Laparoscopy training in United States obstetric and gynecology residency programs.

OBJECTIVES: To assess laparoscopic training curriculums in US Obstetrics and Gynecology residency programs. METHODS: A list of E-mail addresses was obtained for the accredited Obstetrics and Gynecology residency programs in the US from the CREOG Directory of Obstetric-Gynecologic Residency Programs and Directors. An E-mail survey containing 8 questions regarding laparoscopy training was sent to all residency directors with current E-mail addresses. RESULTS: Seventy-four residency directors responded to the survey for a response rate of 41%. Residency programs from all sections of the US were included in the study. Results of the survey indicate that 69% of residency programs had implemented a formal laparoscopy training program. At least half of the program directors surveyed stated that lack of faculty time and funds were the main barriers to laparoscopic surgery training. Seventy-two percent of those surveyed thought that in the future the health-care industry would demand proof of competency in laparoscopy as standard of care. CONCLUSIONS: Most US Obstetrics and Gynecology residency programs have implemented a formal laparoscopy training curriculum, use more than one method to train their residents, and involve almost half of their faculty on average in training residents to perform laparoscopic surgery.     

Preparation and utilization of a site survey book

This paper describes a tool, the site survey book, which can be used to rapidly and efficiently prepare for a site survey. The book is a framework that incorporates all of the special requirements for emergency medicine as listed in the Director of Residency Training Programs. This framework can easily be modified to meet the needs of individual programs, yet still adhere to the director guidelines. The site survey book is designed to be updated periodically, to reflect what is occurring in the program. The report can be used as a master guide, to plan changes in the curriculum, or to plan lectures. Furthermore, it provides a ready method of rapidly acquainting residency candidates with the structure of individual training programs during the interview process.     

So you want to be a neurosurgeon: a career resource guide for successful navigation

Neurosurgery is not just about head injuries and brain tumors. It is a specialty that currently stands at the forefront of biomedical and technological developments. Modern neurosurgery requires not only creativity and perseverance on behalf of your patients but also clinical acumen, surgical judgment, and technical expertise. This career resource guides the reader through the pathway to a practice in neurosurgery.     

Addressing OB/GYN family planning educational objectives at a faith-based institution using the TEACH program

Background

Traditionally family planning education is limited for obstetrics and gynecology residents training at faith-based institutions. We describe the first formalized educational program to teach contraception, sterilization, and abortion at a Catholic institution.

Study Design

We used a six-step curricular development process to design this formal educational intervention. We created a multiple-choice test that participants completed before and after the workshop. We compared average test scores using one-way analyses of variance and assessed psychometric properties of the test.

Results

All 16 obstetrics and gynecology residents at this institution participated in the one-day educational program entitled Teaching Everything About Contraceptive Health (TEACH). Residents improved their pre-test scores, on average, from 57% prior to the workshop to 89% immediately after completion of TEACH (p<.001). Improvement persisted 10 months after completion of the program (p<.001). Psychometric assessment supported the use of the instrument with adequate question difficulty and high discrimination.

Conclusions

A one day curriculum designed to introduce family planning learning objectives at a Catholic obstetrics and gynecology residency program is feasible and results in improved resident knowledge.     

The effect of immediate versus delayed dowel space preparation on the integrity of the apical seal

This in vitro study evaluated the effect of immediate vs delayed preparation of dowel space on the integrity of the apical seal. Twenty human teeth were obturated by lateral compaction of gutta-percha and cement and stored. Two weeks later, 20 more were similarly filled. Using warm endodontic pluggers, dowel spaces were prepared so that either 3 mm or 7 mm of apical fill remained. The specimens were treated in ⁴⁵CaCl₂, horizontally sectioned, and autoradiographs were made. Analysis of the incidence and degree of microleakage showed that delayed preparations significantly increased leakage (P <.01) if only 3 mm of apical fill remained.     

Bolstering confidence in obesity prevention and treatment counseling for resident and community pediatricians

Objective

To assess whether equipping resident pediatricians and community pediatricians with both training and practical tools improves their perceived confidence, ease, and frequency of obesity-related counseling to patients.

Methods

In 2005–2006, resident pediatricians (n = 49) and community pediatricians (n = 18) received training regarding three evidence-based obesity prevention/treatment tools and responded to pre- and post-intervention questionnaires. We analyzed changes in reported mean confidence, ease, and frequency of dietary, physical activity, and weight status counseling.

Results

Baseline scores of confidence, ease, and frequency of counseling were higher in community pediatricians than residents. Mean scores increased significantly in the combined group, among residents only, and trended towards improvement in the community pediatricians following the intervention. Means for “control” questions were unchanged.

Conclusion

Training and tools for residents and community pediatricians improved their confidence, ease, and frequency of obesity-related counseling.

Practice implications

This study demonstrates that when feasible and appropriate tools and training were provided through a simple intervention, physicians gained confidence and ease and increased their counseling frequency. The results here suggest that widespread implementation of such educational interventions for community practitioners and practitioners in training could change the way physicians counsel patients to prevent the often frustrating problem of childhood obesity.     

Second trimester termination of pregnancy: a review by site and procedure type

BACKGROUND: We hypothesized that complications for second trimester terminations are higher in a low-volume residency training program than in a high-volume private practice. STUDY DESIGN: Complications and cost were compared between three groups undergoing second trimester terminations: patients undergoing dilation and evacuation (D&E) at a university hospital (Hospital D&E, n=83) or medical pregnancy termination at a university hospital (Hospital Induction, n=89) and D&E at a private outpatient facility (Clinic D&E, n=253). RESULTS: Major complications occurred in 11% of the Hospital D&E, 10% of the Hospital Induction, and 1% of the Clinic D&E patients (p=.0019). Complication rates remained statistically significant when a logistic regression model was applied to the data. The mean total charge for the three respective groups was US$4625, US$5029 and US$1105 (p<.001). CONCLUSION: Second trimester terminations of pregnancy by D&E in well-selected patients in a dedicated outpatient facility can be safer and less expensive than hospital-based D&E or induction of labor.