Motivational interviewing for maternal Immunizations: Intervention development

Background and ObjectiveVaccine uptake during pregnancy remains low. Our objectives were to describe 1) development and adaptation of a clinician communication training intervention for maternal immunizations and 2) obstetrics and gynecology (ob-gyn) clinician and staff perspectives on the intervention and fit for the prenatal care context.MethodsDesign of the Motivational Interviewing for Maternal Immunizations (MI4MI) intervention was based on similar communication training interventions for pediatric settings and included presumptive initiation of vaccine recommendations (“You’re due for two vaccines today”) combined with motivational interviewing (MI) for hesitant patients. Interviews and focus group discussions were conducted with ob-gyn clinicians and staff in five Colorado clinics including settings with obstetric physicians, certified nurse midwives (CNMs), and clinician-trainees. Participants were asked about adapting training to the ob-gyn setting and their implementation experiences. Feedback was incorporated through iterative changes to training components.ResultsInterview and focus group discussion results from participants before (n = 3), during (n = 11) and after (n = 25) implementation guided intervention development and adaptation. Three virtual, asynchronous training components were created: a video and two interactive modules. This virtual format was favored due to challenges attending group meetings; however, participants noted opportunities to practice skills through role-play were lacking. Training modules were adapted to include common challenging vaccine conversations and live-action videos. Participants liked interactive training components and use of adult learning strategies. Some participants initially resisted the presumptive approach but later found it useful after applying it in their practices. Overall, participants reported that MI4MI training fit well with the prenatal context and recommended more inclusion of non-clinician staff.ConclusionsMI4MI training was viewed as relevant and useful for ob-gyn clinicians and staff. Suggestions included making training more interactive, and including more complex scenarios and non-clinician staff.     

Utility of the 3‐Vessel and 3‐Vessel and Trachea Views in Prenatal Diagnosis of a Pulmonary Artery Sling

A pulmonary artery (PA) sling is a very rare congenital cardiovascular anomaly, and only a few studies have reported PA slings in fetuses. The relationship of the PA, aorta, ductus arteriosus, and trachea can be evaluated in the 3‐vessel and 3‐vessel and trachea views during fetal echocardiography. A PA sling can be detected by abnormal positioning of the left PA in relation to the trachea when sweeping from the 3‐vessel view cranially to the 3‐vessel and trachea view. Here we report 3 cases of fetal PA slings and their follow‐ups. Two cases were confirmed by postnatal echocardiography, and the other case was confirmed by a cardiovascular cast after pregnancy termination. We emphasize that the 3‐vessel and 3‐vessel and trachea views are of crucial importance in the prenatal diagnosis of a PA sling.     

构建数字化、可视化教学平台实现妇产科学教学手段多元化

介绍了构建数字化、可视化教学平台,实现妇产科教学手段多元化的做法。内容包括多媒体课件开发制作,利用医学视听教材,建设妇产科图片数据库,建设妇产科标本库(馆),利用模型、模块进行模拟操作,加强实践技能培养和通过临床见习、实习将理论应用于实践等问题。     

Teaching of medical ethics

Teaching medical ethics in Manchester within the introductory course of obstetrics and gynaecology is a joint activity with the Centre for Social Ethics and Policy. This interdisciplinary teaching has evolved through lecture sessions with small-group discussions dealing with topics of interest in human reproduction. The small-group discussion have been replaced by an open debate conducted by the students. Their own involvement and participation and an exposure to the disciplines of the humanities has broadened their approach to different ways of problem-solving of these real issues.     

永磁速愈贴对妇产科手术切口愈合的观察

目的探讨永磁速愈贴对切13的消肿止痛，促进伤口愈合和防止疤痕粘连与普通敷料进行对比观察。方法将住院行妇产科手术100例患者与同期住院的手术患者进行对比观察。结果永磁速愈贴切13愈合佳者84．0％，良好者13．0％，愈合差为3．0％，而普通敷料为28．0％、60．0％和12．0％，p〈0．01（x^2=63．660）。结论永磁速愈贴切口具有透气、保湿、促进伤口愈合、消肿、止痒，防止疤痕形成等作用。而普通敷料透气性差，保湿性差，术后切口有红肿、缝线反应、切口愈合时间长及切口局部愈合后有痛痒感。     

Undergraduate medical education in obstetrics and gynaecology in the USA and Canada, 1985

Many factors have led to a movement from the emphasis of the 1960s and 1970s on departmental expansion towards an emphasis on cost-effective undergraduate medical education emphasizing the 'art' as well as the 'science' of medicine. In January 1985 a questionnaire was sent under the auspices of the Undergraduate Education Committee of the Association of Professors of Obstetrics and Gynecology to all chairmen of departments of obstetrics and gynecology in the USA and Canada seeking their opinions about these trends and information about the educational programmes in their departments. The information from this study indicates that the chairmen are aware of and responding to this new direction in medical education. A stabilization of teaching staff and clerkship sizes and the emphasis on clinical as well as cognitive evaluation, despite recognition of the cost of the former, shows active interventions towards these ends. An emphasis on education in 'basic' as compared to 'subspecialty' areas which is independent of the subspecialty of the academic chairman also supports this trend.     

浅谈妇产科学的兴趣教学

本文以心理学为依据，探讨了在妇产科学这门课程中实行兴趣教学的重要意义，并联系实践说明了兴趣教学的方法多样性和选择性。     

Postgraduate school of obstetrics and gynecology and nongovernmental organizations: is collaboration possible?

We report the collaboration between the First Postgraduate School of Obstetrics and Gynecology at the University of Milan, Italy, and the nongovernmental organization “Emergency” that operates through its own hospitals in countries devastated by armed conflicts. The collaboration was centered on the maternity clinic that Emergency opened in 2003 in northern Afghanistan. After a woman resident spent 5 months on-site, the collaboration is now extended to all residents with a group with four areas of intervention: guidelines, clinical records and data collection, drugs and medical devices, and teaching material. In addition, it offers consultation by e-mail for any clinical issue that might arise.     

Students'' assessment of a course in obstetrics and gynaecology

A complete annual entry of 181 students were administered a questionnaire in which they were invited to make value judgements about all aspects of their 3-month course in obstetrics and gynaecology. The resulting performance indicators were used to compare individual staff and clinical firms.     

男医学生在妇产科实习的素质能力培养

21世纪需要高素质人才，素质教育是关键。从一定意义上说素质教育就是因材施教，妇产科作为一门比较特殊的学科，在实践教学工作中女患者不愿意示教的情况越来越严重，尤其对于男医学生。本文对男医学生在妇产科实习的素质能力培养进行实践与研究，提出以素质教育为中心，培养出具备高尚的医德、扎实的专业本领和丰富的人文知识的新型人才。