Archana Pradhan

e-Professionalism: a new frontier in medical education.

Background: This article, prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, discusses the evolving challenges facing medical educators posed by social media and a new form of professionalism that has been termed e-professionalism. Summary: E-professionalism is defined as the attitudes and behaviors that reflect traditional professionalism paradigms but are manifested through digital media. One of the major functions of medical education is professional identity formation; e-professionalism is an essential and increasingly important element of professional identity formation, because the consequences of violations of e-professionalism have escalated from academic sanctions to revocation of licensure. Conclusion: E-professionalism should be included in the definition, teaching, and evaluation of medical professionalism. Curricula should include a positive approach for the proper professional use of social media for learners.

Evaluating Pelvic Examination Training: Does Faculty Involvement Make a Difference? A Randomized Controlled Trial

Background: As medical schools continue to strive to deliver high quality education with diminishing resources, the need to evaluate long-standing teaching techniques becomes imperative. The use of gynecological teaching associates to teach pelvic exam skills to medical students is an example of an education intervention that deserves thorough evaluation. Purpose: The objective was to evaluate effects of two pelvic examination training methods on OB/GYN clerkship students with respect to costs, students’ performance, and perception. Method: During the academic year 2007–08, 106 medical students were randomized to receive either pelvic examination training by a gynecological teaching associate (GTA) alone or a standardized patient (SP) accompanied by an obstetrics and gynecology faculty member. Students participated in an objective structured clinical exam (OSCE) and completed questionnaires regarding the educational intervention at the end of the clerkship. Results: The two training methods produced comparable OSCE scores, and students in both groups felt more confident after training and found the training sessions to be valuable. There was a significant cost-savings associated with using GTAs for pelvic exam training. Conclusions: Faculty time and effort need not be utilized for pelvic exam training exercises, since using GTAs for pelvic exam training produces comparable results.

To the point: Medical education reviewsongoing call for faculty development

This article in the To the Point series will focus on best practices regarding faculty development in medical education in the field of obstetrics and gynecology. Faculty development is an essential component in achieving teacher and learner satisfaction as well as improving learner outcomes. The Liaison Committee on Medical Education requires medical school faculty to have the capability and longitudinal commitment to be effective teachers. Although many programs have been created to address faculty development, there remains a paucity of literature documenting the impact of these programs on learner outcomes. We reviewed the qualities of an excellent medical educator, expectations regarding medical school teaching faculty, elements of comprehensive faculty development programs, and outcome measures for evaluating the effectiveness of these programs.

Multicenter trial of the clinical activities tool to document the comparability of clinical experiences in obstetrics-gynecology clerkships.

Purpose To assess the implementation of the Clinical Activities Tool (CAT) for facilitating Liaison Committee on Medical Education-required documentation of the comparability of obstetrics-gynecology (ob/gyn) clinical experiences and midclerkship feedback at multiple sites during one academic year. Method Ob/gyn clerkship students at six U.S. medical schools were given CATs to guide and document clinical experiences from June 2006 to June 2007. Students used a paper CAT at five institutions and an electronic version at one. CATs listed procedures, skills, and topics recommended by the Association of Professors of Gynecology and Obstetrics and included a midclerkship feedback section. Resident/faculty signatures documented completion of items for paper CATs. Electronic CAT item completion was self-documented by students. Students completed a questionnaire on CAT use. Results At the six schools, 876 medical students rotated on ob/gyn clerkships; 808 (92%) submitted CATs. Mean item completion rate was 72%. Five of six schools achieved ≥70% completion rates. Midclerkship feedback signature rates ranged from 0% to 97.8% with four of six schools reporting ≥65% feedback. Comparability of clinical experiences and midclerkship feedback was successfully documented across sites for each institution (number of sites: range = 1–9; median = 5). Questionnaires on CAT use were submitted by 231 students (26%). Students using paper CATs reported that doing so clarified course objectives (93%), provided clerkship guidance/structure (93%), and facilitated interaction with faculty/residents (76%/74%). Students rated the electronic CAT significantly less favorably. Conclusions CAT implementation at multiple institutions for documentation of student clinical experience comparability and midclerkship feedback was successful. Students evaluated the paper CAT positively.

To the point: A primer on medical education research

This article, from the To the Point series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, provides educators with an introduction to medical educational research by describing the framework of educational scholarship, discussing the similarities and differences between clinical and educational research, reviewing the key steps in educational research, and providing examples of well-designed studies in the field of obstetrics and gynecology.

Pelvic and breast examination skills curricula in United States medical schools: a survey of obstetrics and gynecology clerkship directors

BackgroundLearning to perform pelvic and breast examinations produces anxiety for many medical students. Clerkship directors have long sought strategies to help students become comfortable with the sensitive nature of these examinations. Incorporating standardized patients, simulation and gynecologic teaching associates (GTAs) are approaches gaining widespread use. However, there is a paucity of literature guiding optimal approach and timing. Our primary objective was to survey obstetrics and gynecology (Ob/Gyn) clerkship directors regarding timing and methods for teaching and assessment of pelvic and breast examination skills in United States medical school curricula, and to assess clerkship director satisfaction with current educational strategies at their institutions.MethodsOb/Gyn clerkship directors from all 135 Liaison Committee on Medical Education accredited allopathic United States medical schools were invited to complete an anonymous 15-item web-based questionnaire.ResultsThe response rate was 70%. Pelvic and breast examinations are most commonly taught during the second and third years of medical school. Pelvic examinations are primarily taught during the Ob/Gyn and Family Medicine (FM) clerkships, while breast examinations are taught during the Ob/Gyn, Surgery and FM clerkships. GTAs teach pelvic and breast examinations at 72 and 65% of schools, respectively. Over 60% of schools use some type of simulation to teach examination skills. Direct observation by Ob/Gyn faculty is used to evaluate pelvic exam skills at 87% of schools and breast exam skills at 80% of schools. Only 40% of Ob/Gyn clerkship directors rated pelvic examination training as excellent, while 18% rated breast examination training as excellent.ConclusionsPelvic and breast examinations are most commonly taught during the Ob/Gyn clerkship using GTAs, simulation trainers and clinical patients, and are assessed by direct faculty observation during the Ob/Gyn clerkship. While the majority of Ob/Gyn clerkship directors were not highly satisfied with either pelvic or breast examination training programs, they were less likely to describe their breast examination training programs as excellent as compared to pelvic examination training—overall suggesting an opportunity for improvement. The survey results will be useful in identifying future challenges in teaching such skills in a cost-effective manner.

Undergraduate obstetrics and gynecology medical education: why are we underrated and underappreciated?

Obstetrics and gynecology education is one of the lowestranked medical school experiences by US medical school graduates. The inability to provide students with experiential excellence could be a detriment to our patients. The causes of student dissatisfaction are not unexpected: long work hours, minimal hands-on experience, limited faculty interactions, ineffective teaching by residents/fellows, and mistreatment issues. The purpose of this Viewpoint article is to discuss these clerkship weaknesses identified by national and local survey data. Strategies employed by nationally recognized obstetrics and gynecology educators to develop adaptive behaviors to address these educational shortcomings will be reviewed. Background

Barriers and Strategies to Engaging Our Community-Based Preceptors

ABSTRACT Issue: This article, from the “To the Point” series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a review of commonly cited barriers to recruiting and retaining community-based preceptors in undergraduate medical education and potential strategies to overcome them. Evidence: Community-based preceptors have traditionally served as volunteer, nonsalaried faculty, with academic institutions relying on intrinsic teaching rewards to sustain this model. However, increasing numbers of learners, the burdens of incorporating the electronic medical record in practice, and increasing demands for clinical productivity are making recruitment and retention of community-based preceptors more challenging. Implications: General challenges to engaging preceptors, as well as those unique to womens health, are discussed. Potential solutions are reviewed, including alternative recruitment strategies, faculty development to emphasize efficient teaching practices in the ambulatory setting, offers of online educational resources, and opportunities to incorporate students in value-added roles. Through examples cited in this review, clerkship directors and medical school administrators should have a solid foundation to actively engage their community-based preceptors.

A Multi-Modality Pelvic Anatomy Education Program for Ob/Gyn Residents [15O]

INTRODUCTION:Understanding pelvic anatomy is essential to training as an ob/gyn. In most residency programs, residents learn anatomy through self-guided reading and direct experiences in the operating room, which can be limited by time constraints and patient safety concerns. The purpose of our stud

To the Point: The expanding role of simulation in Obstetrics and Gynecology medical student education.

&NA; This article, from the “To the Point” series prepared by the Association of Professors of Gynecology and Obstetrics (APGO) Undergraduate Medical Education Committee (UMEC), provides educators with an overview of the use of simulation in undergraduate medical education in the field of obstetrics and gynecology. Simulation plays an important role in the education of medical students. Students are increasingly serving as clinical observers and providing less direct patient care. Simulation can help standardize education and ensure quality and comparability across an enlarging educational environment. This article summarizes the expanding role of simulation in undergraduate medical education in obstetrics and gynecology and its effect on important learner outcomes such as confidence, knowledge, skills, workplace behaviors, and translation to patient care.