Enhancing Postgraduate Training in Pediatric and Adolescent Gynecology: Evaluation of an Advanced Pelvic Simulation Session

Study ObjectiveTo describe and evaluate a Canadian simulation session designed to teach pediatric and adolescent gynecology (PAG) history taking, examination and operative skills, and an approach to the child and adolescent.DesignObstetrics and gynecology residents in a single academic center participated in a PAG simulation session and rated their gain in knowledge on 6 aspects of PAG care.SettingAcademic half-day at the University of Ottawa Skills and Simulation Centre.ParticipantsTwenty-four Obstetrics/Gynecology residents at the University of Ottawa.InterventionsParticipants completed 4 stations teaching PAG-appropriate history taking, genital examination, Tanner staging, vaginal sampling and flushing, hymenectomy, vaginoscopy, laparoscopic adnexal detorsion, and approach to the child/adolescent. Advanced pelvic models were used for procedure specific stations. Participants completed an anonymous evaluation form at the end of the session.Main Outcome MeasureSelf-perceived increase in knowledge and PAG specific skills after the simulation session.ResultsTwenty-four residents completed the simulation session and post-session evaluation. All residents (100%) agreed that they had gained knowledge in PAG history taking, examination techniques, office procedures, operative skills, approach to child, and approach to the adolescent. Qualitative feedback stressed the excellence of instruction, interaction, immediate feedback, and hands-on experience. All residents (100%) stated the PAG simulation session should continue.ConclusionsThis advanced PAG simulation session increased resident self-perceived knowledge. Other obstetrics/gynecology training programs should consider implementing advanced PAG simulation sessions to increase resident knowledge and confidence in delivering care to the pediatric/adolescent patient.     

Reliability Study for Pediatric and Adolescent Gynecology Case-Based Learning in Resident Education

ObjectiveTo assess web-based teaching as a tool for resident education in pediatric and adolescent gynecology.Study DesignProspective Cohort involving 12 third year OB/GYN residents in a large university-based program. A second look reliability study on a previously utilized, web-based teaching case series in Pediatric and Adolescent Gynecology topics was evaluated. Residents' knowledge regarding the subject matter was assessed by pretest. After completion of the web-based teaching tool, a post test was administered. Residents were also given an opportunity to provide feedback regarding improvements to address future case series development for the tool and resident satisfaction in using this resource for resident education.ResultsThe pre-test group mean score was 11.2 (58.9%), SD = 1.9. The post-test group mean score was 15.2 (80%), SD = 1.70. (P = 0.0002). Resident participants universally reported the case series was a useful teaching tool. Pooled results from 2005–2006 and 2007–2008 also yielded statistically significant scores from pre test to post test (power of >80% at the 95% confidence interval).ConclusionA computer-based learning tool is an effective resource to improve baseline knowledge among ob-gyn residents in the subspecialty field of Pediatric and Adolescent Gynecology.     

Does an Advanced Pelvic Simulation Curriculum Improve Resident Performance on a Pediatric and Adolescent Gynecology Focused Objective Structured Clinical Examination? A Cohort Study

Study ObjectiveTo determine the effect of an advanced pelvic simulation curriculum on resident performance on a pediatric and adolescent gynecology (PAG) focused objective structured clinical examination (OSCE).DesignObstetrics and gynecology residents in a single academic Canadian center participated in a PAG simulation curriculum. An OSCE on prepubertal vaginal bleeding was administered at the biannual OSCE examination 2 months before the simulation curriculum and again 3 months after the simulation curriculum.SettingAcademic half-day at the University of Ottawa Skills and Simulation Centre.ParticipantsObstetrics and gynecology residents from the University of Ottawa.InterventionsParticipants completed 4 stations teaching PAG-appropriate history-taking, genital examination, Tanner staging, vaginal sampling and flushing, hymenectomy, vaginoscopy, laparoscopic adnexal detorsion, and approach to the child and/or adolescent. Advanced pelvic models were used for procedure-specific stations.Main Outcome MeasuresThe primary outcome measure was change in mean score on a prepubertal vaginal bleeding OSCE station. Secondary outcome measures were changes in individual component scores.ResultsFourteen residents completed the simulation curriculum and the PAG OSCE at the 2 separate time points (before and after simulation curriculum). The mean OSCE score before the simulation curriculum was 54.6% (20.5 of 37) and mean score after the curriculum was 78.1% (28.9 of 37; P < .001). Significant score increases were found in history-taking, examination, differential diagnosis, identification of organism, surgical procedures, and identification of foreign body (P < .01 for all).ConclusionThis innovative PAG simulation curriculum significantly increased residents' knowledge in PAG history-taking, examination skills, operative procedures, and approach to the child and/or adolescent. Obstetrics and Gynecology Program Directors should consider incorporating PAG simulation training into their curriculum to ensure that residents meet their learning objectives and increase their knowledge and confidence, which will ultimately benefit patient care.     

Impact of a Pediatric and Adolescent Gynecology Curriculum on an Obstetrics and Gynecology Residency

Study ObjectiveTo determine the effectiveness of a new pediatric and adolescent gynecology (PAG) curriculum for improving obstetrics/gynecology resident physician knowledge and comfort level in patient management and to describe the current deficiencies in resident physician knowledge and comfort level in PAG.DesignA PAG curriculum was implemented for the obstetrics/gynecology resident physicians (n = 20) at the University of South Florida in July 2013. Before and after the curriculum was introduced, resident physicians and recent graduates of the residency program completed a survey to assess their comfort level and a knowledge assessment consisting of 20 case-based questions.SettingUniversity-based residency program.ParticipantsResident physicians and recent resident physician graduates in the Department of Obstetrics and Gynecology.InterventionsIntroduction of a PAG curriculum during the 2013-2014 academic year.Main Outcome MeasuresImprovement in resident physicians' comfort level and knowledge in PAG.ResultsAfter the curriculum was introduced, comfort increased in examining the genitals of a pediatric gynecology patient (median difference = 1.5; P = .003) and history-taking, physical examination skills, and management (median difference = 1; P = .002) compared with before the curriculum. There was no significant difference in overall quiz score (15.5 ± 1.87 vs 15.8 ± 1.3; P = .78).ConclusionA curriculum in PAG did improve resident comfort level in managing PAG patients, but did not significantly improve knowledge of this topic.     

Does the North American Society for Pediatric and Adolescent Gynecology Short Curriculum Increase Resident Knowledge in Pediatric and Adolescent Gynecology?

Study ObjectiveTo determine if the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum improves self-reported knowledge in pediatric and adolescent gynecology (PAG) among obstetrics and gynecology (Ob/Gyn) residents, at programs without PAG-trained faculty.DesignProspective, cross-sectional exposure to the NASPAG short curriculum with a follow-up questionnaire.SettingOb/Gyn residency training programs without PAG faculty.ParticipantsOb/Gyn residents in training from February 2015 to June 2015.InterventionsExposure to the NASPAG Short Curriculum.Main Outcome MeasuresImprovement in self-perceived knowledge after completion of curriculum.ResultsTwo hundred twenty-seven residents met inclusion criteria; 34 completed the study (15% response). Less than 50% of residents reported adequate knowledge in the areas of prepubertal vaginal bleeding, vulvovaginitis, precocious and delayed puberty, Home environment, Education and Employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide/depression, Safety from injury and violence (HEEADSSS) interview, pelvic pain, and bleeding management in teens with developmental delay. After completion of the curriculum, self-reported knowledge improved in 8 of 10 learning objectives, with no significant improvement in bleeding disorders or Müllerian anomalies. There was no association between pretest knowledge and level of residency training, type of residency program, previous exposure to PAG lectures, and previous exposure to patients with PAG complaints.ConclusionSignificant deficiencies exist regarding self-reported knowledge of core PAG topics among Ob/Gyn residents at programs without PAG-trained faculty. Use of the NASPAG Short Curriculum by residents without access to PAG-trained faculty resulted in improved self-reported knowledge in PAG.     

Pediatric and Adolescent Gynecology Practices: A National Survey of Canadian Gynecologists

ObjectiveTo identify 1) the current state of pediatric and adolescent gynecology (PAG) provision of care; 2) barriers to practicing PAG; and 3) the need for increased PAG training in residency and continuing medical education (CME).MethodsObstetricians and gynecologists (OB/GYNs) across Canada who currently practice gynecology were asked to complete an anonymous, self-administered, Internet-based survey.ResultsOne-hundred and forty-seven OB/GYNs across Canada responded to the survey, and after applying exclusion criteria (retired gynecologists, medical students, postgraduate trainees, gynecologists who do not currently practice gynecology, PAG specialists, or OB/GYNs seeing predominantly pregnant adolescent women), 135 were included. Seventy-six percent of survey respondents stated that they care for pediatric and adolescent patients in their practice. The pathologies and surgeries they are comfortable managing are those that are similar to the adult population, such as intrauterine device insertion in the office/OR, adnexal detorsion, laparoscopy in patients over 12 years of age, examination under anesthesia, and hymenectomy. Respondents who stated wanting to learn more about PAG preferred either online learning modules (85%) or CME workshops at regional meetings (91%).ConclusionCanadian OB/GYNs provide PAG care with very little training to support their work. Attention must be given to better training for our residents via available curriculums and teaching modalities, as well as increased access to CME for OB/GYNs.     

Improving Resident Knowledge in Pediatric and Adolescent Gynecology: An Evaluation of the North American Society for Pediatric and Adolescent Gynecology Short Curriculum

Study Objective

Resident education in pediatric and adolescent gynecology (PAG) is challenging. It encompasses patients from neonates to young adults with different disorders involving multiple subspecialties. Residents have inadequate exposure to PAG topics and report lack of knowledge in this area. The objective of this study was to determine if the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum improves self-reported knowledge in PAG among obstetrics and gynecology (ObGyn), family medicine, and pediatric residents.

Identifying a Knowledge Deficit among Pediatric and General Practitioner Trainees in Pediatric and Adolescent Gynecology in an Irish Hospital: A Pilot Study

Study ObjectiveWe aim to show that there is a knowledge deficit among pediatric and general practitioner (GP) trainees in pediatric and adolescent gynecology (PAG) and that this has implications for increased morbidity in girls.Design, Setting, Participants, Interventions, and Main Outcome MeasuresIn October 2019 in a tertiary Irish pediatric hospital 50 junior doctors were approached (of a possible 66) and were surveyed in their knowledge of PAG with a written 21-question questionnaire incorporating 10 topics.ResultsForty candidates participated (n = 31 pediatric and 9 GP). Sixty percent (n = 24/40) incorrectly misdiagnosed vulvovaginitis as candida; 80% (n = 32/40) could not identify labial adhesions; 47.5% (n = 19/40) were unable to define heavy menstrual bleeding. All of the GP trainees (n = 9/9) said they would prescribe the oral contraceptive pill compared with 51.6% (n = 16/31) of pediatric trainees; 52.5% (n = 21/40) did not consider sexually transmitted infection screening; and 70% (n = 28/40) could not identify female genital mutilation. There was generally no statistically significant difference between GP and pediatric trainees.ConclusionA knowledge deficit among trainees was evident in relation to PAG from common to rare, but serious PAG conditions. Misdiagnosis and delayed treatment could lead to increased morbidity for girls. We recommend the introduction of a standardized training program in PAG for trainees.     

Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum 2.0

The degree of exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology and pediatrics. Nevertheless, these programs are responsible for training residents and providing opportunities within their programs to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG resident education by creating and systematically updating the Short Curriculum. This curriculum outlines specific learning objectives that are central to PAG education and lists essential resources for learners' reference. This updated curriculum replaces the previous 2014 publication with added content, resources, and updated references. Additionally, attention to the needs of learners in pediatrics and adolescent medicine is given greater emphasis in this revised North American Society for Pediatric and Adolescent Gynecology Short Curriculum 2.0.     

Postgraduate Training in Pediatric and Adolescent Gynecology: Trainees' Perspectives

ObjectiveThe purpose of this study was to evaluate resident trainees’ perspectives on the pediatric and adolescent gynecology (PAG) training in obstetrics and gynecology training programs in Europe.Study DesignThis study was a cross-sectional survey using an online questionnaire, on the basis of the PAG training in obstetrics and gynecology section of the European Board & College of Obstetrics and Gynaecology Project of Achieving Consensus in Training curriculum. We aimed to survey the national programs in 35 European Network of Trainees in Obstetrics and Gynaecology (ENTOG) member countries. Taking part in the survey was voluntary. The questionnaire was shared on the ENTOG online platforms.ResultsNinety obstetrics and gynecology trainees in 33 of 35 countries responded to our questionnaire. Of the 35 ENTOG member countries, 33 participated in the survey, and a total of 90 responses were collected, giving a response rate of 9% of all European trainees and representing 94% of the member countries. Only 27% of trainees reported having a PAG rotation during their training program, and a PAG elective was only available to 34% of the trainees. Forty-one percent reported that PAG training was not included in their curriculum (no official rotations or lectures planned). Despite the lack of formal training, 72% of trainees felt able to diagnose and manage prepubertal vaginal bleeding and adnexal masses in children and adolescents by the end of their training. Most (58%) also confirmed that they could determine indications for treatment of vulval, vaginal, perineal, and rectal conditions.However, despite scoring positively for the management and counseling of subjects that often overlap with adult patients, such as “contraception in adolescents with health problems,” “acute abdominal pain,” “menstrual abnormalities,” and “vaginal discharge,” the study revealed poorer scores when the trainees were asked about more specific PAG topics such as “premature puberty” and “developmental disorders of the genital tract.”ConclusionMost core training programs across Europe do not include formal PAG training, and trainees reported a need to improve the provision of core PAG training in Europe.     

Pelvic anatomy for obstetrics and gynecology residents: an experimental study using clay models

OBJECTIVE: To determine whether clay modeling with lecture is more effective than lecture alone in teaching female pelvic anatomy. METHODS: A pretest preceded a lecture on female pelvic anatomy in the following five groups of obstetrics and gynecology residents: postgraduate year 1 (PGY-1) residents at Women and Infants Hospital of Rhode Island (RI), PGY-1 residents at University of Connecticut (CT), and PGY-2, -3, and -4 residents at RI. The study group (PGY-1 RI) also participated in a clay modeling session. Both groups of PGY-1 residents were tested immediately (posttest 1) and then 8 weeks later (posttest 2). The PGY-2, -3, and -4 residents had only posttest 2. Data were analyzed with parametric, nonparametric, and repeated measures analyses. RESULTS: There was no significant difference between the mean pretest scores of the five groups. The study group showed significant improvement in mean scores at posttest 1 (29.7 +/- 0.9, P <.001) and at posttest 2 (24.1 +/- 4.6, P =.03) compared with the mean pretest score (17.4 +/- 3.7). The CT residents demonstrated significant improvement in mean scores at posttest 1 (25.2 +/- 4.4, P =.02) but not at posttest 2 (19 +/- 3.7, P =.2) compared with their mean pretest score (15.2 +/- 2.9). There was no significant improvement in the mean scores at posttest 2 for PGY-2, -3, and -4 resident groups compared with their pretest scores. CONCLUSION: Clay modeling with lecture was more effective than lecture alone for teaching pelvic anatomy.     

Female Pelvic Floor Immersive Simulation: A Randomized Trial to Test the Effectiveness of a Virtual Reality Anatomic Model on Resident Knowledge of Female Pelvic Anatomy

Study ObjectiveTo estimate the effect of a virtual reality (VR) anatomic model (VisCubeSX; VisBox, Inc., Saint Joseph, IL) on obstetrics and gynecology residents’ knowledge of female pelvic floor anatomy compared with a traditional curriculum.DesignRandomized controlled trial (Canadian Task Force classification I).SettingAcademic obstetrics and gynecology resident training program.InterventionsTraditional independent study curriculum versus traditional curriculum and VisCubeSX VR curriculumMeasurements and Main ResultsResidents were randomized, stratified by year of training, in a 1:1 fashion to traditional independent study curriculum for pelvic anatomy versus traditional curriculum and the VisCubeSX VR anatomic model. Tests were administered to assess baseline and postintervention knowledge. A postintervention assessment of the VisCubeSX VR anatomic model was performed. Baseline, follow-up, and score improvement were compared between groups using Student t tests and Wilcoxon rank sum tests. Thirty-one residents were randomized. There was a significant improvement in pre- and post-test scores within traditional independent study curriculum participants, 8.1 ± 12.0 points (p = .02), and the VisCubeSX group 8.7 ± 6.4 points (p <.001), but these improvements did not differ between groups (p = .86). This lack of between-group differences was consistent in resident year-stratified analyses. Residents exposed to the VisCubeSX VR anatomic model reported they “somewhat” or “strongly agree” (15/16 [93.8%] and 14/16 [87.5%] of residents, respectively) that the model improved their knowledge of pelvic anatomy and that the model will improve patient care.ConclusionFew studies exist that compare educational outcomes of a traditional independent study of female pelvic anatomy curriculum versus immersive simulation with VR models in female pelvic anatomy. Knowledge scores were not significantly increased with the VR model compared with traditional curriculum, but VR technology was perceived as an enhancement to short-term learning.     

An interactive computer program for teaching residents pap smear classification, screening and management guidelines: a pilot study

OBJECTIVE: To assess the feasibility, utility and resident attitudes towards an interactive, Web-based computer learning program. STUDY DESIGN: Pretest/ posttest evaluation of an interactive curriculum to teach current recommendations for cervical cancer screening and classification and management of abnormal Pap smears. Thirty-five Obstetrics and Gynecology (OB/ GYN) residents were encouraged to complete a Web-based computer program that consisted of a pretest, 9 educational sections (3 didactic and 6 case based), a posttest and an exit survey. Clinical cases involved virtual case management of patients' cytologic, histologic and colposcopic images. Mastery was set at 82% (or 23/28 correct answers). RESULTS: Thirty-one of the 35 residents (89%) completed the curriculum. No resident demonstrated mastery (82%) on the pretest; 15 of 31 residents demonstrated mastery on the posttest (p = 0.04). Mean improvement for all residents was 9 additional questions answered correctly. All the residents thought that the Web site was useful and covered all the learning objectives and would recommend it to other residents. CONCLUSION: A program to teach current cervical cancer screening, classification and abnormal Pap smear management guidelines was useful, feasible and well accepted by residents in this population.     

Pediatric and Adolescent Gynecology in Europe: Clinical Services,Standards of Care,and Training

Study ObjectiveTo identify current clinical services and training available across Europe within pediatric and adolescent gynecology (PAG) and establish the extent to which PAG services meet current European Board and College of Obstetrics and Gynecology (EBCOG) standards.DesignQuantitative and qualitative questionnaire.SettingEuropean countries that are members of the EBCOG and the European Association of Pediatric and Adolescent Gynecology.ParticipantsThirty-six countries that were approached beginning in September 2013; data were obtained from 27 countries.InterventionsQuestionnaires with 28 stems were sent to clinical leaders in 36 European countries.Main Outcome MeasuresNational society, national standards, legislation for female genital mutilation, protocols for transition to adult services, human papilloma virus vaccination programs, sex and contraception education, safeguarding, clinical leads for PAG, delivery of PAG services, and training available for PAG.ResultsOf 36 countries, 27 responded. Seventy-seven percent had a national PAG society but only 44% had national standards in PAG. There was agreement that PAG cases should be multidisciplinary but not all have clinical networks in place to facilitate this. Human papilloma virus programs are available in some European countries and not all have legislation against female genital mutilation. A significant proportion of cases continue to be seen in adult gynecology clinics as opposed to designated PAG clinics with only 41% with processes to transfer patients into adult care.ConclusionIn this article we provide a framework to explore areas for improvement within PAG services and training across Europe. The EBCOG standards of care are not being adhered to in many countries because processes and clinical networks are not in place to facilitate them.     

High-Fidelity Hybrid Simulation: A Novel Approach to Teaching Pediatric and Adolescent Gynecology

Study Objective

To describe a hybrid simulation model for pediatric and adolescent gynecology (PAG) examination teaching, to evaluate if it would be feasible to be conducted as a part of the PAG training, and to find out how it would be perceived by the trainees.

Sexual abuse knowledge base among residents in family practice, obstetrics/gynecology, and pediatrics

STUDY OBJECTIVE: To investigate resident physician knowledge about sexual abuse prevalence and understanding about potential perpetrators. DESIGN: Questionnaires were mailed to program directors in family practice, obstetrics and gynecology, and pediatric residency programs. PARTICIPANTS: The questionnaires were distributed to senior residents in their final months prior to graduation.Interventions: Residents were asked to fill out the questionnaire anonymously and return it to our institution in the prepaid envelope provided. MAIN OUTCOME MEASURES: Demographic characteristics and knowledge of sexual abuse prevalence and perpetrator characteristics were assessed. Chi-square contingency table analysis was used to compare responses of the three specialties. RESULTS: The overwhelming majority (98.8%) of residents correctly identified a family member as the individual most likely to sexually abuse a child. Approximately half of the residents knew the correct prevalence of sexual abuse among females and among males. There was a weak understanding of the potential youthfulness of juvenile offenders. CONCLUSION: We believe that resident understanding of sexual abuse prevalence and about the youthfulness of juvenile offenders can be improved in all three specialties.     

Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum 3.0

Exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology, family medicine, and pediatrics, as well as fellowship programs in adolescent medicine. Nevertheless, these programs are responsible for training residents and fellows and providing opportunities within their programs to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG education by creating and systematically updating the Short Curriculum. This curriculum outlines specific learning objectives that are central to PAG education and lists essential resources for learners’ reference. This updated curriculum replaces the previous 2018 publication with added content, resources, and updated references.     

Effect of a Surgical Teaching Video on Resident Performance of a Laparoscopic Salpingo-oophorectomy: A Randomized Controlled Trial

Study ObjectiveTo assess the effect of a surgical teaching video on junior resident knowledge and performance of a laparoscopic salpingo-oophorectomy (LSO).DesignRandomized controlled trial.SettingUrban tertiary care academic obstetrics and gynecology department.PatientsFirst- and second-year gynecology residents.InterventionsAccess to an education video on LSO for 1 week before performing this surgery in the operating room.Measurements and Main ResultsTwenty-four junior residents were recruited and randomized to either the educational video group or traditional residency training group. All participants completed a demographic survey and knowledge questionnaire before performing an LSO, which was video-recorded. Video recordings of surgical performance were analyzed using the Objective Structured Assessment of Technical Skills (OSATS; 20 points) and an LSO-specific tool (30 points). Participants completed a self-assessment questionnaire before completing the procedure. The primary outcome measure was the difference in OSATS scores. The secondary outcomes were the knowledge questionnaire scores and self-assessed confidence scores. There were no significant differences between demographic variables of the 2 groups. The primary outcome revealed no significant differences in mean (standard deviation) OSATS scores (10.64 [2.05] vs 11.55 [1.85], p = .3) or LSO-specific tool scores (16.45 [2.68] vs 17.85 [2.63], p = .24). However, there was a significant difference in mean knowledge scores between the video and the traditional training (8.42 [0.79] vs 7.11 [1.36], p = .01) groups. In addition, residents in the video group had more confidence in their knowledge of pelvic anatomy (3.83 [0.39] vs 3.00 [1.00] out of 5.00, p = .04).ConclusionFor junior learners, the use of an LSO video improved knowledge and confidence in anatomy but did not translate to improved surgical performance in the operating room. Surgical videos are a useful adjunct and complement hands-on technical teaching.     

What Do Patients Attending an Antenatal Clinic Know About the Role of Resident Physicians?

ObjectiveTo assess antenatal patients’ working knowledge of resident physicians involved with their care.MethodsA prospective short-answer survey was distributed to a convenience sample of 120 consecutive patients of a busy obstetrical practice in a teaching hospital in 2006. Patients were asked about resident physicians’ roles and responsibilities, level of education, hours of work, and relationship to the attending physician.ResultsThe majority of patients had attended the teaching hospital within the preceding year and had also previously delivered a baby at the hospital. Only 7% of patient participants correctly identified a resident as actively involved in their care and only 18% correctly identified the attending physician as the residents’ supervisor and/or educator. Most patients correctly identified the resident’s highest level of education as university (90%) and knew that the resident was under the supervision of the attending physician (70%). Except the 5% of participants who answered “don’t know,” all respondents greatly underestimated residents’ average weekly hours of work.ConclusionsPatient knowledge of the role of the resident physician in the health care team is lacking. Increasingly, patients wish to be educated and engaged in their health care management. Given the significant role of residents in patient care in Canada’s teaching centres, further attention should be paid to finding out what patients wish to know about their care providers and providing them with that knowledge.