OBGYN Residents Research Articles

The Innovative Use of a Paging Simulation to Assess Professionalism and Communication Competencies

BACKGROUND: Communication and professionalism competencies present assessment challenges for medical educators at the undergraduate and graduate medical education levels. A simulated paging curriculum could provide an opportunity to assess and supply feedback on the level one milestone Professionalism and Communication competencies for medical students matching into OBGYN residencies. METHODS: Fourth-year medical students enrolled in a 4-week residency preparation course participated in a paging simulation curriculum consisting of six cases. A Certified Nurse Midwife (CNM) simulated the role of floor nurse and recorded the time from the page to a response time. After each case, the CNM assessed level one communication competencies for each student using a 100 mm visual analogue scale. The CNM assessed global effectiveness in communication using a 1–10 scale. RESULTS: A response time within 5 minutes occurred for 83% of the 171 pages sent. Sixty percent of pages were returned in under 3 minutes. The mean score for “respectful when communicating” and “cooperative when communicating” was 87 and 86%, respectively. Assessment of “structured when communicating” had a mean of 77% and “able to gather and share information” 75%. The overall mean score for global effectiveness of communication during the scenario was 9. DISCUSSION: The paging simulation offered a unique platform for the assessment of Professionalism and Communication level one competencies. While students were effective when communicating, structured conversation, and the ability to gather and share information might be improved. This curriculum provided an opportunity for informed feedback to individual students on these necessary skills in an OBGYN residency.

Creating a Sustainable ObGyn Residency in a Resource-Limited Country Improves Maternal Health Outcomes

BACKGROUND: The 2013 maternal mortality ratio (MMR) in Guyana was 250/100,000 live births according to the WHO, compared to a regional average of 68. Inadequate quality of care, shortage of skilled health care professionals, and systemic limitations are contributing factors. METHODS: In 2012 University Hospitals/Case Medical Center (UHCMC), Georgetown Public Hospital Corporation (GPHC) and University of Guyana collaborated to develop a 4-year ObGyn training program using curriculum formalized at UHCMC, modified to suit local needs. A multi-academic institutional partnership allowed international faculty involvement in training Guyana's first ObGyn residents (MDG-8). Maternal morbidity and mortality outcomes (MDG-5) were prospectively maintained, analyzed, and compared to rates prior to program implementation. RESULTS: Twenty-three residents were trained and five residents completed the program in 2016. Full-time staff are present in Guyana, and 52 faculty from partnering institutions travelled to Guyana to teach and provide patient care. Development of modified evidence-based clinical guidelines improved quality of care and patient safety outcomes. MMR from direct causes decreased country-wide and at GPHC during the 4-year period. Success was due to shared institutional vision, establishment of partner organizations, resident leadership development, and systems-based improvement. Future challenges include trainee retention and continued sustainability. DISCUSSION: Guyana’s first ObGyn residency program can serve as a model for similar endeavors in global health. Creation of sustainable training programs in ObGyn through international partnerships is essential progress toward achieving MDGs 5 and 8.

A Needs Assessment Report for Development of an Obstetrics and Gynecology Skills Elective

OBJECTIVE: We completed a needs assessment for obstetrics and gynecology exam and procedural skills to inform a 4th-year exam and procedural skills elective. METHODS: We surveyed 4th-year medical students matching in ob-gyn and junior ob-gyn residents about what skills should be included in a 4th-year procedure elective. We created a 15-question survey of ob-gyn exam and procedural skills using APGO Medical Student Educational Objectives and Year One Milestones, with answers on a Likert scale. RESULTS: Ten (7%) 4th-year medical students who matched into ob-gyn residency and 18 (48%) ob-gyn residents at the University of Colorado completed the survey. They identified basic ultrasound skills (96%), postoperative care (96%), and surgical preparation (93%) as the most valuable procedural skills to include in a 4th-year medical school elective for students entering into an obstetrics and gynecology residency. The procedural skills with the lowest support for to inclusion in an elective were hysteroscopy (32%), laparoscopy (43%), and colposcopy (61%). CONCLUSION: Students entering ob-gyn and junior ob-gyn residents desire training in ultrasound skills, basic surgical preparation, and postoperative care education over more complex ob-gyn procedural skills before residency. We will use these results to create a 4th-year medical student elective that includes these skills.

An 8-Week Mindfulness-Based Stress Reduction Course for Ob/Gyn Residents: A Pilot Study

BACKGROUND: Studies have linked improved physician well-being with better patient outcomes. Despite the documentation of growing job dissatisfaction, burnout, and depression among OBGYN residents, few interventions have been studied. Mindfulness-based stress reduction (MBSR) has been shown to significantly improve personal well-being and job satisfaction in primary care specialties, but has not been investigated in obstetrics and gynecology. METHODS: An 8-week MBSR course specifically designed for medical professionals was created and led by a certified Mindfulness Teacher. Participants completed a pre- and postintervention survey measuring burnout, anxiety, mindfulness, resilience, stress, and depression by validated scales. McNemar's test was used to assess changes in outcome measures. RESULTS: All 21 of the eligible residents participated in four or more of the eight weekly 1-hour lectures. At the 2-month postintervention survey, participants demonstrated statistically significant improvements in stress, anxiety, and focus. Residents showed no statistical improvement in depression or burnout scores. DISCUSSION: Our pilot study demonstrated that an 8-week MBSR course was associated with improvements in some but not all measured outcomes of burnout, mindfulness, resilience, stress, and depression. We are currently piloting a reformatted course with shortened but more frequent programs to support and improve the well-being of our residents.

Operative Learning Needs and Preparation for the Gynecologic Operating Room: A Comparison Between Junior and Senior Residents

BACKGROUND: Differences in operative learning needs and preoperative educational resources utilized by OBGYN residents across postgraduate year (PGY) levels in preparation for gynecologic operative cases are unknown. Understanding these learning needs and preparatory patterns can inform surgical curricula development and address gaps in preparation. METHODS: A cross-sectional survey developed with validity evidence was administered to a registry of 19 OBGYN residency programs. Residents were surveyed on 12 operative learning needs that persisted following routine preoperative preparation and resources utilized to prepare for gynecologic surgical cases and the frequency of use. RESULTS: Participants included 214 residents distributed similarly across PGY levels. The frequency of unmet operative learning needs was consistent across PGY levels with no differences in 8 of 12 topic areas. Junior and senior residents reported a similar ranking of their most frequently unmet operative learning needs in topics of anatomy, patient outcomes, suture selection, and follow-up procedures. No significant differences between junior and senior residents were noted in their regular/frequent use of preparatory educational resources, and more than 90% of both groups reported YouTube as the most commonly accessed web-based resource. DISCUSSION: Despite differences in years of training and surgical case experience, junior and senior residents reported similar unmet operative learning needs and preparatory resource utilization. These findings call for improved alignment in training and identify considerations for future surgical curricula development.

Implementing Patient Satisfaction Surveys to Assess Resident Professionalism and Communication

OBJECTIVE: To develop and implement an outpatient patient feedback measure to assess OBGYN resident professionalism and communication. METHODS: After obtaining institutional IRB exemption, we used four questions from inpatient Press Ganey survey assessing communication and professionalism (Did your doctor: 1) treat you with courtesy and respect; 2) listen carefully to you; 3) explain things in a way you could understand; and 4) give you time to ask questions) with the answer scale: Never, Rarely, Sometimes, Always. We administered the same questions to OBGYN residents to determine their baseline perception of their patient–physician communication and professionalism skills. EVALUATION: This was a longitudinal study, with collection of outpatient OBGYN patient surveys initially over 3 months. After pilot data (n=22) yielded the same answer (Always) for each question, the answer scale was changed (Yes, No, and Unsure). Data from the new questionnaire (n=34) again yielded the same answer (Yes) to each question. Resident answers showed slightly more variation. All residents (n=17) felt they treated patients with courtesy and respect and gave time for questions. Only 1/17 resident felt s/he sometimes did not listen carefully to patient concerns and 5/17 residents felt they had a hard time explaining things in a manner patients would understand. DISSEMINATION: This was initiated to create a template that could be used by other residency programs as part of their evaluation system. REFLECTIVE CRITIQUE: This is not useful in its current form. I plan to reassess the survey content, process and administration.

Cultural Self-Awareness Training in OBGYN Residency

OBJECTIVE: Develop and implement a training session for our OBGYN department that expands knowledge of one's own culture and fosters an awareness of the cultures of colleagues. METHODS: Needs Assessment including review of the 2014 ACGME Annual Resident Survey, which highlighted need for improved respect in the workplace. This prompted a meeting of the Designated Institutional Officer with the faculty of the OBGYN department regarding improved communication and sensitivity. An extended cultural competency curriculum was suggested from this meeting. Discussions with the institutional Director for Inclusion and Diversity Strategy confirmed that policies of inclusion and diversity are reviewed at new resident orientation; however, there is no further formal training for residents. Focus Group conducted with graduating residents to discuss their experiences during residency regarding issues of respect in the workplace and cultural sensitivity. Developed Framework for curriculum. Workshop conducted to address the specific objectives: Increase knowledge concerning cultural awareness and cultural competency; Identify personal attitudes regarding culturally sensitive issues and biases; Develop skills for addressing culturally sensitive issues. EVALUATION: Pre- and posttests developed with the Office of Diversity and Inclusion to assess knowledge, attitudes, and beliefs. Twenty-one residents and faculty attended the workshop. Nineteen of 21 (90%) of participants felt more open to learning of others' cultures and beliefs after this activity, and 18/21 (86%) felt closer to their colleagues after this activity. DISSEMINATION: Present to local “Ed Talks” conference, which promotes Educational Scholarship across the institution. Submit to MedEdPortal. REFLECTIVE CRITIQUE: The workshop was very well-received by those in attendance.

Development and Evaluation of an eLearning Module on the Prepubertal Exam and Vaginoscopy for Ob-Gyn Residents

OBJECTIVE: To develop and evaluate a self-study module for Obstetrics and Gynecology (Ob-Gyn) residents to improve knowledge and skills with prepubertal exam and vaginoscopy. METHODS: We developed an interactive module to teach CREOG Learning Objectives in pediatric and adolescent gynecology: prepubertal vaginal bleeding evaluation, including prepubertal exam, vaginal culture, office lavage, and vaginoscopy. After pilot-testing with chief residents and recent graduates, we held a focus group to solicit feedback resulting in modifications. EVALUATION: After obtaining IRB approval, we offered the revised module to all current Ob-Gyn residents (n=37). We solicited residents by e-mail communication and offered a small incentive. The evaluation tool queried satisfaction, confidence with knowledge and skill in the tested areas, and assessed knowledge of prepubertal bleeding before and after module completion. Of the 37 residents, 26 (70%) participated. Satisfaction with knowledge improved from 30.8% to 100% (P<.0001). Reported confidence in being able to independently perform a prepubertal genital exam improved from 7.7% to 53.8% (P<.001). Reported confidence in in being able to independently perform vaginoscopy did not change significantly (0%–11.5%, P=.24). DISSEMINATION: We will submit this module to the AAMC MedEdPORTAL. We aim to design a multi-institutional research study to assess whether the module improves knowledge and skills on this topic at institutions throughout the country. REFLECTIVE CRITIQUE: Although residents overall found benefits, improving their confidence with vaginoscopy performance was limited. The module may serve as an introduction to vaginoscopy, but skill acquisition may rely on actual performance.

Resident Practices Regarding Prenatal Contraceptive Counseling

OBJECTIVE: Prenatal contraceptive counseling has been associated with effective postpartum contraceptive use; therefore, proper training in providing this service is paramount. The purpose of this cross-sectional study is to determine obstetrics and gynecology (ob-gyn) residents' prenatal contraceptive counseling practices. METHODS: Data were obtained via anonymous surveys completed by University of Texas, Medical Branch in Galveston (UTMB) ob-gyn residents. RESULTS: Twenty-one of 25 residents (84%) completed the survey. Five (20%) PGY-1, seven (28%) PGY-2, five (20%) PGY-3, and four (12%) PGY-4 residents participated. With regards to prenatal contraceptive counseling practices, 11 (52%) reported initiating prenatal contraceptive counseling in the third trimester or later, 20 (95%) described spending 10 minutes or less on contraceptive counseling during all prenatal care, and nine (43%) respondents reported counseling about all four major contraceptive categories (oral pills/patches/rings, injections, long-acting reversible contraceptives/IUDs/implant, and sterilization). When asked for reasons for not doing prenatal counseling, residents cited either time-constraints and simply forgetting to counsel. One-third of the residents felt that they “miss[ed] some aspects of proper counseling.” Finally, one 3rd year and one 4th year stated they had no formal training in contraceptive counseling, and only four (16%) residents reported formal didactics on contraceptive counseling specific to the prenatal period. CONCLUSION: Prenatal contraception counseling was inadequate in one ob-gyn residency program. Our findings suggest that further research and uniform guidelines regarding resident education on contraceptive counseling are warranted.

Engaging Residents in Quality Improvement: A Multidisciplinary Collaboration to Decrease the Primary Cesarean Delivery Rate at a New Academic Medical Center

BACKGROUND: Our facility performs more than 9,000 deliveries per year, with a primary cesarean birth rate of 35% and is the primary teaching site for a new Ob/Gyn residency program. An innovative curriculum includes a formal course in quality improvement methods for new faculty, and active participation of all residents in a QI project. In an effort to decrease the primary cesarean birth rate, a multidisciplinary QI project was developed. METHODS: The team was led by two community faculty members and included two residents, nursing and hospital administration. Interventions included mandatory completion of a FHR course, provider education on current terminology and recommended interventions, and monthly reporting of cesarean delivery rates. The team used a fishbone analysis of the steps leading to a cesarean delivery to create a data collection checklist. Charts were reviewed by the residents to confirm the indication for cesarean delivery along with other pertinent variables. RESULTS: The primary cesarean birth rate decreased from 35% in the first quarter of 2015 to 27% in the first quarter of 2016, a 24% decrease. The project team continues to meet quarterly to discuss ongoing activities necessary to maintain and increase the improvement observed in the initial quarter. Residents and faculty report a strong sense of accomplishment as a result of the project, and an interest in continued participation in QI activities. DISCUSSION: Interdisciplinary partnerships between OBGYN residents, faculty and hospital administration/staff to develop and implement quality improvement projects can improve patient care and provide learners with the knowledge and expertise to engage in quality projects in their future practice.

Diagnosis and Lifestyle Modification Counseling for Adolescents With PCOS: An Assessment of Learning Needs in OBGYN, Pediatrics, and Family Medicine Residents

OBJECTIVE: To assess the knowledge gaps in residents of three disciplines to both accurately diagnose polycystic ovary syndrome (PCOS) and use lifestyle modification counseling with adolescents who have PCOS. METHODS: A 21-question survey was administered several months before and then 2 weeks after an interactive didactic session with resident physicians in Pediatrics, Family Medicine, and OBGYN at Erlanger Health System, to assess knowledge of disease mechanism, knowledge of treatment options, focus of counseling, adequacy of resources, and potential barriers to counseling. Basic descriptive and frequency analyses were conducted on all items. EVALUATION: Most residents, regardless of specialty, did not feel confident diagnosing PCOS in adolescents and this confidence decreased after the didactic session, presumably with increased knowledge of the complexity of PCOS. Although more than two thirds of residents acknowledged lifestyle modification as first-line management, most spent 5 minutes or less counseling on lifestyle changes. This trended consistently toward spending more time in the second survey. Most did not understand that 5% weight loss often restores menses. Residents felt barriers to counseling could be addressed via quick text links for the EHR media resources, patient didactic sessions on eating and exercise, and educational pamphlets. They expressed an interest in having such resources provided. The overall interest in lifestyle counseling increased statistically after the intervention. DISSEMINATION: A motivational interviewing curriculum will be developed, implemented and evaluated to address the learning needs identified by the survey, followed by repeat collection of survey data. Patient resources will be part of this. It will be submitted to the MedEd Portal. REFLECTIVE CRITIQUE: This needs assessment was conducted in residency programs at one institution including the three types of specialists who treat teens with PCOS. It demonstrated a need to educate these residents and equip them to better educate their adolescent patients with PCOS.

Behind the Curtain: What Makes the Land of OB GYN Appealing to Our Students

BACKGROUND: In 2005, in response to a decline in residency applications in OBGYN, the American College of Obstetrics and Gynecology Presidential Task Force outlined strategies for attracting medical students to OBGYN. Our program implemented interventions across all years of medical school education, increased efforts to “teach the teachers,” and improve faculty and resident relations with students. Application rates increased, but little is still known about which interventions work. METHODS: This qualitative study received IRB approval. Students applying or recently matched into OB GYN residency programs from the Class of 2014–2016 were included. Eleven participants completed a phone interview exploring why they chose OB GYN, focusing on positive and negatives experiences. The survey instrument was designed to include open ended questions and a Likert-type survey. Grounded theory methodology was used for analysis. Participants received a $50 Starbucks card. RESULTS: Preliminary analysis identified the following themes: 1) potential for a “meaningful” job and a future role in women's health, advocacy for women or empowerment of women; 2) first impressions in the clinical clerkship and “welcoming” teams; 3) content and diversity of our field; 4) impact of supportive mentors in career decisions. DISCUSSION: Participants identify important events that even precede medical school, but commonly highlight finding meaning in their work, and identifying with others that share in their interest and goals as guiding them toward OB GYN.

Preparing Fourth-Year Medical Students to Collaborate With Nurses: An Innovative Paging Curriculum

BACKGROUND: Effective communication and collaboration between physicians and nurses improves patient care outcomes, decreases costs, and is a crucial aspect of new interns' responsibilities. However, little formal training is provided to graduating medical students. METHODS: A simulated paging curriculum was administered to 4th-year medical students participating in an OBGYN residency preparation elective. Certified Nurse Midwives administered the pages, and simulated the role of a floor nurse. Students completed a survey before and after the curriculum. Students indicated on a 100 mm visual analogue scale (1=not comfortable at all, 100=extremely comfortable) their comfort gathering information, their comfort providing patient care management, and their comfort collaborating on patient care with a nurse. Pre- and postresponse means were compared utilizing paired t tests. RESULTS: Eleven students completed the paging curriculum, and eight (72%) responded to the survey. After the curriculum, students felt more comfortable gathering information from a nurse (before 57.1, after 87.5; P=.0071), providing patient care management with a nurse (before 47.8, after 85.6; P=.0038), and collaborating on patient care with a nurse (before 66.1, after 93.6; P=.0015). DISCUSSION: Medical students felt more comfortable collaborating with nurses on patient care after participating in a simulated paging curriculum. Although a limitation of our study is the small sample size, these pilot data suggest that improvement in the nursing-resident interaction can be made with innovative simulated paging curricula.

Abortion Training in U.S. Obstetrics and Gynecology Residency Programs

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) requires ob-gyn programs include “access to experience with induced abortion.” Yet in 2004 when last studied, only 51% included routine abortion training. METHODS: Directors of 240 ob-gyn residency programs were invited to complete an online survey. Training was considered routine when the director reported abortion training was included in a rotation dedicated to family planning and/or dedicated time for abortion training. We assessed program directors' reports of resident experience by training type using χ2, t tests, and logistic regression. RESULTS: One hundred ninety (79%) directors responded. Sixty-one percent reported that training was routine, 32% said it was available or optional for residents, and 7% said it was not available. Routine training, compared with optional training, was correlated with higher mean total numbers of abortion procedures per graduating resident (87.2 versus 48.1, P<.001). Seven directors (4%) reported that their program had been cited for inadequate abortion training. DISCUSSION: Abortion training in ob-gyn residency programs has substantially increased from 12% in 1992 to 61% in 2014, and as in other studies, routine training is associated with greater clinical competence (Almeling R, Tews L, Dudley S. Fam Plann Perspect 2000;32:268–71, 320. MacKay HT, MacKay AP. Fam Plann Perspect 1995;27:112–5. Eastwood KL, Kacmar JE, Steinauer J, Weitzen S, Boardman LA. Obstet Gynecol 2006;108:303–8). In a third of programs, residents needed to seek out training themselves, and 7% of programs offered no opportunity for training, falling short of meeting the ACGME requirement.

Enhancing Family Planning Training at a Catholic OBGYN Residency Program

OBJECTIVE: Residents in Catholic hospitals face restrictions in family planning training based on the Ethical and Religious Directives. Our objective was to create a rotation that addresses ACGME competencies in family planning and abortion training for the OBGYN residency program at Saint Joseph Hospital. METHODS: In July 2016, a family planning grant was awarded to the OBGYN residency program at Saint Joseph Hospital to create a family planning rotation to improve on-site family planning curricula at Saint Joseph Hospital and provide planned, off-site abortion and contraception training at a family planning clinic affiliated with a nearby academic center. All residents participated in family planning didactic sessions, simulation sessions, and annual values clarification workshop. Residents who participated in the family planning rotation were assigned readings (American College of Obstetricians and Gynecologists publications and journal articles), an e-learning curriculum (LEARN module), and trained in providing contraception and uterine evacuation procedures. Residents who chose to opt-out of performing uterine evacuation procedures were considered partial participators. EVALUATION: We will compare pre- and postmean test scores for LEARN modules and median number of family planning procedures before and after the family planning rotation. Participating residents will complete rotation evaluations and comments will be evaluated using thematic codes. Preliminary data suggest residents gain more experience in uterine evacuations and LARC contraception procedures after the rotation. DISSEMINATION: Our family planning rotation can serve as a model for other faith-based residency programs to improve training. REFLECTIVE CRITIQUE: The family planning rotation provides an opportunity to improve training in our Catholic hospital-based program.

Are We on the Same Page? A Multi-Institutional Evaluation of Faculty and Resident Training Needs

BACKGROUND: Resident and faculty needs are important in guiding the educational agenda; studies demonstrate that these groups do not always agree on needs. A previously piloted 50-item needs assessment evaluating content areas of feedback, the 15 Ob-Gyn milestone procedures, and simulation was used to assess and compare faculty and resident needs. METHODS: The needs assessment was administered electronically to two academic Ob-Gyn residency programs (located in South Carolina and Texas) in June 2016; all items were ranked on a 5-point agreement scale. Equivalent versions were written to capture resident and faculty perceptions of the training program; results were anonymous and participation was voluntary. RESULTS: Forty-two surgical faculty (52.5%) and 47 residents (62.5%) completed the needs assessment; t tests compared resident/faculty group differences. Both groups agreed on the adequacy of surgical content, however, faculty consistently self-reported delivering feedback at a significantly higher level than residents' perceived receiving it (P<.05) for 8/16 feedback items. Overall, both groups were least satisfied with training in breech vaginal delivery, 3rd/4th-degree laceration repair and operative vaginal delivery; residents were most satisfied with training in cesarean delivery while faculty were most satisfied with laparoscopy. Both groups agreed simulation can improve procedure performance; no significant differences existed. These findings were consistent between institutions, although each institution's levels of agreement differed for individual items. DISCUSSION: Although residents and faculty agree on areas of strengths and weaknesses, significant differences exist in perception of feedback delivery and reception.

Stop, Look, Listen, Then Breathe: The Impact of a Narrative Medicine Curriculum on Pediatric Residents (Descriptive Abstract)

Prevention of burnout and promoting resilience and well-being has become a focus in Graduate Medical Education. Likewise, much attention has been given to the effect that one’s state of mind, health and self-care practice has on physician wellness, fatigue and burnout. Narrative Medicine (NM) has been shown to promote physician wellness, emotional well-being and self-care. NM increases mindfulness within clinical practice by allowing individuals to pause, breathe, and reflect. NM has been shown to reduce physician burnout by increasing empathic engagement, decreasing jadedness, providing insight into patient perspective, and improving one’s sense of purpose. A study on NM workshops with OBGYN residents showed an association with decreased levels of burnout. However, a study on how a NM curriculum impacts pediatric resident well-being has not been done. This qualitative study explores how NM may achieve more empathic and effective patient-physician relationships, and decrease burnout and depersonalization. Two NM professionals facilitate 3 groups of 6-8 mixed year pediatric residents (19 total) in a series of 1 hour workshops over 4 four consecutive weeks. The workshops incorporate discussion of art, literature, spirituality, and shared reflective writing. Workshops are designed to empower residents by making self-care and mindfulness practices more accessible, and encourage emotional well-being and listening. The themes explored include: narrative humility, delivering bad news, death and illness, and self-care. Workshops begin by asking residents, “What may be preventing you from being present for the hour?” along with brief meditation and breathing exercises. These moments enable participants to acknowledge barriers preventing them from being attentive, and allow reflection. Resident perspectives are elicited through discussions and post-workshop surveys to discover which, if any, elements of the curriculum support them emotionally. Examples of discussion topics include: How overwhelmed do you feel as a resident; how much value do you place on time throughout the day; how much time do you take for yourself, and how do you find solitude and well-being in these moments; do you feel supported; how do you deal with stress; what is the purpose of the workshop for you as a resident; how will these methods help to be present to patients, families, and residents themselves? Preliminary analysis of curriculum feedback reveals that NM workshops help with coping with stress, give time to relax and self reflect, and increase positive physician/patient engagement. Ongoing data collection will contribute to further analysis as workshops progress. Given the high stress, anxiety-provoking environment that is a fact of residency, a comprehensive wellness curriculum is known to strengthen resident well-being. Incorporating a NM component into a wellness curriculum could teach residents to listen and reflect, improve humane and effective communication, promote more meaningful patient interactions, and foster resilience among pediatric residents.

Modern Learning: How Today’s Obstetrics and Gynecology Residents Gain Knowledge [2I

INTRODUCTION: Little is known about OB-GYN residents’ habits or preferences with regard to self-education. We investigated current resident learning behaviors and preferences, as well as attitudes towards podcasting as an educational tool. METHODS: A 28 question survey was generated to query resident self-education generally and genetics education specifically. An invitation to complete the online survey was sent to all ACGME Program Directors, asking them to forward the survey to their residents. Data was collected and analyzed using Qualtrics Software. RESULTS: 195 residents from 51/292 (17.5%) programs participated in the study. Average age was 28.9 years (SD 2.3 years), 85% were female, 13% were male. Half of residents (51%) reported spending between three and five hours a week on self-directed learning activities, excluding lectures, with 31% spending even less time, between zero and two hours. Residents reported they most commonly used UptoDate (129, 66%), Google (121, 62%), and Guidelines/Practice Bulletins (100, 43%) for learning. Guidelines and Practice Bulletins were considered very helpful for learning by 86% (167/195) followed by UpToDate (151, 77%). Only 35% (70) found textbooks helpful. A majority of residents reported they would be very likely to complete residency curriculum podcasts lasting 10 minutes (78%) or 20 minutes (63%). Residents would listen to podcasts while commuting to work (142, 78%), doing household chores (104, 53%), or exercising (50%). CONCLUSION: Residents spend five hours or less on self-education per week, and prefer concise, easily accessible learning modalities. Podcasts may be a useful educational tool for the modern OB-GYN resident.

A Prospective Trial: Traditional Versus Video-Based Teaching for Minimally Invasive Gynecologic Surgery [5I

INTRODUCTION: To compare traditional versus video-based education in gynecologic surgery on task-specific cognitive and surgical skills performance among millennial trainees. To evaluate the impact of learning preference on performance. METHODS: Prospective study in academic medical center. OBGYN residents and medical students on gynecology were assigned to traditional (TT) or video-based (VBT) training for total laparoscopic hysterectomy skills. TT included routine didactic and clinical instruction. VBT additionally included two types of videos: 1) cognitive, 2) psychomotor skills-based. Participants received pre- and post-intervention knowledge and skills assessments. The VARK© questionnaire determined learning preference. Change in assessment scores was compared. The relationship between learning preference, intervention group, and change in assessment scores was analyzed. RESULTS: 120 students (n=59 VBT v. n=61 TT) and 24 residents (n=12 per group) participated. Mean improvement in knowledge assessment score was 8.65 for VBT v. 7.03 for TT (p=0.02) for medical students, and 4.17 for VBT v. 4.09 for TT (p=0.98) for residents. Mean skills test score was 6.22 with VBT v. 4.28 with TT (p less than 0.001) for students, and 2.45 with VBT v. 0.36 with TT (p=0.04) for residents. Among students, as visual learning preference increased, change in knowledge assessment score increased (p=0.04, CI 0.01-0.49). A similar trend was seen with auditory learning preference (p=0.04, CI 0.01-0.56). Among residents, as auditory learning preference increased, change in skills assessment score increased (p=0.03, CI 0.08-1.34). CONCLUSION: Video-based teaching is an effective educational tool in gynecologic surgery. Cognitive and skills-based performance may be enhanced among individuals with visual and/or auditory learning preferences.

Survey of OBGYN Residents to Assess Awareness and Use of the U.S. CDC Medical Eligibility Criteria for Contraceptive Use [15A

INTRODUCTION: The CDC created the US Medical Eligibility Criteria (MEC) for Contraceptive Use in 2010 to serve as a tool for provider guidance when counseling patients with various medical conditions on safe use of contraception. Our study sought to assess US OB/GYN residents’ knowledge and use of this tool and how they choose to use it. METHODS: All US OBGYN residency program coordinators were emailed and asked to distribute a link to our online survey to their residents. Descriptive statistics and Fisher’s exact test were used to analyze the results. RESULTS: Ninety responses were obtained. Of the respondents, 91% were aware of the MEC, and 82% had used them. Of those who had used the MEC, 61% used the free smartphone app. Of those who did not use the MEC, most used UptoDate or asked a colleague to obtain contraception counseling information. There was no significant difference in use of the MEC among programs with and without Family Planning Fellowships or Ryan Programs. CONCLUSION: Most respondents were aware of and using the MEC, most often the downloadable smart-phone app. Due to a low response rate, additional assessment of resident use of the MEC is needed to fully understand how to improve OBGYN awareness and use of the MEC.