OB/GYN

Ob / Gyn
  • 文章类型: Journal Article
    该模块教授生殖健康本科医学教育的核心知识和技能,利用交互式小组翻转课堂方法和基于案例的指导,提供正常和异常妊娠和分娩管理的指导。
    在教育会议之前提供了预先准备材料。2小时的会议是由临床教育工作者使用教师指南进行的。利用自愿调查,我们收集数据以衡量每次教育课程后妇产科学生和辅导员的满意度.
    在9个月内抓到6个职员,116名学生参加,64名学生完成了满意度调查,97%的人同意该会议有助于将知识和原则应用于常见的临床情景。大多数学生(96%)自我报告说,他们实现了会议的学习目标,利用前期工作和互动小组教学。九位临床指导员完成了调查;所有人都同意提供的材料使他们能够促进主动学习,与传统教学法相比,大多数人(89%)同意他们花更少的时间准备教授该课程。
    此交互式翻转课堂课程满足了与使用标准化材料管理怀孕和分娩有关的文员学习目标。该课程也减少了临床教育工作者的准备时间。
    UNASSIGNED: This module teaches core knowledge and skills for undergraduate medical education in reproductive health, providing instruction in the management of normal and abnormal pregnancy and labor utilizing interactive small-group flipped classroom methods and case-based instruction.
    UNASSIGNED: Advance preparation materials were provided before the education session. The 2-hour session was facilitated by clinical educators using a faculty guide. Using voluntary surveys, we collected data to measure satisfaction among obstetrics and gynecology clerkship students and facilitators following each education session.
    UNASSIGNED: Capturing six clerkships spanning 9 months, 116 students participated, and 64 students completed the satisfaction survey, with 97% agreeing that the session was helpful in applying knowledge and principles to common clinical scenarios. Most students (96%) self-reported that they achieved the session\'s learning objectives utilizing prework and interactive small-group teaching. Nine clinical instructors completed the survey; all agreed the provided materials allowed them to facilitate active learning, and the majority (89%) agreed they spent less time preparing to teach this curriculum compared to traditional didactics.
    UNASSIGNED: This interactive flipped classroom session meets clerkship learning objectives related to the management of pregnancy and labor using standardized materials. The curriculum reduced preparation time for clinical educators as well.
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  • 文章类型: Journal Article
    没有关于健康的社会决定因素(SDoH)如何影响患者护理和健康结果的明确教育和培训,医学院未能有效地装备未来的医生为患者服务。我们创建了这个关于健康公平的研讨会,重点是SDoH,以帮助学生更有效地与不同人群沟通。
    为三年级医学生和教职员工提供了课程指南,学习目标,角色扮演小插曲,其中包含特定于职员的历史和身体检查,时间表,在以SDoH为中心的2小时会议中讨论问题。研讨会的影响是通过调查的混合方法分析来衡量的。
    根据87名参与者的调查前后结果,医学生强烈同意(1)与临床接触相比,SDoH对患者健康结果的影响更大(pre:67%,职位:87%),(2)收集有关SDoH的信息是他们的责任(pre:86%,职位:97%),(3)邻域安全是SDoH的关键之一(pre:88%,职位:97%),(4)他们了解上游干预措施的影响(pre:35%,职位:93%),(5)他们可以在每次医疗时有效地筛查所有患者的SDoH(pre:27%,职位:86%),和(6)他们可以找到初步资源,以快速帮助需要帮助的患者关于特定的SDoH(pre:26%,职位:85%)。
    这是本次研讨会的第一次迭代;挑战涉及内容的试点,时间限制,车间的组织结构设计。未来的方向包括使SDoH课程成为本科医学教育和多样化临床环境的组成部分。
    UNASSIGNED: Without explicit education and training on how social determinants of health (SDoH) impact patient care and health outcomes, medical schools are failing to effectively equip future physicians to serve their patients. We created this workshop on health equity with a focus on SDoH to help students more effectively communicate with diverse populations.
    UNASSIGNED: Third-year medical students and faculty were provided with class guides, learning objectives, role-play vignettes containing clerkship-specific history and physical exams, schedules, and discussion questions during a 2-hour session centered on SDoH. The workshop\'s impact was measured through mixed-methods analysis of surveys.
    UNASSIGNED: Based on pre- and postsurvey results from 87 participants, medical students strongly agreed that (1) SDoH factor more into a patient\'s health outcomes than the clinical encounter (pre: 67%, post: 87%), (2) it is their duty to gather information about SDoH (pre: 86%, post: 97%), (3) neighborhood safety is one of the key SDoH (pre: 88%, post: 97%), (4) they understood the impact of upstream interventions (pre: 35%, post: 93%), (5) they could efficiently screen all patients for SDoH at every medical encounter (pre: 27%, post: 86%), and (6) they could find preliminary resources to quickly assist patients in need of help regarding particular SDoH (pre: 26%, post: 85%).
    UNASSIGNED: This was the first iteration of this workshop; challenges involved piloting the content, time restraints, and organizational structure of the workshop design. Future directions include making SDoH curricula an integral part of undergraduate medical education and diverse clinical environments.
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  • 文章类型: Journal Article
    每年有数以百万计的患者出现在美国急诊科的OB/GYN问题。急诊医学受训人员必须做好充分的准备,照顾这一人群,无论它们在训练环境中出现的频率如何。我们在本课程中使用了主动学习和游戏化原则,以提高学习者的参与度和参与度。
    我们根据对Tintinalli的OB/GYN内容和美国急诊医学委员会的临床实践模式的回顾,选择了OB/GYN主题。每个课程都包括基于案例的讲座和使用基于游戏的Kahoot的评论问题!在线软件。课程前和课程后的调查以5点Likert量表评估了居民对护理紧急OB/GYN病变的信心。我们设计了调查问题,评估了柯克帕特里克培训评估水平的第一级;这些问题由部门的医学教育奖学金委员会进行了审查和修订,以确保有效性。
    每次会议平均有18名居民参加。76%的居民(34人中有26人)完成了课前调查,67%(34人中有23人)完成了课程后调查,44%(34个中的15个)完成了这两个。对于所有受访者,平均报告对课程主题的信心从3.5增加到4.0(p<0.05)。对于完成两项调查的居民,置信度从3.4增加到4.0(p<0.01)。
    此课程的应用显着提高了学习者对目标OB/GYN主题的信心。未来的方向可能包括评估柯克帕特里克模型中更高水平的课程影响,扩展会话以包括更多的交互时间,并添加建议的读数。
    Millions of patients present to US emergency departments every year with OB/GYN concerns. Emergency medicine trainees must be adequately prepared to care for this population, regardless of how commonly they appear in the training environment. We used active learning and gamification principles in this curriculum to increase learner engagement and participation in the material.
    We chose OB/GYN topics based on review of Tintinalli\'s OB/GYN content and the American Board of Emergency Medicine\'s Model of Clinical Practice. Each session comprised a case-based lecture and review questions using the game-based Kahoot! online software. Pre- and postcurriculum surveys assessed residents\' confidence in caring for emergent OB/GYN pathologies on a 5-point Likert scale. We designed survey questions assessing the first level of Kirkpatrick\'s levels of training evaluation; these questions were reviewed and revised by the department\'s Medical Education Scholarship Committee for validity.
    A mean of 18 residents attended each session. Seventy-six percent of residents (26 of 34) completed the precurriculum survey, 67% (23 of 34) completed the postcurriculum survey, and 44% (15 of 34) completed both. For all respondents, mean reported confidence with curriculum topics increased from 3.5 to 4.0 (p < .05). For residents completing both surveys, confidence increased from 3.4 to 4.0 (p < .01).
    Application of this curriculum significantly improved learner confidence in targeted OB/GYN topics. Future directions could include evaluating curricular impact at higher levels in the Kirkpatrick model, extending sessions to include more time for interaction, and adding suggested readings.
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  • 文章类型: Journal Article
    未经评估:早期妊娠诊断的评估和管理在临床上与生育年龄患者的多个专科相关。我们设计了一个互动的,小团体,妇产科科生早期妊娠相关翻转课堂教学理念。
    UNASSIGNED:学生在加入由OB/GYN部门的临床教育工作者协助的小组之前,会收到预先准备的材料。在每次2小时的会议之后,学生和辅导员被要求自愿完成满意度调查。
    未经授权:超过六个职员,发生在9个月内,116名学生参加。83名学生完成了满意度调查,98%的人同意该课程有助于将学到的原则应用于患者护理。非常高的比例的学生(平均:93%)自我报告说,他们完成了预科和互动小组教学后实现了会议的学习目标。11位临床指导员完成了调查,91%的人同意他们能够使用这些材料促进主动学习,82%的人同意与传统教学法相比,该课程减少了他们的个人准备时间。
    UNASSIGNED:这种交互式翻转课堂课程可实现指定的学习目标,并帮助学生在评估早期妊娠时应用所学到的概念,同时规范文员教育并减轻临床教育工作者的负担。
    Evaluation and management of an early pregnancy diagnosis are clinically pertinent to multiple specialties that will encounter reproductive-age patients. We designed an interactive, small-group, flipped classroom session teaching concepts related to early pregnancy for obstetrics and gynecology clerkship students.
    Students received advance preparation materials prior to joining the small group facilitated by clinical educators in the OB/GYN department. Following each 2-hour session, students and facilitators were asked to voluntarily complete a satisfaction survey.
    Over six clerkships, which occurred across 9 months, 116 students participated. Eighty-three students completed the satisfaction survey, with 98% agreeing that the session was helpful in applying learned principles to patient care. A very high rate of students (average: 93%) self-reported that they achieved the session\'s learning objectives after completing the prework and interactive small-group teaching. Eleven clinical instructors completed the survey, with 91% agreeing that they were able to facilitate active learning using the materials and 82% agreeing that the curriculum reduced their personal preparation time to teach compared to traditional didactics.
    This interactive flipped classroom session achieves specified learning objectives and helps students apply learned concepts in the evaluation of early pregnancy while standardizing clerkship education and reducing the burden on clinical educators.
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  • 文章类型: Journal Article
    背景:育龄妇女异常子宫出血(AUB)的鉴别诊断范围很广,包括常见和危及生命的疾病。AUB的识别和准确诊断很重要,但对医学生来说可能是具有挑战性的。我们为医学生在OB/GYN职员期间开发了标准化的患者(SP)相遇。
    方法:我们实现了两个SP遭遇,AUB和性交困难,其中包括后期见面会说明和SP评估。这里,我们描述了在AUB上的SP遭遇的实现。学生收到了关于他们的人际交往和历史学习技能的形成性反馈,鉴别诊断,以及SP以及OB/GYN居民和教职员工的管理计划。学生的累积反馈是在职员中和职员之后获得的。报告了学生经验的汇总统计和定性数据。
    结果:SP病例在杜克大学医学院实施,有101名二年级医学生在2018年9月至2019年7月期间完成了治疗。关于AUB案件,SP确定学生是适当的历史接受者,5分的平均评价得分为3.45分(SD=0.15分)。大多数学生(94%)正确地确定了至少一个诊断并提供了证据。子宫内膜癌/增生(63%)和子宫平滑肌瘤(60%)最有可能被发现。关于这两个SP遭遇,在82名学生(81%)完成了结束实习调查,57%的人表示,经验至少充分或更好地增强了他们的整体学习。
    结论:AUB案例为学生提供了锻炼其诊断和管理技能的机会。
    BACKGROUND: The differential diagnosis for abnormal uterine bleeding (AUB) among reproductive-age women is broad and includes common and life-threatening conditions. Recognition and accurate diagnosis of AUB are important but can be challenging for medical students. We developed a standardized patient (SP) encounter for medical students during their OB/GYN clerkship.
    METHODS: We implemented two SP encounters, on AUB and dyspareunia, that included a postencounter note and SP evaluations. Here, we describe the implementation of the SP encounter on AUB. Students received formative feedback on their interpersonal and history-taking skills, differential diagnosis, and management plan from the SP as well as OB/GYN residents and faculty. Student cumulative feedback was obtained mid-clerkship and following the clerkship. Summary statistics and qualitative data for students\' experiences are reported.
    RESULTS: SP cases were implemented at the Duke University School of Medicine with 101 second-year medical students who completed the encounter from September 2018 to July 2019. Regarding the AUB case, SPs identified students as adequate history takers, with a mean evaluation score of 3.45 (SD = 0.15) out of 5. Most students (94%) correctly identified at least one diagnosis and provided evidence. Endometrial cancer/hyperplasia (63%) and uterine leiomyoma (60%) were most likely to be identified. Regarding both SP encounters, of the 82 students (81%) completing the end-of-clerkship survey, 57% indicated that the experience enhanced their overall learning at least adequately well or better.
    CONCLUSIONS: The AUB case provided students with the opportunity to exercise their diagnostic and management skills.
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  • 文章类型: Journal Article
    Medical students lack knowledge about the effects of bariatric surgery on pregnancy and medical management of obesity as it relates to reproductive health. Additionally, there is bias toward obese patients among clinicians and learners. Our goal is to improve knowledge and make students aware of the possibility of bias in their management of obese patients.
    We designed a flipped classroom learning experience focused on teaching students about the impacts and management of obesity and bariatric surgery on pregnancy and reproductive health. Before the seminar, students took the Implicit Attitude Test (IAT) and read two articles. During the 60-minute seminar, students worked in small groups discussing clinical vignettes, IAT results, and how bias affects patient care. One faculty preceptor oversaw the work and led discussions. We evaluated pilot seminars using Kirkpatrick levels 1 (reaction) and 2 (knowledge) outcomes. We measured change in knowledge after the seminar (using pre- and postseminar quizzes) and assessed students\' feedback using a postseminar survey.
    This module was piloted with one in-person group (n = 9) and one virtual group (n = 11) of third-year medical students. Students\' knowledge improved (48% vs. 84% correct, p < .001), and they displayed statistically significant improvements in quiz scores postseminar.
    Educators striving to teach learners about the management of obesity in pregnancy using evidence-based medicine should integrate this module into their medical student clerkship curricula.
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  • 文章类型: Journal Article
    Learning to elicit a sexual history and counsel patients on sexual pain aligns with the Association of Professors of Gynecology and Obstetrics clerkship objectives. This topic can be challenging to cover due to lack of exposure in clinical encounters and inadequate coverage in preclinical studies.
    Second-year medical students in the OB/GYN clerkship participated in a standardized patient (SP) encounter on dyspareunia, receiving formative feedback on sexual history taking, differential diagnosis and management plan, and their SP\'s comfort during the encounter. Student feedback was obtained mid- and postclerkship. Summary statistics and regression models comparing SP encounter scores with shelf exam and clerkship scores are reported.
    From September 2018 through July 2019, 101 students completed the encounter. Students asked an average of 3.9 of 13 sexual history questions. Sixty-six percent of students identified a correct diagnosis; 48% provided a management plan. The majority of students were very good or excellent at creating a safe environment. Most reported the encounter enhanced their learning (62%) and identified knowledge gaps (72%). SP encounter score was not associated with shelf exam score or clerkship letter grade but was associated with final clerkship score (unadjusted ß = 0.2, p = .009; adjusted ß = 0.1, p = .2). A summary didactic session was developed following student feedback.
    This SP encounter and summary didactic session allowed students to improve their sexual history taking and may be associated with clerkship performance. These skills are necessary to advocate for patients with sensitive complaints across specialties.
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  • 文章类型: Journal Article
    背景:纵向临床医师的医学教育新模式可以通过高科技模拟来补充,这为学习者巩固临床知识和实践决策技能提供了安全的空间,团队合作,和沟通。我们开发了跨学科培训干预措施,包括模拟案例和结构化汇报,以将主要学术医学中心的儿科和产科之间的临床内容联系起来。
    方法:在这种情况下,一名38岁的女性在妊娠38周时出现分娩并伴有肩难产。经过适当的演习,一个沮丧的新生儿分娩,需要复苏。所需的主要设备包括高科技或低技术的分娩人体模型和婴儿人体模型。
    结果:54名三年级医学生在完成儿科和产科综合医师职位时参加了这种基于模拟的干预措施。91%的学生同意肩难产模拟是为他们的学习水平设计的,并提高了他们处理风险分娩的能力。94%的人同意新生儿复苏模拟的设计适合他们的学习水平,89%的人报告干预后在诊所处理类似情况的能力增强.5分制的平均总体评分分别为4.24(SD=0.61)和4.06(SD=0.89)(1=差,5=优秀)用于产科和儿科模拟,分别。
    结论:产科和儿科综合方案是可行的,并且临床上是准确的。在三年级课程中,两个不同的医学领域在逻辑上被纳入一个有凝聚力的基于模拟的培训干预措施,学生发现积极和现实。
    BACKGROUND: The new model in medical education of longitudinal clinical clerkships can be complemented by high-technology simulation, which provides a safe space for learners to consolidate clinical knowledge and practice decision-making skills, teamwork, and communication. We developed an interdisciplinary training intervention including a simulation case and structured debriefing to link clinical content between pediatrics and obstetrics at a major academic medical center.
    METHODS: In this case, a 38-year-old female at 38 weeks gestation presents with onset of labor complicated by shoulder dystocia. After the appropriate maneuvers, a depressed neonate is delivered and requires resuscitation. Major equipment needed includes a high- or low-technology birthing mannequin and an infant mannequin.
    RESULTS: Fifty-four third-year medical students participated in this simulation-based intervention at the completion of their integrated pediatrics and obstetrics clerkship. Ninety-one percent of students agreed that the shoulder dystocia simulation was designed appropriately for their learning level and enhanced their ability to handle a risky delivery. Ninety-four percent agreed that the neonatal resuscitation simulation was designed appropriately for their learning level, and 89% reported an enhanced ability to handle a similar situation in the clinic following the intervention. The average overall ratings were 4.24 (SD = 0.61) and 4.06 (SD = 0.89) on a 5-point scale (1 = poor, 5 = excellent) for the obstetrics and pediatrics simulations, respectively.
    CONCLUSIONS: The integrated obstetrics and pediatrics scenario is feasible to run and clinically accurate. Two distinct areas of medicine in the third-year curriculum are logically incorporated into one cohesive simulation-based training intervention that students found positive and realistic.
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