A 50-Year Commitment to American Indian and Alaska Native Women.

Since 1970, the American College of Obstetricians and Gynecologists' Committee on American Indian and Alaska Native Women's Health has partnered with the Indian Health Service and health care facilities serving Native American women to improve quality of care in both rural and urban settings. Needs assessments have included formal surveys, expert panels, consensus conferences, and onsite program reviews. Improved care has been achieved through continuing professional education, recruitment of volunteer obstetrician-gynecologists, advocacy, and close collaboration at the local and national levels. The inclusive and multifaceted approach of this program should provide an effective model for collaborations between specialty societies and health care professionals providing primary care services that can reduce health disparities in underserved populations.

Midwives and obstetrician-gynecologists collaborating for Native American women's health.

Certified Nurse-Midwives (CNMs) and Obstetrician-Gynecologists (OBGs) have a long history of successful collaborative practice serving Native American women from the 1960s. CNMs provide holistic, patient-centered care focusing on normal pregnancy and childbirth. OBGs support CNMs with consultation services focusing on complications during pregnancy and specialty gynecology care. Collaborative care in Indian Health Service and Tribal sites optimizes maternity care in a supportive environment, achieving excellent outcomes including low rates of cesarean deliveries and high rates of successful vaginal birth after cesarean.

Creating an ideal objective structured clinical exam for an obstetrics and gynecology medical student clerkship.

OBJECTIVE: The objective of the study was to describe our experience with the Objective Structured Clinical Exam during the third-year obstetrics/gynecology clerkship. STUDY DESIGN: Our 8-station Objective Structured Clinical Exam is described in detail. We analyzed grades from the Objective Structured Clinical Exam for overall distribution, comparing among and between groups by year and among exam sites and correlating with the National Board of Medical Examiners subject exam and the final clerkship grades. RESULTS: The Objective Structured Clinical Exam is provided at 3 sites, 1 at a technically advanced simulation center. Most students (54.6%) received a grade of A; however, the mean grade from the Objective Structured Clinical Exam at the simulation center (3.41 on a 4-point grade-point average scale) was lower than that at the clinic sites (3.60, P = .005; 3.73, P < .001). Effect of rotation order was identified only in the first year. Grades from the Objective Structured Clinical Exam were positively but weakly correlated with National Board of Medical Examiners subject exam and final clerkship grades. CONCLUSION: An Objective Structured Clinical Exam in the obstetrics/gynecology clerkship can be administered with limited resources and provides a valuable assessment method.

Incorporating problem-based learning into an obstetrics/gynecology clerkship: impact on student satisfaction and grades.

OBJECTIVE: The purpose of this study was to describe the effect of the problem-based learning method on student grade and on student and faculty satisfaction. STUDY DESIGN: The problem-based learning method was instituted at 2 of 5 obstetrics/gynecology clerkship sites. Students and faculty were surveyed, with the use of a Likert scale, regarding aspects of satisfaction with the clerkship. Responses were compared according to problem-based learning usage. Student performance was also assessed according to problem-based learning usage, with a comparison of several grade components. Statistical analysis involved t-tests and Kendall's tau-C. RESULTS: For the year that was assessed, 54 of 156 students used the problem-based learning method. Mean student satisfaction responses were significantly higher for students who used the problem-based learning method. Faculty satisfaction was also significantly higher for the problem-based learning method, compared with other teaching methods. Mean scores on the National Board of Medical Examiners subject examination were higher for problem-based learning but did not reach statistical significance. Grade distribution was not significantly different for the groups. CONCLUSION: The problem-based learning method was associated with improved student and faculty satisfaction and did not affect student grades negatively.

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.