Gynecology Residents Research Articles

Equity in visual representation of vulvar conditions in major gynecology textbooks

ObjectivesTo evaluate images of vulvar conditions (VCs) in major gynecologic textbooks and describe the skin tone representation. MethodsImages of VCs in gynecological textbooks for medical students, obstetrics and gynecology (OBG) residents, and fellows were compiled. Texts were categorized into education levels (medical student, resident, or fellow) and selected based on the recommendations of OBG attendings and fellows at LSUHSCNew Orleans. Skin tones were scored according to the Fitzpatrick Scale (FS) and categorized as benign, infectious, inflammatory, and dysplasia/cancerous. Publishing and primary author demographics were collected. Proportional odds regression (POR) predicted FS based on image pathologies and book titles. ResultsOf 512 images selected from 21 textbooks, 77.0% [N = 395] were lighter skin tones (FS I-III). VCs were represented by the darkest skin tone (FS of VI) in 19.6% of images in texts targeting residents, compared to 8.5% and 4.5% in fellow and student textbooks, respectively (p <0.001). Compared to a cornerstone surgical atlas, the pediatric and adolescent gynecology text consisted of lighter skin tones. A prominent general gynecology text used darker skin tones. Images of infectious conditions were more likely to be darker skin tones than other VCs (p = 0.010). ConclusionsMost textbook images of VCs represent lighter skin tones, and women with darker skin are more underrepresented in texts geared at fellows and students. Inadequate exposure to the appearance of VCs on darker skin promotes and propagates racial inequities in healthcare. Medical textbooks should present visually diverse images of vulvar pathologies to train physicians to be well versed in caring for patients of all skin tones.

Preparing for the Fundamentals of Laparoscopic Surgery Exam: A Survey of Residents in Obstetrics & Gynecology

To describe the actual work-load and experience for first-time resident test takers preparing to meet the new high stakes cognitive and technical skills testing requirement for board certification in Obstetrics and Gynecology. A retrospective observational study. Participating residents completed a 2 page questionnaire about their preparation for the exam. Results are reported in aggregate. This study was conducted at the University of Texas Southwestern Medical Center, an academic medical school affiliated with both a private and public tertiary hospitals. Residents in obstetrics and gynecology who have completed their Fundamentals of Laparoscopic Surgery (FLS) certification exam between September 1, 2018 and September 31, 2019. Thirty-three PGY-2 and PGY-3 residents completed the survey. Participants spent an average of 6.7 ± 3.1 hours viewing online modules over an average of 3.6 ± 2.1 nonconsecutive days. Utilizing the campus simulation center, residents spent an average of 2.1 ± 2.1 hours on each of the 5 tasks to practice to the established proficiency score. Twenty-two out of 31 residents rated the ligating loop the easiest skill to master and 13/31 residents rated the precision cut the most difficult. The pass rate for the technical skills portion was 100% (33/33 residents) and for the cognitive portion was 93% (31/33 residents). Our data suggest that residents spent upward of 10 hours practicing to proficiency on the simulation tasks, in addition to time spent watching FLS-provided training videos. The 100% pass rate for the technical skills portion at our program may be impacted by a required technical skills curriculum that residents must complete prior to registering for the FLS exam. Obstetrics and gynecology residents and training programs will benefit from understanding the time and resources required for first-time resident test takers preparing to take the Fundamentals of Laparoscopic Surgery exam.

Practical COVID-19 Prevention Training for Obstetrics and Gynecology Residents Based on the Conceive-Design-Implement-Operate Framework.

BackgroundThe spread of COVID-19 poses a challenge for obstetrics and gynecology (O&G) residents. In order to improve the theoretical knowledge and practical skills of residents in epidemic prevention and control, reduce work pressure and improve professional skills, effective and sound training models are required to improve the protection of O&G residents from COVID-19.MethodA total of 38 standardized training O&G residents working in Shengjing Hospital of China Medical University in March 2020 was selected. They were randomly divided into intervention and control groups. The control group underwent a protection theory exposition according to the traditional training method, while the intervention group adopted a conceive–design–implement–operate (CDIO) mode, arranged training courses in combination with the O&G specialty, and completed four modules of CDIO. After the training, the theoretical knowledge and practical operation were assessed, and the work stress and occupational identity scales were assessed. The assessment results and scores of the two groups of residents were analyzed.ResultsCompared with the scores of the residents in the control group, the theoretical and technical scores of the residents in the intervention group significantly improved (P < 0.05). In the evaluation of organizational management, workload, interpersonal relationship, and doctor–patient relationship pressure, the scores of the intervention group were lower than those of the control group, with a statistical difference (P < 0.05). For the intervention group, the job stress and professional identity evaluation scores were significantly higher than those of the control group (P < 0.05).ConclusionThe CDIO model can effectively enhance the theoretical knowledge and practical skills of O&G residents in COVID-19 epidemic prevention protocols to reduce work pressure and improve professional identity. In addition, it provides new ideas, methods, and approaches for future clinical practice training.

Addressing surgical training inequities: city-wide collaboration in gynecologic surgical skills simulation for resident education

The objectives are to 1) create and implement a novel multi-institutional minimally invasive gynecologic surgical skills simulation course for first- and second-year obstetric and gynecology residents from four different residency programs, 2) address surgical training inequities by fostering a multi-institutional collaboration among different residency programs, 3) assess the efficacy of the simulation session on improving the residents’ confidence and knowledge, and 4) assess the impact of the multi-institutional collaboration on resident and faculty education. A four-hour gynecologic surgical skills simulation course for first- and second-year residents was developed by a team of gynecology faculty. The simulation course had multiple stations that focused on essential laparoscopic, vaginal and robotic surgical skills including the laparoscopic skills required for the Fundamentals of Laparoscopic Surgery (FLS) curriculum, trocar insertion, and vaginal clamp placement and suturing. There were additional interactive stations that provided education on various surgical energy modalities, hemostatic agents, and a three-dimensional virtual reality simulator for robotic surgical skills. The simulation session was piloted in September 2021 in a stand-alone simulation center. The participating residents and faculty completed a pre- and post-simulation survey. 27 first- and second-year residents participated in the course. 21 residents (78%) completed the pre-simulation survey, and 16 (59%) residents completed the post-simulation survey. On the pre-simulation survey, 15 (71%) respondents reported that they were either not familiar or slightly familiar with the FLS requirements. On the post-simulation survey, 12 (75%) respondents reported that they were moderately familiar or very familiar with the FLS requirements. 15 (94%) respondents found that the simulation session improved their overall surgical skills. Higher confidence ratings for various surgical skills were observed on the post-simulation survey compared to the pre-simulation survey. All the residents found that working with residents and faculty from different institutions was moderately to very beneficial to their learning. 13 faculty participated in teaching and 12 (92%) completed the pre-simulation survey, and 13 (100%) completed the post-simulation survey. Nearly all the faculty (92%) found that working with faculty from different institutions was moderately to very beneficial in improving their teaching skills. This novel multi-institutional minimally invasive gynecologic surgical skills simulation increased the residents’ confidence and preparedness for gynecologic surgery. Multi-institutional collaboration is a novel aspect of this simulation session which was well received by both the residents and faculty and can improve surgical training inequities.

Optimal timing of fundamentals of laparoscopic surgery (fls) in obstetrics & gynecology residency

Successful completion of Fundamentals of Laparoscopic Surgery (FLS) is required for board certification eligibility of graduating OB/GYN residents. Recommendations or requirements for when residents take the course and exam vary across programs. The aim of this study is to investigate the optimal postgraduate year (PGY) to complete FLS in order to maximize learning for trainees.

Watching surgical tapes: video playback as an educational tool for improving resident laparoscopic performance

In this single masked, randomized controlled study, we evaluate if watching video recordings of oneself performing Fundamentals of Laparoscopic Skills (FLS) exercises results in an improvement on the 30-point Global Operative Assessment of Laparoscopic Skills (GOALS) assessment among Obstetrics & Gynecology (Ob/Gyn) residents. Participants were randomized to verbal feedback only (control) or verbal feedback and watching their video recording (intervention). Each participant completed the five FLS exercises using a laparoscopic box trainer while being timed, video recorded and receiving real-time feedback from an Ob/Gyn faculty member. Baseline GOALS assessment was completed by participants and faculty evaluator. Participants randomized to the intervention were allowed to watch their video recording and the faculty evaluator was masked to this randomization. All participants then repeated the FLS exercises while being timed and this was again scored using the GOALS assessment. In addition, all participants completed a pre- and post-test survey to gauge their laparoscopic comfort level. Two-sample t-test was used to assess within-group differences in overall GOALS scores and exercise times while Wilcox Rank Sum test was used for within-group comparisons of survey responses. Between-group analysis for change in GOALS scores, exercise times and survey responses was performed using the Mann-Whitney test. Differences in variables across Post Graduate Year (PGY) levels were evaluated using ANOVA and Kruskal-Wallis tests. Twenty-three Ob/Gyn residents in the 2020-2021 academic year completed the study; 12 were randomized to the intervention and 11 received verbal feedback only. Relative to baseline, there were significant within-group improvements in the faculty (p<0.01) and self-reported GOALS scores (p<0.01). Between the groups, the intervention group improved by 3.2 points more than the control group based on masked faculty evaluation (95% CI 1.4 to 5.0 points, p<0.01). This between-group difference was not significant in resident self-scores. Overall time improved for all participants (15:54 ± 0.21 minutes pre and 13:13 ± 0.14 minutes post) but this difference was not significant between groups. Higher PGY residents reported significantly more comfort performing laparoscopic tasks, earned higher GOALS score (faculty and self-scores), and completed the first set of exercises in less time. A significant interaction between PGY and intervention was detected using 2-way ANOVA with between-group improvement in GOALS score most strongly associated with PGY4 residents (p<0.01). This suggests that while all learners objectively benefit from watching recordings of themselves performing surgical tasks, advanced learners may benefit the most when video recordings are used as an educational tool.

Current medical education and future possibilities for simulation-based hysterectomy model

Simulation is a strategy or technique for creating an experience without having to go through the actual event. Simulation provides a multidimensional safety container for learning while also opening up opportunities not available in real-world learning. Surgical education has been founded on a learning-by-doing apprenticeship approach for almost a century, with a high patient volume used to teach residents certain surgical skills step by step under various levels of supervision. This traditional paradigm is currently hampered by a number of factors: Surgical techniques have gotten increasingly difficult and specific, resulting in a decrease in the number of patients undergoing particular treatments. During the COVID-19 pandemic (Coronavirus Disease-19), there are reduction in hysterectomy surgeries. This study reviews at the impact of simulation-based hysterectomy training on the education of obstetrics and gynecology residents. The study found out that in the last ten years, simulation-based hysterectomy models, both low- and high-fidelity simulator models, from abdominal, laparoscopic, or vaginal hysterectomy simulator models, have been used in medical education to improve residents' knowledge, skills, and confidence about the instruments and procedures involved in a hysterectomy. The simulation-based hysterectomy model, when combined with a didactic lecture and real instruments for instruction, can be incorporated into the teaching curricula of Obstetrics and Gynecology residencies. In the future, we will need to develop hysterectomy simulator models and using more difficult anatomic models and simulation situations.

Obstetrics and gynecology residents' satisfaction and self-confidence after anal sphincter injury simulation-based workshop in Indonesia: a pre- and post-intervention comparison study.

PurposeObstetric anal sphincter injury is one of the most common complications during delivery. Simulation models with manikins can be used as an effective medical learning method to improve students’ abilities before encountering patients. The present study aimed to describe the development of an anal sphincter injury model and to assess residents’ satisfaction and self-confidence after a perineal repair workshop with an anal sphincter injury simulator in Indonesia.MethodsThis was a cross-sectional study with evaluation of outcomes before and after the workshop. We created a silicone-latex simulation anal sphincter injury model. Then, we validated this simulation and used it as a simulation model for the workshop. We asked residents about their satisfaction with repairing anal sphincter injuries using a simulation model and residents’ self-confidence when practicing anal sphincter injury repair.ResultsAll residents felt the simulation-based workshop was valuable (100%). Most of the scores for the similarity of the simulation model were good (about 8 out of maximum 10). The self-assessment of confidence was measured before and after the workshop. Overall self-confidence increased significantly after the workshop in identifying the external sphincter ani (EAS) (P=0.031), suturing the anal mucosa (P=0.001), suturing the internal sphincter ani (P=0.001), suturing the EAS (P<0.001), and evaluating the sphincter ani tone (P=0.016).ConclusionThe anal sphincter injury simulator improved residents’ self-confidence in identifying the EAS, suturing the anal mucosa, suturing the internal sphincter ani, suturing the EAS, and evaluating sphincter ani tone.

Analysis of the stress level of resident physician education program specialist in Obstetrics and Gynecology Andalas University in 2020

Introduction:The Specialist Doctor Education Program (PPDS) is one of the academic education of general practitioners and is known as a resident doctor to become a specialist and is at the forefront ofhealth services. Resident doctors are expected to be flexible clinicians, educators, researchers, andadministrators by the end of their residency training. It often requires stressful hard work, and is oftenreported as a cause of burnout, anxiety, depression, anger, irritability, anxiety, sleep deprivation,fatigue, substance abuse, and psychosocial problems. One of the problems that often occurs with residents is long working hours. Based on the working hours regulation adopted in the UK since 1998, namely the European Working Time Directive (EWTD) and a policy change in 2007 and 2009 called The New Deal, the working hours of resident doctors to achieve optimal performance is 56 hours per week. In the initial survey of 10 PPDS Obgin Unand residents, network station residents still had to carry out their duties 24 hours a day for 1 month in the hospital. Except for applying for certain permits. If you add up, the average working hours in 1 week is more than 60 working hours. Objective: This study aims to determine the stress level of resident doctors in the Education Program of Obstetric and Gynecology Specialist, Andalas University in 2020Methods: This research is a quantitative study followed by qualitative method using an explanatory design. Data was taken using the triangulation method. The data was taken from questionnaires, Focus Group Discussion (FGD), and document review from Obstetric and Gynecology residents of all semester at Andalas University.Results: The highest stress level in the Obstetric and Gynecology residents of Andalas University in 2020 was 60.3% at moderate level, there was a relationship between stress levels with graduation and semester. The highest stress domain is ARS (Academic Related Stressor) and SRS (Social Related Stressor).Conclusion: the stress level in the Obstetric and Gynecology residents of Andalas University in 2020 is at a moderate level, and the highest stress domain is ARS (Academic Related Stressor) and SRS (Social Related Stressor).Keywords: Resident Doctor; Obstetric and Gynecology; stress

Community-Institutional Partnerships to Strengthen Maternal Health Care: Case Study of the First Obstetrics and Gynecology Specialty Training Program in Liberia.

Despite major setbacks to its health infrastructure and health workforce capacity, Liberia began its first post-graduate training program for physicians in 2013. Specialty training in Internal Medicine, Pediatrics, General Surgery and Obstetrics and Gynecology were the four inaugural Residency programs that recruited graduates from the country's only medical school, A.M. Dogliotti College of Medicine. The Obstetrics and Gynecology residency program was designed to combat the rising maternal mortality and strengthen health systems to improve maternal care. The program adapted in the face of challenges posed by limited financial support, lack of specialist-faculty and general physician shortages and the Ebola virus outbreak. The manuscript discusses the challenges and successes of the program and demonstrates how the shortage of teaching faculty was addressed by developing a collaboration between local government and educational communities, a United States (US) academic institution and volunteers from the Global Health Service Partnership.

A Study to Evaluate the Practice and Training in Obstetric Ultrasound at Accredited Obstetrics and Gynaecology Training Institutions in Nigeria.

There is a global trend towards domiciling Obstetric and Gynaecologic ultrasound scan services and training within the Obstetrics and Gynaecology Department. This requires readiness on the part of the Obstetrics and Gynaecology residency programmes to offer hands-on training and mentorship to its trainees. This study aims to assess the services and training potential of these centres in Obstetrics and Gynaecology ultrasound in Nigeria. A cross-sectional descriptive questionnaire-based survey among the various tertiary health facilities which offer post graduate fellowship training in Obstetrics and Gynaecology in Nigeria was conducted. A list of all the centres accredited for obstetrics and gynaecology residency training by the National Postgraduate Medical College of Nigeria was obtained. An obstetrician was identified, and a pretested self-administered questionnaire was mailed to him as a hard copy and an electronic copy was forwarded as well. The questionnaire was filled by the Obstetrician and returned for collation. The completed forms were populated into an excel spreadsheet and summary and descriptive statistics carried out. There was a valid 71% response rate from the 56 accredited centres. Thirty five percent of the centres had established subspecialty units. Only 10% had fully functional ultrasound service that catered for over half of their clients. Half of the responding centres did not have any ultrasound scan machines, and these too lacked any trained personnel in ultrasound within the department. Nearly all respondents supported the drive towards an obstetrician led ultrasound scan service but majority cited lack of protocols, trained personnel and dedicated time as major impediments to achieving this ideal. There is a lack of preparedness for domestication of obstetric ultrasound service and training in the obstetrics and gynaecology Department in Nigeria. There is the need to address the acute shortage of personnel to expand the frontiers of ultrasound service and training.

July Effect in Obstetric Outcomes.

ObjectiveThe July effect represents the month when interns begin residency and residents advance with increased responsibility. This has not been well studied in Obstetrics and Gynecology residencies and no study has been conducted evaluating obstetric outcomes. The purpose of this study was to evaluate the July effect on obstetric outcomes. Women who delivered between July and September (quarter 1) were compared to those delivering between April and June (quarter 4).MethodsThis retrospective cohort study compared outcomes of deliveries between quarter 1 and quarter 4 from 2017 to 2020. Outcomes evaluated were postpartum length of stay (LOS), postpartum readmission, wound complication, wound infection, blood transfusion, estimated blood loss, 3rd and 4th degree lacerations, 5 min APGAR scores, and cesarean delivery rates.ResultsThere were 3693 deliveries in quarter 1 and 3107 deliveries in quarter 4. There was a higher incidence Of wound infection during the April–June period (N = 21; 0.68%) compared to July–September (N = 10; 0.27%; p = 0.0135). Although LOS for both periods were the same, the average postpartum LOS during July–September was slightly longer than April–June (1.7 days; SD = 1.1 vs 1.6 days; SD = 1.2; p = 0.0026). All other pregnancy outcomes were similar between the two groups.ConclusionOverall, the July effect is minimal on obstetric complications. However, LOS between July and September may differ because all residents are less experienced in quarter 1. Wound infection rates were higher in April–June, perhaps because new PGY-1s went from assisting to primary on cesarean surgeries starting in the 4th quarter of the year.

Burden of Women's Infectious Disease and Analysis of Current Awareness and Value Perceived of the Obstetrical and Gynecological Specialty

Aim: Given the relevance of irresistible infections to the wellbeing of women, we intended to evaluate the current attentiveness, interest and relevance of the unresisted obstetrical and gynecological infection among the residents and residents of contemporary obstetrics and gynecology. Methods: Two independent assessments which deal with attention, appreciation. Sub-specialty premiums were also sent out to (1) an irregular 22 percent sample of residents in obstetrics and gynecology and (2) all Gynecology obstetrics mailed out. Results: More than two-thirds of the chief students in the scientific section were aware of the specialty and 68,2% respected compelling disease experts. About a third of the employees were attentive to the specialization. The formal training of clinical specialists in the field of intractable diseases was reported by thirty-six percent of chief residents. Conclusion: Pakistani obstetrics and residents of gynecology and leaders have little knowledge of the sub-specialty. There is an open specialty to formal instruction by practitioners skilled in the field for residents in irresistibly infected object ology and gynecology. These findings may lead to continuous enrollment efforts in obstetrical and gynecology sub-specialties of irresistible diseases. Keywords: Women's Infectious Disease, Obstetrical and Gynecological Specialty, Pakistani Population.

Assessment of Resident Burnout After Formalization of Wellness Program.

Burnout has reached epidemic levels among resident physicians. Characterized by emotional exhaustion (EE), depersonalization, and feelings of inefficacy, burnout negatively affects patient outcomes, increases costs, and decreases physician quality of life. These negative outcomes catalyze leaders in graduate medical education to address burnout and reverse its trends. The primary aim of this project is to design a residency Wellness Program utilizing the facets of physician wellness, assess levels of burnout among resident physicians, and determine the program's effects on burnout. A Wellness Program was formalized at a Midwestern, military-civilian Obstetrics and Gynecology residency program for the 2019-2020 academic year. Resident wellness and perceptions were assessed at three time points (0, 6, and 12 months) through surveys consisting of free response, yes-no questions, and the Maslach Burnout Inventory Scales. On average, 17 of 24 residents completed all three survey assessments. Perception of the residency program prioritization of wellness increased significantly from 52.9% to 94.4% (P = .007). Residents consistently demonstrated burnout throughout the year with low levels of EE, high levels of depersonalization, and moderate levels of personal achievement. Residents were consistently satisfied with their personal wellness (80%-92.9%) during the program. Residents wanted to see physical activity incorporated into the program. This study assessed burnout during a formalization of a Wellness Program and insight on resident perceptions and wellness requests. Military medicine, graduate medical education, and other residency programs can utilize this research to better develop and study the implementation of wellness initiatives aimed at reducing burn out.

Sex and Racial/Ethnic Diversity in Accredited Obstetrics and Gynecology Specialty and Subspecialty Training in the United States

To compare trends in racial and gender diversity in Obstetrics and Gynecology (OBGYN) residency and fellowship programs from beginning of program accreditation in 2012 to the most recently published report for 2018. Data was abstracted in August 2020 from publicly available reports on the Accreditation Council for Graduate Medical Education (ACGME) website. Reports from 2012 to 2018 were compared with Chi-square tests and the Cochran-Armitage trend test assessed trends over time. U.S. medical residents and fellows, with a focus on those in accredited OBGYN fellowship programs (Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Gynecologic Oncology (GYNONC), Maternal Fetal Medicine (MFM), and Reproductive Endocrinology and Infertility (REI)). From 2012 to 2018 men in all residency programs increased 0.88% (from 53.92% male to 54.80%, p < 0.0001). Across all years there were less men in OBGYN (16.89%) compared to all residency programs (54.39%, p < 0.0001). All OBGYN fellowships combined had more men proportionately than OBGYN residencies (24.14% vs. 16.89%, p < 0.0001). MFM had the most men (26.7%) then GYNONC (25.18%), FPMRS (21.36%), and REI (20.09%) (p = 0.024). There were no statistically significant trends in sex or race over time. From 2012 to 2018 residents overall were 42.96% white. OBGYN residents overall were 54.20% white. GYNONC had the highest percentage of white trainees (73.45%), followed by MFM (67.8%), REI (65.62%), then FPMRS (60%) (p = 0.0003). According to ACGME core competencies, residents are expected to demonstrate sensitivity and responsiveness to diverse patient populations (professionalism) and advocate for improvements to systems-based practice. These results may suggest systemic issues in the recruitment of women and people of color into competitive sub-specialty programs. Such deficiencies in representation can impact patient care. Future research is needed to assess trends over time as data become available and to evaluate specific barriers to applications and selection of minority applicants.

Analysis of Service Quality and Resident Supervision in Accordance with Hospital Accreditation Standards

Background &#x0D; Resident supervision plays an important role in accomplishing service excellence in teaching hospitals, while still supporting residents’ competency achievement. This preliminary study aims to obtain an overview of resident supervision and the achievement of quality services to conduct hospital accreditation standard.&#x0D; &#x0D; Material and methods&#x0D; A retrospective study with a cross-sectional design was conducted in May 2020 involving Obstetrics and Gynecology residents who carried out a Caesarean section. Data was collected from medical records manually, with additional information from Obstetrics and Gynaecology Department. Univariate analysis was completed to generate a profile of supervision and the achievement of quality services in accordance with hospital accreditation standard.&#x0D; &#x0D; Result&#x0D; Of the 86 Caesarean sections conducted in May 2020, only 75 involved residents, with 42 (56%) procedures carried out by chief residents and 33 (44%) by apprentice stage residents. Supervision during procedures was carried out in 74 cases (98.6%), with 33.3% given moderate-high supervision during hospitalization, 52% moderate low, and 14.7% low supervision. The completeness of the medical records revealed 85,3% appropriate marked site, 96% surgery reports, 78,7% education sheet. It is found that 64 % of pre-operative visits and 65,3% of post-operative visits were carried out by residents. In addition, case discussion, death case reports, as well as resident evaluation were carried out to conduct patient safety and quality service improvement.&#x0D; &#x0D; &#x0D; &#x0D; Conclusion&#x0D; Supervisory evaluation could be provided directly or by conducting case discussions, as well as medical record review; otherwise, to enhance quality achievement, the development of an integrated supervision system is required.

Mentalization-Based Treatment for a Physician With Borderline Personality Disorder.

Mentalization-Based Treatment for a Physician With Borderline Personality Disorder.

Vaginal Delivery of the Second Twin: A Simulation Program for Residents in Obstetrics and Gynecology in a Type III University Maternity Hospital

Vaginal Delivery of the Second Twin: A Simulation Program for Residents in Obstetrics and Gynecology in a Type III University Maternity Hospital

The blame game- experiences of female residents in obstetrics & gynecology regarding lapses in patient safety.

Objectives:Primary objective was to explore experiences of female residents of Obstetrics and Gynecology (OB/GYN) regarding lapses in patient safety (PS) while secondary objective was to explore factors hampering or favouring improvement of PS in OB/GYN.Methods:In this qualitative narrative study carried out in OB/GYN department of Combined Military Hospital (CMH) Lahore for six months from 1st April to 30th September 2021, six fourth-year residents were asked to write narratives of their personal experiences of medical error (witnessed or committed) in detail and reflect on those experiences, which were then transcribed. Code labels and themes were assigned manually. Interpretation of these themes was done after thematic content analysis.Results:Six, fourth-year female residents with a mean age of 28.6±1.8 participated in the study. Two main themes with sub-themes were identified: 1) Challenges in patient safety (Personal challenges, Workplace challenges, Barriers to PS), 2) Lessons learnt from experiences (Self-improvement and; Promotion of patient safety culture). Heavy workload with long working hours, lack of communication and teamwork, lack of experience and inadequate supervision were major factors involved in PS lapses experienced by residents.Conclusion:Incidents of Patient Safety (PS) lapses had a strong impact on the emotional and professional life of residents. Formal PS training with improvement of working conditions may help promote PS culture.

Senses and meanings of medical professionalism for gynecology and obstetrics residents

Resumo: Introdução: Profissionalismo é condição essencial para a atuação do médico. A especialidade de ginecologia e obstetrícia (GO) tem sido marcada por uma demanda crescente de processos disciplinares. Diante dessa realidade, o Colégio Americano de Ginecologia e Obstetrícia (ACOG) recomendou registrar comportamentos destrutivos ou hostis que afetem a segurança do paciente e a qualidade do cuidado, remediá-los e educar o corpo clínico de instituições sobre isso. Apesar da importância do profissionalismo para a formação dos futuros profissionais, a ausência de consenso sobre a definição e os modos de mensuração desse aspecto dificulta a implementação de ações direcionadas voltadas a esse fim. Objetivo: Este estudo teve como objetivo conhecer os sentidos e significados atribuídos pelos residentes de GO ao profissionalismo médico. Método: Realizou-se estudo exploratório, qualitativo, por meio de grupos focais, com 21 residentes de GO de Fortaleza, no Ceará, no Brasil. A análise de conteúdo na modalidade temática respaldou a análise dos dados, e a interpretação amparou-se no interacionismo simbólico. Resultado: Os sentidos e significados atribuídos pelos residentes ao profissionalismo expressaram-se em quatro temáticas: conjunto de condutas em benefício do paciente; relação médico-paciente e com a equipe de trabalho; conjunto de atributos profissionais; e exercício moral e ético da profissão. Conclusão: O profissionalismo é entendido como um conjunto de características que incluem a formação integral do médico, a partir de competências, conhecimentos científicos, valores, habilidades técnicas e raciocínio clínico, possibilitando o exercício da medicina com respeito, moral e ética.