 3D-Printed Amniocentesis Simulation Model and Impact on Resident Confidence

Background: Non-invasive prenatal screening has decreased opportunities for diagnostic antenatal procedures during residency training. Commercially available models are often cost prohibitive while homemade models can be low fidelity and non-reusable. Objective: To create a training tool with realistic anatomy, tissue-specific tactile sensation, and cost-effective assembly for amniocentesis procedural technique practice and evaluate its impact on trainee confidence with performance. Study Design: Collaborating with biomedical engineering students, our team defined several characteristics to achieve a high-fidelity model: compatible with ultrasound, anatomically accurate, demonstrate tactile realism, endure repeat use, and be cost-effective. A 3-D printed model was created that satisfied fidelity guidelines after rigorous materials and imaging testing. Results: We implemented the model in the observed structured clinical exam for Obstetrics and Gynecology residents in which trainees (PGY2-4) performed an amniocentesis after guided practice with Maternal-Fetal Medicine faculty. Residents were given pre and post-simulation Likert scale surveys regarding confidence and satisfaction with the model. Descriptive analyses and paired t-test were used for analysis. 19 residents completed both pre and post surveys. Mean resident confidence in performing an amniocentesis increased from 1.6 to 3.2 (p&lt;0.001, scale 1-5) after the practice session. Most residents (89.5%) strongly agreed that the model was easy to use and would use it to practice independently. Conclusion: This novel 3-D printed, ultrasound compatible, anatomically accurate, and cost-effective amniocentesis model provides high-fidelity procedural practice and improved trainee confidence. Models such as these have the potential to greatly impact skill development for rare procedures. Future directions include modifying this model for additional fetal procedures, such as cordocentesis.

Trends in vacuum and forceps delivery in teaching hospitals and academic health systems in West Java, Indonesia: A retrospective study.

Recently, there has been a decline in the use of vacuums and forceps. This is due to complications that occur in the mother and baby as well as the operator's ability to operate the instruments. Concerning Professional Education Standards for Obstetrics and Gynecology Specialists, the minimum skill that must be achieved by vacuum extraction and forceps is a minimum of five cases. This is difficult to achieve with the number of obstetrics and gynecology residents in West Java. A retrospective study was conducted using medical records based on the International Classification of Disease 10th Revision from 1 to 28 February 2023 at teaching hospitals and Academic Health System in West Java, namely Hasan Sadikin Hospital, Al-Ihsan Hospital Bandung, and Cikalong Wetan Hospital West Bandung, in the period 1 January 2018 to 31 December 2022. The main outcome was vacuum and forceps extraction with consecutive sampling. The relationship between maternal characteristics such as maternal age, parity, gestational age, and indication for delivery with vaginal operative delivery was descriptive statistics analyzed using IBM SPSS Statistics 26. Trends indicate that the percentage of vaginal operative deliveries tends to be low, below 5%. Vacuum deliveries decreased from 0.75% in 2018 to 0.68% in 2022, while forceps deliveries decreased from 2.77% to 0.98% over the same period. This study concludes that there was an insufficiency of vacuum extraction and forceps delivery cases at the teaching hospital and Academic Health System in West Java to achieve a minimum case of vacuum and forceps. Further research studying how educational interventions improve operative delivery skills might be considered.

Current status of laparoscopy teaching in gynecology and obstetrics medical residency in Brazil.

To characterize laparoscopy teaching in Medical Residency Programs in Gynecology and Obstetrics in Brazil, and to evaluate preceptors' characteristics in laparoscopy programs and map laparoscopic training practice scenarios. This descriptive cross-sectional study evaluated questionnaire responses from coordinators of the Medical Residency Programs in Gynecology and Obstetrics from 2019 to 2021. The questionnaire was sent to 175 programs, and 90 responses were received (51.4%). From the 85 valid responses, it was noted that 67 programs had laparoscopic training. Of the 64 responses received regarding location, 32 replies (50%) indicated the Southeast of Brazil, particularly some country's capitals. In 37.3% (n=25) of the cases, the program coordinator performed laparoscopy. The chief of the laparoscopy sector has advanced experience in most 52.5% (n=10) medical residency services; the preceptors also had advanced experience in 89.4% (n=59) of the services. Residents received laboratory training in 39.4% (n=26) of the services. In most cases, training was performed using a physical simulator. Of the 26 medical residency services with laparoscopy training outside the operating room, 80.8% (n=21) performed them as part of the curriculum, 61.5% (n=16) had a schedule for the same, and only 3.9% (n=1) were objectively evaluated. Laparoscopy teaching in Brazil is heterogeneous, with only a few programs offering any training in laparoscopy. The preceptors had advanced experience and participated in laboratory and operating room training. Only a few programs have their own laboratories or training centers, and most teaching programs do not plan to set up training centers.

Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics &amp;amp; Gynecology Residency Websites between Two Consecutive Years

Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics &amp;amp; Gynecology Residency Websites between Two Consecutive Years

Designing a Multidisciplinary Cardio-obstetrics Curriculum for General Cardiology and Obstetrics Residents: A National Survey of Educational Needs

BackgroundThe increasing and potentially preventable cardiac events in pregnant patients have led to calls to enhance multidisciplinary cardio-obstetrics education. To design a multidisciplinary cardio-obstetrics curriculum for general cardiology and obstetrics and gynecology (OBGYN) residents, we need to define educational needs from the perspectives of both cardiology and OBGYN residents. Our study characterizes the educational needs of Canadian cardiology and OBGYN residents. MethodsCanadian cardiology and OBGYN residents were surveyed on clinical exposures, perceived needs for topics, unperceived needs for topics (multiple-choice questions) and preferences for educational formats. High priorities were defined as ≥ 50% of responses indicating a perceived need or ≥ 50% indicating an unperceived need. ResultsA total of 154 residents participated (cardiology n = 44, OBGYN n = 110). Residents reported insufficient clinical exposure to nearly all cardiac disorders, with 33% of exposures occurring in multidisciplinary contexts. All topics aside from gestational hypertension were rated as high priority on perceived needs by both specialties. High-priority unperceived needs were congenital heart disease (both specialties), pre-existing acquired heart disease (both specialties), medication safety (OBGYN), peripartum management (OBGYN), and pregnancy-related heart disease (OBGYN). Cardiology and OBGYN residents shared preferences for in-person simulation, virtual simulation, and online modules. ConclusionsResidents in both specialties reported low clinical exposure to most cardiac disorders during pregnancy, identified high-priority perceived needs in multiple topics, and shared 2 high-priority unperceived needs. OBGYN residents identified 3 additional high-priority unperceived needs. These data can inform design of multidisciplinary cardio-obstetrics curricula for general cardiology and OBGYN residents.

Program Signaling in Obstetrics and Gynecology Residency Applications.

The objectives of this study were to evaluate how obstetrics and gynecology residency program directors used applicant signaling and to understand how two tiers of signals influenced interviews, ranking, and matching into programs. A multimethod, deductive-sequential design was employed using a national survey of residency program directors and a convenience sampling of programs to study how obstetrics and gynecology program directors used program signals in the 2022-2023 residency-application cycle. A total of 80.5% (236/293) of program directors receiving the survey provided information about signaling, and 20 programs provided application outcome data for applicants who signaled them. The majority of program directors (86.9%) opted into signaling, 43.4% used signals as part of their initial screening, and 33.1% used it as a tiebreaker after reviewing applications, with 45.4% feeling it improved their ability to conduct a holistic review and 41.5% inviting applicants they may not have invited previously. Among programs providing applicant data, the influence of signals on the chances of an applicant being interviewed varied, but an overall strong positive effect of signaling was observed across the sample. The mean rank was 42 for gold signals, 45 for silver, and 38 for no signal (F(3)=5.97, P <.001). Signaling was widely used by programs and was an effective tool to allow applicants to communicate real interest in a program. Signaling was associated with an increased likelihood of an applicant's being interviewed but did not influence an applicant's position on the rank list.

Modification of Fundamentals of Laparoscopic Surgery Manual Tasks Simulation Curriculum With the Addition of the Vaginal Cuff Closure Training

Fundamentals of Laparoscopic Surgery (FLS) is a multiple-choice test and a manual skills exam using simulation that Obstetrics and Gynecology (OBGYN) residents must pass to qualify for board certification. There is insufficient validity evidence supporting the use of FLS as a high-stakes exam. This study examines the correlation between OBGYN residents' performance on the FLS manual tasks and simulated vaginal cuff closure. We compared residents' performance on FLS tasks with simulated vaginal cuff suturing on a model. During the first coached simulation session, after completion of training on the standard 5 FLS tasks, residents were coached on vaginal cuff closure using a simulated model placed inside the standard FLS box trainer. At a subsequent session, their performance was scored using the Global Operative Assessment of Laparoscopic Skills Scale (GOALS) and a second task-specific metric, and these scores were compared to their official FLS score. Twenty-nine residents completed the vaginal cuff simulation training between June 2019 and November 2021. Nineteen of the 29 were able to complete the cuff closure with the mean time to completion being 14.5 minutes. We found no correlation between official manual skills FLS scores and vaginal cuff GOALS scores (rho = -0.02, p = 0.90) or cuff closure assessment tool score (rho = -0.015, p = 0.048). There was also no correlation between time to completion for any FLS task and vaginal cuff closure OSAT scores. All residents reported that they found the cuff to be a useful addition to the FLS curriculum. Our study demonstrated that trainee performance on a simulated vaginal cuff closure model did not correlate with official FLS manual tasks skills. This finding adds to the body of evidence disputing the use of FLS as a high-stakes exam to assess laparoscopic skills in gynecology in the relationship with other variables category.

A Framework for Diversifying Obstetrics and Gynecology Training Programs.

There is an urgent need to diversify the physician workforce in obstetrics and gynecology to serve a diverse patient population and mitigate disparities in care. There is a paucity of data on how to improve recruitment of individuals from underrepresented minoritized groups to the field of obstetrics and gynecology. This article outlines important steps for sharing the department's commitment to diversity, equity, and inclusion; addresses ways to attract a diverse applicant pool; and reviews the importance of and need to perform a holistic review of applicants. This commentary also shares some approaches to support faculty and trainees that may lead to sustained increases in diversity. Using this framework, the authors successfully increased the diversity of their obstetrics and gynecology residency program.

Ethics education among obstetrics and gynecologists in Saudi Arabia: a cross-sectional study

There are a lot of efforts to promote ethics education and training at an undergraduate and postgraduate level around the world, including in Saudi Arabia. However, there is still a lack of structured ethics education curricula in obstetrics and gynecology residency programs in Saudi Arabia. In the current scenario, where new ethical dilemmas are emerging, an ethics education that only focuses on teaching the ethical principles does not enhance the competence to deal with the ethical challenges in daily practice. This study evaluates the lack of ethics education and training in obstetrics and gynecology residency programs in Saudi Arabia. A cross-sectional survey of working obstetricians and gynecologists in Saudi Arabia was conducted among all working levels of doctors (the residents, registrars, consultants, and program directors) from various hospitals of Saudi Arabia. 391 practitioners responded to the survey, representing a response rate of 39.1%, including 257 (66.4%) females and 130 (33.6%) males. 74 (23.0%) received formal education (medical school = 35%; residency programs = 11.8%; sub-specialty programs = 4.3%; postgraduate programs = 7.4%), 85 (26.4%) received informal education (online training = 12.8%; conferences = 18.9%; courses and workshops = 13.3%; self-learning = 31.7% and daily practices = 20.7%), and 78 (19.95%) received no ethics education. Almost all the respondents had a positive attitude towards ethical principles, but a least percent were competent to deal with the ethical challenges. The bottom line of this survey is the imperativeness of reinforcement of formal ethics education in obstetrics and gynecology postgraduate programs in Saudi Arabia.

LGBTQI content on obstetrics and gynecology residency websites

BackgroundIn the United States (US), many obstetrics & gynecology (OB-GYN) trainees feel unprepared to care for lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) individuals, but interest in this topic is rising. Residency program websites are one way that directors can advertise whether this training is offered within their program. We aimed to describe the extent to which LGBTQI content is currently featured on OB-GYN residency websites across the country.MethodsWe identified all OB-GYN residency programs in the United States using a publicly available database. We systematically searched for select LGBTQI keywords on program websites. We collected data on mentions of LGBTQI didactics and rotations. We also searched whether LGTBQI keywords were included in diversity, equity, and inclusion (DEI) statements. We used multivariable logistic regression to compare the characteristics of programs that do and do not include this content. We used STATA SE Version 16.0 for all analyses and set the level of significance at 5%.ResultsWe included 287/295 US OB-GYN residency programs in our analysis (97.3%) and excluded 8 that did not have websites. We identified any LGBTQI content on 50 program websites (17.4%), and specific mention of didactics or rotations on 8 websites (2.8%). On multivariable analysis, programs in the West were more likely to include any LGBTQI content compared to programs in the South (OR 2.81, 95%CI 1.04–7.63), as were programs with 1 or 2 fellowships (OR 3.41, 95%CI 1.43–8.14) or 3 or more fellowships (OR 4.85, 95%CI 2.03–11.57) compared to those without fellowships. Programs in departments led by female chairs were also more likely to include LBTQI content (OR 3.18, 95%CI 1.55–6.51).ConclusionsAcademic programs, West Coast programs, and those with departments led by female chairs are more likely to mention LGBTQI keywords on their websites. Given the increasing interest in LGBTQI education for OB-GYN trainees, program directors should consider providing training opportunities and including this content on their websites.

The International Society for the Study of Vulvovaginal Disease (ISSVD) Vulvar Awareness Day Campaign: Knowledge of Vulvovaginal Diseases Among Italian Obstetrics and Gynecology Residents.

The objective of this study is to investigate vulvovaginal disease (VVD) awareness in Italian obstetrics and gynecology (Ob/Gyn) residents. A 25-question survey on VVD basic knowledge (17 questions) and willingness to improve it (8 questions) was distributed through Ob/Gyn resident online group chats, from different Italian Universities in January 2023. A total number of 250 residents were invited to participate; 124 responses were obtained (response rate: 50%). Data were collected and analyzed using descriptive statistics through REDCap. Overall, 87 of the 124 respondents (70%) fully completed the questionnaire and represented the study group. Residents were distributed among years of residency: 15% first year, 31% second year, 23% third year, 11% fourth year, and 20% fifth year. Most (60%) never attended a VVD clinic during residency, with an increasing percentage of attendance in later residency years (15% at first year vs 65% at fifth).Participants reported low knowledge of vulvar precancerous lesions and vulvoscopy but better knowledge of vaginitis, vulvar self-examination, and lichen sclerosus. Of the respondents, 50% were not satisfied with the education provided during residency, and more than 60% lacked confidence in managing VVD.All participants expressed a strong desire to improve their knowledge and skills, with 100% agreeing that every gynecologist should know the "basics" and 98% wanting to improve their knowledge through webinars (45%), lessons (34%), newsletters, and videos (19%). Our findings indicate a significant need to improve VVD knowledge among Italian Ob/Gyn residents. Further efforts are necessary to provide information about VVD and comprehensive training programs in Italian Universities.

(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&#x0D; 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.&#x0D; Objective&#x0D; This study aims to analyze the readiness of the team that will support the ERAS application at General Academic Hospital (RSUD) Dr Soetomo.&#x0D; Methods&#x0D; 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.&#x0D; Results &#x0D; 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.&#x0D; Conclusion&#x0D; 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.