Medical Students In Obstetrics Research Articles

Reliability of the carousel simulator for assessing labor cervical dilation in medical obstetrics education.

To determine the reliability of the Carousel simulator in medical education for obstetric examinations. Cervical dilation examination training in pregnant women exposes patients to additional uncomfortable and health-risk procedures, a gold standard, and does not objectively evaluate the medical student's competence. We studied the reliability of training internship medical students in obstetrics. Participating students were assigned to take the examination of digital assessment of the cervical dilation on the simulator. Classes performed 12 consecutive randomly blind predetermined cervical dilation examinations using the Carousel simulator. The exact answer and the answer with certainty within ±1 cm were registered and analyzed. Incorrect or outlier answers were considered with a cutoff of ≥2 cm from the dilation. A dispersion graph for each centimeter of dilation simulation was constructed. Sixty-six medical obstetricians took part, performing 396 examinations. Thus, we observed 49 outliers (12.37%) in simulated assessments. According to the analysis, we did not observe outliers from dilation 1 to 4 cm; dilation 7 to 9 cm had a higher index of outlier measurements. We did not consider any dilation simulation dispersion graphic as a null correlation. A strong correlation was seen in the dilation 1 to 6 cm and the dilation 10 cm. The dilations 7, 8, and 9 cm showed a weak correlation. The Carousel simulator model is a reliable method for student learning. The simulator is an essential study tool capable of reducing the embarrassment and possible harm caused by the excessive and repetitive number of invivo digital vaginal examinations. Novel studies are proposed to improve the simulator device and method, mainly to estimate the adequate repetitions and training needed before invivo practice.

Plotting through the pandemic

The COVID-19 pandemic necessitated the development of teaching resources that can be used in Emergency Remote Teaching (ERT). The closure of educational institutions necessitated that teaching and learning approaches would ensure continuity of the teaching enterprise. A teacher and two final year medical students developed an online, asynchronous resource to teach undergradute medical students in obstetrics on the use of the partogram (a labour monitoring tool) and a gravidogram (a pregnancy monitoring tool). The resource was designed to be used on any web browser and device using low bandwith to ensure accessbility where there is limited connectivity. Students were able to asynchronously engage with the learning material, complete the labour and pregnancy graphs based on cases designed for the exercise and submit it to the teacher for feedback. This short report sheds light on the process and lessons learned from the developement of this electronic learning resource.

Tracking Obstetrical and Gynecological Experiences Using Mobile Devices [19P

INTRODUCTION: Tracking clinical experiences is important toward progression of entrustable professional activities required by medical schools. The purpose of this study was to determine the effectiveness of using an innovative real-time mobile device tracker for medical student clinical experiences compared with the traditional tracking using a passport log. METHODS: A prospective single cohort observational study was performed using third year medical students in obstetrics and gynecology rotations. Participants downloaded the obstetrics and gynecology (OBG) tracker and recorded their clinical experiences; procedures, number, and degree of involvement. Results were compared with data from the passport log. Outcomes included data comparison from both tracking methods and end of clerkship student surveys. Internal review board exemption was obtained. Paired t-tests were used for data analysis. RESULTS: Thirty-six students participated in the study over 6 months. The OBG tracker recorded 269 entries, the passport recorded 187. The OBG tracker recorded higher numbers of procedures compared to the passport (procedure type, 56 OBG tracker, 8 passport, p<0.001; degree of involvement, 30 OBG tracker, 0 passport, p<0.001). OBG tracker also tabulated student involvement in cases; 40.2% vaginal deliveries, 41.2% delivered placentas, 62.0% coached patients, 50.9% inserted catheters, 35.8% sutured, 33.3% pelvic exam, 23.3% breast exams. Student surveys rated OBG tracker more useful than the passport (OBG tracker 1.29, passport 4.06, p<0.001). CONCLUSION: The use of a mobile device tracker for clinical experiences allowed for more meaningful real-time data of learners than the traditional passport logs. Tracking detailed experiences and degree of involvement is important to entrustment decisions in medical education.

A questionnaire survey of second year graduate-entry medical students’ perception of obstetrics and gynaecology as a future career speciality

The aim of this study was to explore the impressions of second year graduate-entry medical students of Obstetrics and Gynaecology, before their attachment in the speciality in the subsequent year, so as to improve its appeal to them and increase their recruitment into it. A total of 74 questionnaires were distributed at the end of the Learning Opportunities in Clinical Setting (LOCS) week in the speciality and 66 (89.19%) completed questionnaires were returned. Over 4% of the respondents were considering the speciality as their career choice and less than half would consider it as a second option. Whilst more than a third perceived some of the demerits of the speciality, more than a third endorsed its merits. This showed the need to explore and address their concerns about training and working in the speciality. Having a health-related primary degree, prior employment and being female were significantly associated with choosing the speciality as a career (p < .001). Barriers for male respondents were flagged, which need to be addressed, and a bias towards Obstetrics was noted, which reflects the narrow focus on the Labour Ward and necessitates a broader exposure to the speciality.Impact statementWhat is already known on this subject? The perception of third year graduate-entry medical students of Obstetrics and Gynaecology is biased towards Obstetrics, and they have apprehensions about the challenges of training and working in the speciality.What do the results of this study add? The views of second year graduate-entry medical students are consistent with the views of third year graduate-entry medical students, which shows that these views may be formed early.What are the implications of these findings for clinical practice and/or further research? More research is needed to establish and understand the perception of the speciality earlier than second year and explore the value of practical steps that may improve this perception and increase the interest in it and recruitment into its training programmes.

The Evidence Base for Education - Medical Students in Obstetrics and Gynaecology

This article was migrated. The article was not marked as recommended. Every person has been through a pregnancy at least once (as a fetus) and many will experience it several times. It is crucial that doctors are aware of the evidence base so to make good decisions and provide accurate advice in pregnancy. This review article summarises the evidence on Medical Education for undergraduate and postgraduate medical students, with many generic points to allow others to apply teaching points to their own specialities.

Teaching Patient Handoffs to Medical Students in Obstetrics and Gynecology: Simulation Curriculum and Assessment Tool.

Patient handoffs, the communications required for the safe transfer of patient care, are known to be a common source of medical errors. Simulation exercises are effective techniques for teaching the procedures and patient interaction skills involved in a handoff. We developed a teaching tool that allows students to individually interact with a simulated patient, develop a treatment plan, and practice a handoff to another provider. The curriculum is a flexible instructional tool to teach patient handoffs in the context of a simulated obstetric emergency for learners at the clerkship through first-year obstetrics and gynecology resident levels. The curriculum secondarily teaches management of first-trimester bleeding with acute blood loss and can be adapted to allow advanced learners to practice obtaining informed consent. To evaluate this simulation for educational effectiveness, we developed a faculty observation assessment tool. The simulation assessments for history taking, fund of knowledge, and interpersonal skills were predictive of subsequent clerkship clinical grades. Eighty percent of students agreed the exercise was realistic, 95% agreed it was relevant to the clinical curriculum, 90% agreed the simulation taught handoff skills, and 73% agreed the simulation increased confidence in handoff skills. Students uniformly found the curriculum to be relevant, realistic, and effective at teaching handoff skills. Use of this curriculum has the potential to improve students' communication skills, handoff performance, and confidence during an obstetrics and gynecology clerkship. The assessment tool may allow early identification of students in need of improvement in communication skills.

Acceptability of clinical teaching by mentorship among medical students in Nigeria

Background: Mentoring is “a process whereby an experienced, highly regarded, empathetic person guides another individual in the development and reexamination of their own ideas, learning, and personal and professional developments.” We determine the acceptability of mentoring by undergraduate medical students in obstetrics and gynecology and the challenges of mentoring as perceived by the mentees. Patients and Methods: All undergraduate students of obstetrics and gynecology for 2009/2010 sessions were assigned to a mentor according to their admission numbers for clinical teaching. Guidelines were drawn for the scope, mode of teaching as well as the timing of contact for 16 weeks. Structured questionnaires were administered to assess their acceptability of the scheme as well as the problems of mentoring. The data were analyzed by the statistical package for social sciences. Results: One hundred and twenty 5th year medical students were interviewed. They were aged 22-32 years with a mean of 25.7 years. There were 82 (73.2%) males and 30 (26.8%) females. The students were in medical schools for an average of 6.1 years. Eighty-two students (73.2%) assessed the scheme as good while 4 (3.7%) assessed it as poor. The teaching objectives were judged to be satisfactorily met by 99 (88.6%) students and 91 (81.3%) assessed contact with teachers as satisfactory. The clinic facilities were thought to be good for learning by 102 (91.1%) and 79 (70.5%) considered the facilities provided to be conducive for individual private learning. Facilities for research were considered to be adequate by 53 (47%). The main drawback of the scheme was lack of uniformity in standard by the mentors, as reported by 87 (77.6%). Conclusion: Mentoring in clinical medicine is both convenient and acceptable by medical students.

Gender bias in training of medical students in obstetrics and gynaecology: a myth or reality?

To investigate the experience of medical students during a clinical attachment in obstetrics and gynaecology (O&G). A questionnaire was distributed to medical students who completed their O&G posting between August 2012 and August 2013. The first part included basic demographic details (age, gender, and ethnicity) and frequency of actual clinical experience; the second part explored students' perception of their training and their relationship with other staff, in particular feeling of discrimination by specified groups of medical personnel. The responses were recorded using a Likert scale and were recategorised during analysis. A total of 370 questionnaires were distributed, and 262 completed questionnaires were returned, giving a response rate of 71%. Female students had a significantly higher median (IqR) number of vaginal examinations performed 0.25(0.69) (p=0.002) compared to male students. Male students experienced a higher proportion of patient rejections during medical consultation, 87% vs. 32% of female students (p<0.001), a higher rate of refusal for clerking (71.4% vs. 57.5% of females, p=0.035) and a higher rate of patients declining consent for internal examination (93.3% vs. 67.6% of females, p<0.001). The majority of male students felt that their gender negatively affected their learning experience (87% vs. 27.4% of the female students, p<0.001). Male students reported a significantly higher proportion of discrimination against their gender by medical officers (p=0.018) and specialists/consultants (p<0.001) compared to females but there was no discrimination between genders by staff nurses or house officers. A majority (58%) of female students stated an interest in pursuing O&G as a future career compared to 31.2% of male students. Our study confirmed that gender bias exists in our clinical setting as male students gain significantly less experience than female students in pelvic examination skills. We also demonstrated that compared to female students, male students experience higher levels of discrimination against their gender by trainers who are medical officers and specialists/consultants. Trainers must improve their attitudes towards male students, to encourage them and make them feel welcome in the clinical area. We must minimize gender discrimination and educational inequities experienced by male students, in order to improve their learning experience.

Residents as Teachers: A Paradigm Viewed Positively by Medical Students in Obstetrics and Gynecology

Background Multiple pedagogical approaches are employed by medical students to prepare for the National Board of Medical Examiners (NBME) Subject Exams. We investigated the utility of a resident-led educational review session on medical student NBME subject exam scores in Obstetrics and Gynecology.

Small-group discussion versus lecture format for third-year students in obstetrics and gynecology.

To compare lecture and small-group discussion for third-year medical students in obstetrics and gynecology. Over a 2-year period, 91 third-year medical students in the obstetrics and gynecology clerkships were given educational sessions on diabetes and hypertension in pregnancy by a single instructor, either in a traditional lecture format or in a small-group discussion. After the instructional sessions, students anonymously completed a 20-question multiple-choice examination on the covered topics. They also completed an evaluation form on the instructional format, using a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). At the completion of each clerkship, students repeated the same multiple-choice examination. There was a significantly higher level of enjoyment (median value 5 versus 4, P <.001) and sense of educational stimulation (median value 5 versus 4, P <.001) in the discussion group, and students in the discussion group were less desirous of the alternate instructional format than those in the lecture group (median value 2 versus 3, P <.001). However, there were no differences in the test scores, either immediately after the instructional sessions or at the end of the clerkships. There was a 90% power to detect a 15% difference in postinstructional test scores. Third-year medical students learning about hypertension and diabetes in pregnancy during their obstetrics and gynecology clerkship strongly preferred small-group discussions over traditional lectures. However, this preference did not lead to improved test scores on these subjects.

Teaching critical appraisal to medical students in obstetrics and gynecology

Critical appraisal might be the most important skill to acquire in medical school. Despite its importance, this issue has received little attention in obstetrics and gynecology training. This article describes the approach used at San Francisco General Hospital. We teach critical appraisal in several ways. We provide a series of student seminars that foster critical reading of the literature. Topics range from technology assessment to contraception to sexually transmitted diseases. Evidence-based ward rounds complement the experience. During the rotation, each student formally reviews one topic in women’s health using the US Preventive Services Task Force rating system. Although we lack a quantitative assessment of this approach, student feedback has been enthusiastic. Critical appraisal skills enable students to continue their medical education after completion of their formal training.

A Curriculum of Clinical Practice for Medical Students in Obstetrics and Gynecology

A Curriculum of Clinical Practice for Medical Students in Obstetrics and Gynecology