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

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

Profile of student clerkship administration in obstetrics and gynecology

To determine a current profile of clerkships in obstetrics and gynecology, a national survey was conducted. The average clerkship director is 48 years old and has held that post for 6 years. Board certification has been accomplished by 91%, of whom 23% are also certified in a subspecialty. An advanced degree in education is held by 14%. Of full-time faculty, 81% are actively involved with medical student teaching; of part-time faculty, 62% teach students. The average number of 16 students completing the clerkship each 7 weeks is similar to that in previous reports. Evaluation of student performance varies but generally involves assessment of clinical activities (98% of programs), a written examination (96%), and an oral examination (54%). Clerkship directors find the responsibility of coordinating undergraduate education an important task from which they derive personal satisfaction.     

Women's perceptions of and experiences with medical student involvement in outpatient obstetric and gynecologic care in the United Arab Emirates

OBJECTIVE: The purpose of this study was to determine the experiences, satisfaction, and comfort of women with medical student participation in outpatient care during obstetric and gynecology clerkships. STUDY DESIGN: A consecutive sample of 303 women who attended the clinic were interviewed before consultation; a structured questionnaire was used. RESULTS: Two hundred sixty-four women (87.1%) accepted student involvement; 158 women (59.8%) and 173 women (66.5%), respectively, preferred female students or preceptors. Comfort levels were significantly lower with male students or preceptors in all skills that were tested (P <.0001), particularly pelvic examination and the discussion of sexual problems. Acceptance was associated significantly with older age (P <.0001), higher parity (P <.0001), higher education (P =.002), husband's occupation (P =.006), obstetric consultation (P <.0001), previous teaching encounters (P =.0006), recognition of the students' roles (P =.004), and satisfaction with clinical service (P = 0.01). Reasons for nonacceptance (n = 39 women, 12.9%) were concern about privacy during examination (53.8%) or counseling (25.6%) and the extent of the students' involvement (20.5%). CONCLUSION: Most women agreed to participate in the teaching of obstetric and gynecologic skills to medical students.     

Tenure of academic chairs in obstetrics and gynecology: a 25-year perspective

OBJECTIVE: To assist in predicting future leadership needs, this longitudinal study examines turnover and net retention rates among chairs at university obstetrics and gynecology departments between 1981 and 2005. METHODS: A database of appointment dates and tenure of chairs at each of 125 Association of American Medical Colleges-approved United States medical schools was collated using membership listings from the Association of Professors of Gynecology and Obstetrics and from the Council of University Chairs in Obstetrics and Gynecology. Complete data from 118 departments were confirmed by selective correspondence at individual departments and further review by the investigators. RESULTS: A total of 260 individuals (232 men, 28 women) became new chairs between 1981 and 2005. The annual turnover rate increased gradually from 6.0% to 12.7%. Five-year net retention rates remained steady between 1982 and 1997 but dropped after 1997 (85.6% compared with 63.2%; P=.03). A chair's tenure ranged widely (1 to 23 years; median 8 years), regardless of gender or school type, size, or location. Approximately one half of interim chairs became permanent chairs, usually at their own institution. The number of new women chairs increased from none in 1981 to 17 (15.2% of total chairs) in 2005. CONCLUSION: Academic chair positions in obstetrics and gynecology experienced a doubling in annual turnover rates, while retention rates declined. The proportion of chairs occupied by women increased progressively. LEVEL OF EVIDENCE: II-2.     

Variation in medical student grading criteria: a survey of clerkships in obstetrics and gynecology

OBJECTIVE: Our purpose was to assess how obstetrics/gynecology clerkships incorporate methods of student assessment into grades. STUDY DESIGN: A survey that included a broad range of assessment methods was distributed to obstetrics/gynecology clerkship directors registered with the Association of Professors of Gynecology and Obstetrics. Respondents were asked to indicate the methods used for assessment and to indicate the weight assigned to these methods in determining a student grade. RESULTS: Of the 146 surveys distributed, there were 53 respondents (36.4%). The most common methods of subjective assessment included evaluation of patient presentation skills and performance on ward rounds. The 2 most commonly used objective methods, general assessment of cognitive knowledge and the National Board of Medical Examiners Subject Examination in Obstetrics and Gynecology, generally accounted for 75% of the final grade, although these same 2 components also had the widest range of assigned weights reported. CONCLUSION: Assessment methods and incorporation into a final grade vary widely across obstetrics/gynecology clerkships.     

Yoga instructors’ reported benefits and disadvantages associated with functioning online: A convenience sampling survey

BackgroundAmong numerous changes in response to the COVID-19 pandemic, most yoga classes have repositioned online. However benefits, difficulties and satisfaction of teaching yoga online remain to be studied. With this background the present survey aimed to determine: (i) benefits, disadvantages and satisfaction of teaching yoga online and (ii) their association with characteristics related to (a) socio-demographic, (b) online yoga teaching experience and (c) yoga practice.MethodsThree hundred and five yoga instructors were invited to take part in the online survey. Of these, 181 (m:f = 98:83) responded to the survey satisfactorily and were included.ResultsThe three most common benefits of teaching yoga online were: (i) a sense of safety from risk of COVID-19 (93.92%), (ii) cost saving (82.87%) and (iii) wider access to trainees within India (77.90%). The three most common disadvantages were: (i) technical difficulties (74.03%), (ii) missing in-person contact (63.90%) and (iii) concern that online instructions can lead to injury (59.16%). Around 66.30% respondents were satisfied with the monitoring of trainees during online yoga classes while 70.16% respondents were satisfied with the level of attention they could pay to the topic they were teaching during online yoga class. The benefits and disadvantages of teaching yoga online varied with the characteristics of yoga instructors (p < 0.05, χ2 test).ConclusionsThe benefits and disadvantages of teaching yoga online are of relevance during and beyond the pandemic. Characteristics related to (i) socio-demographics, (ii) online yoga teaching and (iii) yoga practice influence reported benefits and disadvantages of teaching yoga online.     

The obstetrics and gynecology clerkship: building a better model from past experience

OBJECTIVE: The study was undertaken to identify factors contributing to the poor student perception of the obstetrics and gynecology clerkship. STUDY DESIGN: Third-year medical students at the University of Michigan complete an annual questionnaire about the overall quality of their clinical experiences. In addition, at the end of each rotation, the students complete an evaluation form assessing various aspects of their learning experience. We reviewed data collected from 2000 to 2002. We calculated effect sizes using mean scores and SDs to compare individual aspects of the learning environment across the clerkships. RESULTS: Twenty-six percent of the third-year medical students at the University of Michigan rated the strength of their obstetrics and gynecology experience as very or exceptionally strong. Compared with the other 6 clerkships, the rotation had one of the lowest ratings for overall quality. Aspects of the clerkship experience we identified as potentially explaining this overall poor rating include the clarity of the clerkship goals and objectives, clarity of expectations for student performance, accessibility of faculty, experiences in learning history-taking skills, experiences in learning physical examination skills, and student perception that they were treated in a respectful/professional manner. CONCLUSION: Aspects of the clerkship experience identified by this study as potentially explaining the low ratings of the obstetrics and gynecology rotation should be studied in greater detail. Addressing these factors will be critical for improving the overall student perception of the obstetrics and gynecology clerkship.     

“There are guiding hands and there are controlling hands”: Student midwives experience of mentorship in the UK

Objective

to explore student midwives’ experience and views on the role of the mentor in practice, and to survey perceptions of the qualities required for mentorship.

Design

qualitative longitudinal cohort study using focus groups.

Setting

an academic division of midwifery at a university in the East Midlands region of the UK.

Participants

58 women enrolled in a three-year midwifery education programme at the university.

Measurements

the focus groups were conducted with two cohorts of midwifery students at four time points during their three-year education programme.

Findings

the themes that emerged from the data were: qualities of good mentors; relationships; expectations of mentors; role models; and mentorship experience.

Conclusions

mentors are used as role models by the students in both positive and negative ways. The relationship that the student has with a mentor is fundamental to their confidence in practice, although there is an appreciation that sometimes there are problems with personality clashes. Expectations of the mentor are a major issue for student midwives, and this can be affected by the length of time they have worked with a mentor. There was general consensus about the qualities of a good mentor.     

Medical Students' Acquisition of Adolescent Interview Skills after Coached Role Play

Study Objective

To develop and evaluate an educational activity designed to teach the adolescent Home, Education and employment, Eating, Activities, Drugs, Sexuality, Suicide/depression, and Safety (HEADS) examination.

护生临床带教模式改进后的效果观察

目的：通过实践对比及问卷调研探索一种合理、高效的护生临床带教模式。方法：采取分组方式,对不同分组安排不同的临床带教模式实习,实习结束后分别对护生、护士和患者进行问卷调查。结果：责任制护理组效果明显高于功能护理组。结论：责任包干制护理方式让护生工作积极性提高,护生能够主动地、正确地完成工作任务,同时还提高了其分析、处理和总结问题的能力。     

Prevalence of urinary incontinence symptoms among black,white, and Hispanic women

OBJECTIVE: To compare the prevalence of urinary incontinence symptoms among black, white, and Hispanic women. METHODS: Women attending our gynecologic clinic were asked to complete a survey. The survey asked: "Do you lose urine when you cough, sneeze, lift, jump, or get up from a bed or chair? Do you wear a pad or protective undergarment because you lose urine when you cough, sneeze, lift, jump, or get up from a bed or chair? Do you urinate more than once every hour during the day? Does the urge to urinate wake you from your sleep more than twice most nights? Do you lose urine less than 5 minutes after you feel the urge to urinate more than once per week? RESULTS: Seven hundred ninety-nine black, 932 white, and 639 Hispanic women completed the survey. More white women reported urinary incontinence than did black or Hispanic women (41% versus 31% versus 30%, P <.001) because of their higher prevalence of stress incontinence symptoms (39% versus 27% versus 24%, P <.001). The percentage of women who had urge incontinence symptoms was very similar between the three groups (19% versus 16% versus 16%, P =.214). More black and white women reported mixed incontinence than Hispanic women (14% versus 15% versus 9%, P <.001). More black women had frequency and nocturia than the other two groups (31% and 35% versus 19% and 19% versus 25% and 26%, P <.001). CONCLUSION: The prevalence of incontinence symptoms is significantly different among black, Hispanic, and white women.     

上海市大学生生殖健康现状调查与教学研究

目的:了解上海市大学生生殖健康现状,进一步提高大学生的生殖健康水平。方法:在上海市14所高校进行大学生生殖健康状况调查,共有5422名在校大学生参与。根据调研结果,在上海交通大学开设性与生殖健康选修课,同时,根据学生的教学反馈及后续调研,进行教材与教学方式的更新。结果:大学生生殖健康服务落后于现实需求,在性观念日益开放的同时缺乏对生殖健康相关知识的认识。而选修课与专家讲座是最受学生欢迎的教学方式。接受课程培训后,大学生对常见生殖健康问题知晓率明显提升。通过3年的生殖健康教育与教学改革,摸索出了一套符合新时代大学生要求的教学手段,更新了自编生殖健康教材。结论:大学生生殖健康服务落后于现实需求,需尽快为大学生提供良好的生殖健康服务,开设选修课是较好的方法之一。     

Burnout in chairs of obstetrics and gynecology: diagnosis, treatment, and prevention

OBJECTIVE: The purpose of this study was to determine the prevalence of burnout in chairs of academic departments of obstetrics and gynecology, identify important stressors, and develop strategies to treat and prevent burnout. STUDY DESIGN: We performed a cross-sectional study of 131 chairs in the United States and Puerto Rico. We used a 6-part questionnaire focusing on demographics, potential stressors, satisfaction with personal and professional life, self-efficacy, burnout as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and support from the spouse/partner and family. Statistical analyses were performed with the chi(2) test for categorical variables and t test or analysis of variance for continuous variables. RESULTS: Questionnaires were returned from 119 chairs, 110 men and 9 women, a response rate of 91%. Chairs had served an average of 7.2 years. They worked an average of 67.4 hours each week, spending 45% of their time in administrative duties, 31% in patient care, 15% in teaching, and 8% in research. Female chairs worked significantly more hours per week than male chairs, 76.9 versus 66.7 hours (P =.005). Chairs who had served >10 years worked significantly fewer hours each week than did those who had been chairs <5 years, 63.2 versus 69.2 hours (P =.04). The most significant stressors were hospital/departmental budget deficits, Medicare/Medicaid billing audits, loss of key faculty, union disputes, and faculty, resident, and staff dismissals. To deal with stress, chairs most often spent time with family and friends. Twenty-two percent of chairs were somewhat-very dissatisfied with their positions. The MBI-HSS revealed a high subscale score for emotional exhaustion, moderate-high for depersonalization, and high for personal accomplishment. High emotional exhaustion was observed in younger chairs, those who worked nearly 70 hours each week, and those with less spouse/partner support. Burnout was more common in new chairs. CONCLUSION: Burnout in chairs of obstetrics and gynecology is characterized by a high level of emotional exhaustion, moderate-high depersonalization, and high personal accomplishment. These findings should be used to develop programs to improve the psychologic well-being of our academic leaders.     

Professionalism in obstetrics-gynecology residency education: the view of program directors

OBJECTIVE: To define the qualities of professionalism emphasized in obstetrics-gynecology residencies and identify existing means of evaluating them. METHODS: A survey, designed to assess the importance of professionalism in residency programs and what means are utilized for its development, was sent to all 270 obstetrics-gynecology residency program directors in the United States. RESULTS: Two hundred thirteen surveys were returned (79%). Ninety-seven percent of all respondents indicated that they thought the development of professionalism was necessary for training obstetrics-gynecology residents, and 84.3% thought that formal educational training time should be devoted to this development. Over 85% endorsed faculty examples and mentoring as their methods of teaching professionalism. Respondents ranked honesty; accountability to patients, colleagues, and society; respect for patients; integrity; and excellence as the most important qualities of professionalism. Almost 79% believed those qualities were as important and as necessary as qualities of skill and knowledge in residency training. Almost 80% of respondents thought that the establishment of formal professionalism guidelines would be valuable in their training programs. CONCLUSION: A critical quality in resident education is professionalism, which receives emphasis in training programs largely through faculty example and mentoring. The variability inherent in such methods might be reduced by residency wide guidelines for uniform application of standards and to avoid arbitrariness in enforcement.     

Obstetrics and gynecology between clinics and research

An evaluation of a 25-year chairmanship at the University of Nijmegen is given. The main tasks were patient care, teaching and research. Patient care was influenced by new techniques later introduced into the various subdisciplines of Obstetrics and Gynecology. Evaluation of patient care was guaranteed by annual reports focussing on avoidable factors for morbidity or mortality. Furthermore the department was visited every five years by a hospital recognition committee for specialist training. There were just two juridical complaints that finally were denied. Clinical teaching involved medical students, interns and residents. The changes in teaching followed an international change from one-person lectures to student study groups. Efficacy of teaching was evaluated by an inter-university comparison of study duration. Nijmegen scored high. The evaluation of teaching for residents was done by the yearly one-day participation in the American CREOG (Council Resident Examination Obstetrics and Gynecology) multiple choice examination. The level of final positions of trained residents can also be seen as a partial result of the quality of training. Twenty out of 128 (15.6%) were nominated as professors. The Ph.D. residents were all working in major teaching hospitals. Research efforts were evaluated by the number of Ph.D.'s acquired by residents. Fifty-three percent of the residents accomplished a Ph.D. thesis. This was ten times the mean of the country. Several new techniques were introduced by the department in the Netherlands: amniotic fluid analysis, chromosomal investigations, fetal monitoring, animal studies, laparoscopy, ultrasound, radio-immuno-assay, gasanalysis of cord blood, genetic counseling, monoclonal antibodies and prolactin-agonists. Four research lines could be considered as an international breakthrough: the silent fetal heart rate pattern, dopamine-agonists, fetal behavioural states and homocysteine metabolism associated with neural tube defects. The last "homocysteine" project was multidisciplinary and brought about most grants. The impact factor of publications doubled from 1985 till 2000 because of publications in high-ranking general-medicine journals. It is concluded that a university chairmanship needs fertile soil in which "the genes can express themselves". Research grants can act as a fertiliser. For an international approach prerequisites are a multidisciplinary project with publication in high ranking (general medicine) journals. This policy was created in Nijmegen, a well known University for teaching, patient care and research.     

Nationwide survey on attitudes of midwifery students concerning participation in regional maternal and child health services

Attitudes of midwifery students toward participation in regional health services for mothers and children were investigated. A questionaire was administered to midwifery students in 33 schools scattered over Japan, and 563 students responded. Main findings were as follows. 51% were 22 years of age. All recognized a need for midwives' involvement in regional maternal and child health care. 58.1% would actually like to work in that area, while 38.9% would not. 83.3% did internship in regional health services for an average of 2 weeks. The majority of those who interned there for 3 weeks or more wished to work there in the future; they would like to provide local residents with continuing health care and guidance on a daily basis. Public health clinics, midwifery clinics, and maternal and child health centers were among the regional places of employment the students chose. Of 327 students who opted for regional health services, 183 (56%) would like to gain more clinical experience in hospitals and outpatient clinics elsewhere. Lack of clinical experience and adequate facilities were among the main reasons why 38.9% did not want to work for regional health services. The survey reflected a recent trend in midwifery education, in which midwife is defined as a professional nurse specializing in reproduction and advocating maternal and child health care.     

Endoscopy teaching in Canada: a survey of obstetrics and gynecology program directors and graduating residents

OBJECTIVE: To examine the current state of basic and advanced gynecologic endoscopy teaching in Canadian Obstetrics and Gynecology (Ob/Gyn) residency programs. METHODS: On Institutional Research Board approval, 2 pretested anonymous questionnaires were developed: one distributed to all Canadian Ob/Gyn program directors and a second to graduating residents (Canadian Task Force classification III). Two mailings were sent to maximize response, and some department chairs received personal telephone calls by the senior author to encourage participation. Residents on maternity leave were excluded from the study. RESULTS: Fifteen of 16 (94%) program directors, and 47 of 62 (76%) residents participated. Directors expect all residents to be knowledgeable and competent performing basic endoscopic procedures on graduation. However, considerable variation exists among programs that teach advanced endoscopy. Some of the more important factors limiting integration of advanced endoscopic teaching include paucity of trained faculty, lack of attending interest, scarcity of operating time, and financial constraints. Most graduating residents consider undertaking additional gynecologic endoscopy fellowships. CONCLUSION: Most Ob/Gyn program directors and graduating residents consider endoscopic surgery essential to contemporary practice. There is consensus to improve resident teaching in gynecologic endoscopy and commitment to better prepare future practitioners to ensure patient safety. Paucity of trained faculty and fiscal constraints appear to be important limiting factors.     

翻转课堂教学模式在妇产科学带教中的应用

目的 翻转课堂是一种新颖有效的教学模式,本研究将翻转课堂教学模式引入妇产科见习带教中,探讨该模式在妇产科见习教学过程中的应用与意义.方法 选取至温州医科大学附属第一医院妇产科见习的大四学生60名,研究组采用翻转课堂教学模式,对照组采用传统教学模式.分别对两组学生进行问卷调查、成绩考核来评价相应教学模式效果.结果 研究组...