Current status of laparoscopy teaching in gynecology and obstetrics medical residency in Brazil.

OBJECTIVE: To characterize laparoscopy teaching in Medical Residency Programs in Gynecology and Obstetrics in Brazil, and to evaluate preceptors' characteristics in laparoscopy programs and map laparoscopic training practice scenarios. METHODS: This descriptive cross-sectional study evaluated questionnaire responses from coordinators of the Medical Residency Programs in Gynecology and Obstetrics from 2019 to 2021. RESULTS: The questionnaire was sent to 175 programs, and 90 responses were received (51.4%). From the 85 valid responses, it was noted that 67 programs had laparoscopic training. Of the 64 responses received regarding location, 32 replies (50%) indicated the Southeast of Brazil, particularly some country's capitals. In 37.3% (n=25) of the cases, the program coordinator performed laparoscopy. The chief of the laparoscopy sector has advanced experience in most 52.5% (n=10) medical residency services; the preceptors also had advanced experience in 89.4% (n=59) of the services. Residents received laboratory training in 39.4% (n=26) of the services. In most cases, training was performed using a physical simulator. Of the 26 medical residency services with laparoscopy training outside the operating room, 80.8% (n=21) performed them as part of the curriculum, 61.5% (n=16) had a schedule for the same, and only 3.9% (n=1) were objectively evaluated. CONCLUSION: Laparoscopy teaching in Brazil is heterogeneous, with only a few programs offering any training in laparoscopy. The preceptors had advanced experience and participated in laboratory and operating room training. Only a few programs have their own laboratories or training centers, and most teaching programs do not plan to set up training centers.

Professional activity and experience after a residency training program in ObGyn: A 10-year analysis.

OBJECTIVE: To describe the profile and professional trajectory of the obstetrics and gynecology (ObGyn) graduates over the past decade, at a referral university hospital. METHODS: A cross-sectional study was conducted, utilizing a survey that targeted graduates of the ObGyn residency program from the last decade, asking about demographics, medical undergraduate, residency details, post-residency trajectory, satisfaction levels, and social media usage. A descriptive analysis was performed. Comparative analyses, including gender-based differences, were assessed using chi-squared or Fisher exact tests (P < 0.05). RESULTS: Among 126 graduates, 84 agreed to participate (66.67%), predominantly comprising females with an average age of 33 years. Most identified themselves as white. The majority had pursued their undergraduate studies at the same institution (78.6%) and subsequently acquired specialized titles in ObGyn from the national society. Most of them were employed in both public and private sectors (71.08%). Male graduates held the majority of medical shifts in obstetrics. A significant gender-based salary discrepancy was noted, favoring males. More than half of the professionals utilized social media for work-related purposes. Many expressed the necessity for supplementary education beyond public health, particularly career management. CONCLUSION: The findings highlight a predominance of female and white individuals among the graduates. Overall, graduates expressed contentment with their education and professional engagements. A gender-based income disparity was identified, favoring male graduates. Studies like this can provide insights for improving medical residency education.

Producción científica sobre obstetricia y ginecología en revistas científicas estudiantiles cubanas (2014-2022) / The Scientific Production about Gynecology and Obstetrics in Cuban Student Journals (2014-2022)

Introducción: El desarrollo de la investigación científica en las ciencias de la salud constituye un componente medular en el sistema de asistencia médico-sanitaria que influye en los niveles de salud y la calidad de vida de la población. Objetivo: Caracterizar la producción científica sobre obstetricia y ginecología en revistas científicas estudiantiles cubanas en el período 2014-2022. Métodos: Se realizó un estudio bibliométrico de la producción científica anteriormente descrita, cuyo universo quedó conformado por 104 artículos publicados. No se aplicaron técnicas de muestreo y fueron evaluadas las variables: año de publicación, idioma, revistas científicas estudiantiles, cantidad de autores, institución de procedencia, temáticas abordadas, tipo de artículo y cantidad de referencias. Se aplicó la estadística descriptiva. Resultados: El año 2021 resultó el más productivo con 31 artículos (29,81 por ciento); la revista científica 16 de Abril publicó el 28,85 por ciento de estos. Existió un predominio de investigaciones con autoría múltiple, aquellos firmados por cuatro autores fueron los más destacados con el 29,81 por ciento y el 16,34 por ciento de los autores provenían de la Universidad de Ciencias Médicas de Pinar del Río. Las investigaciones vinculadas al área de la obstetricia como temática central tuvieron la mayor prevalencia. Sobresalieron los artículos originales con 74 investigaciones para un 71,15 por ciento. Conclusiones: La actividad científica estudiantil en la especialidad de ginecología y obstetricia se ha visto favorecida por un crecimiento ascendente. Respaldada por la colaboración entre múltiples autores, así como por varios órganos de difusión, permiten lograr un mayor alcance e impacto, en especial mediante la publicación de investigaciones originales(AU)

Introduction: The development of scientific research in health sciences is a fundamental component within medical-healthcare systems that influences the health levels and the quality of life of the population. Objective: To characterize the scientific production on obstetrics and gynecology in Cuban student scientific journals in the period 2014-2022. Methods: A bibliometric study was carried out of the scientific production described above, the universe of which consisted of 104 published articles. No sampling techniques were applied, and the variables year of publication, language, student scientific journals, number of authors, institution of origin, addressed topics, type of article, and number of references were evaluated. Descriptive statistics were applied. Results: The year 2021 was the most productive, with 31 articles (29.81 percent); the scientific journal 16 de Abril published 28.85 percent of them. There was a predominance of research with multiple authorship; those signed by four authors were the most widely represented, accounting for 29.81 percent. 16.34 percent of the authors came from Universidad de Ciencias Médicas de Pinar del Río. Pieces of research related to the area of obstetrics as the central topic had the highest prevalence. Original articles stood out, with 74 pieces of research, accounting for 71.15 percent. Conclusions: The student scientific activity in the specialty of gynecology and obstetrics has been favored by an upward growth. Supported by the collaboration among multiple authors, as well as by several dissemination bodies, they allow achieving greater reach and impact, especially through the publication of original pieces of research(AU)

Assessing Endoscopic Suture Performance of Gynecology and Obstetrics Residents Following Methodic Training.

OBJECTIVE: To evaluate the performance of residents in gynecology and obstetrics before and after practicing laparoscopic sutures, to establish when the training shows the best results, in addition to comparing whether being in different years of residency influences this progression. METHODS: A prospective cohort study involving 32 medical residents evaluated with a pretest to establish their previous knowledge in laparoscopic suture. This test consisted of knotting two wires, one made of polypropylene and the other of polyglactin, with a blocking sequence of five semi-knots. We set a 30-minute limit to complete the task. Then, the residents held four training meetings, focusing on suture, Gladiator rule, knot, and symmetries, in addition to executing blocking sequences. A second test to establish progress was performed. RESULTS: Regarding the time spent to make the stiches using polyglactin wire, a statistically significant time improvement (p < 0.01) was observed, with a 10.67-minute pretraining median (mean 12.24 minutes) and a 2.53-minute posttraining median (mean 3.25 minutes). Regarding the stitches with polypropylene wire, a statistically significant time improvement (p < 0.05) was also observed, with a 9.38-minute pretraining median (mean 15.43 minutes) and a 3.65-minute posttraining median (mean 4.54 minutes). A total of 64.2% of the residents had been able to make the knot with polypropylene previously. One hundred percent were able to complete the task in the posttest. CONCLUSION: Model training using the Gladiator rule for laparoscopic suture improves the knotting time with statistically similar performance, regardless of the year of residency, after systematic training.

OBJETIVO: Avaliar a performance de residentes em ginecologia e obstetrícia antes e depois de praticarem suturas laparoscópicas, com o intuito de estabelecer quando o treinamento mostra os melhores resultados, comparando se estar em diferentes da residência influencia essa progressão. MéTODOS: Um estudo coorte prospectivo envolvendo 32 médicos residentes avaliados com um teste pré-treinamento para avaliar seus conhecimentos prévios em sutura laparoscópica. Esse teste consistia em atar nós em dois fios, um de polipropileno e o outro de poliglactina, com uma sequencia de bloqueio de cinco seminós. Definiu-se um limite de 30 minutos para se completar a tarefa. Depois, os residentes tiveram quatro reuniões de treinamento, focadas em sutura, técnica da Regra do Gladiador, nós e simetria, executando, ainda, uma sequência de pontos. Um segundo teste foi feito para avaliar o progresso. RESULTADOS: Com relação ao tempo para realizarem os pontos com fio de poliglactina, uma melhora de tempo estatisticamente significativa (p < 0.01) foi observada, com uma mediana de 10.67 minutos no pré-treinamento (média de 12.24 minutos) e uma mediana de 2.53 minutos no pós-treinamento (média de 3.25 minutos). Com relação ao fio de polipropileno, uma melhora de tempo estatisticamente significativa (p < 0.05) também foi observada, com uma mediana de pré-treinamento de 9.38 minutos (média de 15.43 minutos) e uma mediana de pós-treinamento de 3.65 minutos (média de 4.54 minutos). Um total de 64.2% dos residentes foram capazes de realizar os nós com polipropileno inicialmente. Cem por cento do residentes foram capazes de completar a tarefa no pós-teste. CONCLUSãO: O modelo de treino usando a técnica da Regra do Gladiador para sutura laparoscópica melhora o tempo de atar nós com uma performance estatisticamente similar, não havendo diferenças quanto ao ano da residência, após treinamento sistematizado.

Clinical Simulation in the Training of Obstetrics and Gynecology Resident from the Perspective of Medical Residency Programs.

OBJECTIVE: This study analyzes the role of clinical simulation in internal medical residency programs (IMRP) in Obstetrics and Gynecology (OB/GYN), attributed by the supervisors, in the training of residents in the city of São Paulo (SP). METHODS: Cross-sectional descriptive, qualitative, and exploratory approach. Semi-structured interviews were performed with ten supervisors of Medical Residency programs in Obstetrics and Gynecology. Interviews were analyzed by means of content analysis under the thematic modality, starting with the core the role of clinical simulation in Obstetrics and Gynecology Medical Residency Programs. RESULTS: Supervisors view Clinical simulation as: a complementary tool for the teaching and learning process, a possibility of a safe teaching and learning environment, an opportunity to learn from mistakes, a support for professional practice committed to patient safety, a learning scenario for teamwork, a scenario for reflection on the work process in Obstetrics and Gynecology, a scenario for evaluative processes in the medical residency. Still according to supervisors, Clinical Simulation favors decision-making and encourages the resident participation in activities. CONCLUSION: Supervisors recognize Clinical Simulation as a powerful pedagogical tool in the learning process of resident doctors in Obstetrics and Gynecology Residency Programs.

OBJETIVO: O presente estudo analisa o papel da Simulação Clínica em programas de Residência Médica (PRM) de Obstetrícia e Ginecologia, atribuído pelos supervisores, na formação do residente no município de São Paulo (SP). MéTODOS: Abordagem qualitativa, transversal, de natureza exploratória e descritiva. Foram realizadas entrevistas semiestruturadas com dez supervisores de programas de Residência Médica de Obstetrícia e Ginecologia. Para análise das entrevistas foi realizada análise de conteúdo na modalidade temática partindo do seguinte núcleo: o papel da simulação clínica nos Programas de Residência Médica de Obstetrícia e Ginecologia. RESULTADOS: A Simulação Clínica, na visão dos supervisores, emerge como: ferramenta complementar para o processo de ensino e aprendizagem; possibilidade de um ambiente de ensino e aprendizagem seguro; possibilidade de aprendizagem a partir do erro; suporte para prática profissional comprometida com a segurança do paciente; cenário de aprendizagem para o trabalho de equipe; cenário de reflexão sobre o processo de trabalho em Obstetrícia e Ginecologia; favorecimento na tomada de decisão; cenários de processos avaliativos na residência; e, por fim, estímulo à participação dos residentes nas atividades. CONCLUSãO: Os supervisores reconhecem a Simulação Clínica como uma ferramenta pedagógica potente no aprendizado dos médicos residentes em Obstetrícia e Ginecologia.

Percepción de la simulación en obstetricia y ginecología en el pregrado y posgrado de una universidad privada chilena / Perception of simulation in obstetrics and gynecology at the undergraduate and postgraduate levels of a private Chilean university

INTRODUCCIÓN: La simulación es una herramienta que promueve la confianza y desarrollo de habilidades en los participantes. En la evaluación de programas formativos la percepción de utilidad se vincula a la confianza y aprendizaje, y corresponde al primer nivel de evaluación según Kirkpatrick. OBJETIVO: Evaluar la percepción de internos y residentes de obstetricia y ginecología en escenarios de simulación. MATERIAL Y MÉTODOS: Investigación descriptiva cuantitativa, en una muestra a conveniencia de internos y residentes, quienes contestaron una escala de valoración global y de preferencias sobre sus simulaciones. RESULTADOS: Se obtuvieron 63 respuestas de internos (63%) y 7 de residentes (78%). La valoración promedio de las simulaciones fue de 6,42 en los internos y de 6,64 de los residentes. El 67% de los internos y el 86% de los residentes no eliminaría ninguna simulación. Los internos repetirían todas las simulaciones, en tanto que los residentes repetirían tres simulaciones de un total de 11. CONCLUSIONES: La valoración de las simulaciones fue alta en ambos grupos, difiriendo en las actividades que prefieren repetir, lo cual puede relacionarse con las competencias inherentes al rol de especialista en comparación al rol del médico general o a las diferencias en autoconfianza de internos y residentes.

INTRODUCTION: Clinical simulation is a training tool that promotes confidence and the development of procedural skills in participants, from initial training to the training of professional teams. In the evaluation of training programs, the measurement of perceived usefulness is linked to confidence and learning and corresponds to a first level of evaluation of the quality of training according to Kirkpatricks model. OBJECTIVE: To evaluate the perception of medical interns and Obstetrics and Gynecology fellows regarding simulation scenarios. MATERIAL AND METHODS: Quantitative descriptive research, in a convenience sample of interns and fellows, who answered a scale of global assessment and preferences about simulations. RESULTS: The average score was 6.42 for the interns and 6.64 for the scholarship recipients. With odd answers about the repetition of scenarios. 67% of the interns and 86% of the fellows responded that they would not eliminate any simulation. Conclusions: The evaluation of the scenarios was excellent and satisfactory by the participants.

Diseño de la asignatura Obstetricia y Ginecología basada en la formación de competencias / Design of the Obstetrics and Gynecology subject based on competency training

Introducción: La sociedad contemporánea reclama la presencia de personas competentes, con la recursividad necesaria para acometer de manera innovadora las funciones y tareas para las que han sido preparadas desde el punto de vista teórico. Solo que esta preparación, como eslabón aislado, no garantiza la generación de sujetos competentes. La calidad de los servicios de salud se mide por el nivel de competencia de sus trabajadores. Dentro de los aspectos generales del sistema de educación superior, se mantiene que estos estarán en continuo perfeccionamiento. Es necesario diseñar estrategias didácticas en la asignatura Obstetricia y Ginecología para la formación basada en competencias para el desempeño. Objetivo: Diseñar los procesos didácticos para la formación de competencias en Obstetricia y Ginecología. Posicionamiento del autor: Se necesita diseñar estrategias didácticas en la asignatura de Obstetricia y Ginecología para la formación basada en competencias para el desempeño, para lo cual se realizó un análisis documental, histórico-lógico, de los programas de estudios de la asignatura de Obstetricia y Ginecología, previo a 2010, para proponer las transformaciones pertinentes en los procesos didácticos de la asignatura. Conclusiones: Los resultados mostraron las transformaciones realizadas al programa de la asignatura desde 2010 hasta 2020. El diseño estuvo basado en el modelo por competencias para el desempeño, por la necesidad de incrementar la calidad de los servicios de salud, a partir de los principios de la educación médica cubana como parte del sistema nacional de salud(AU)

Introduction: The contemporary society demands the presence of competent people, with the necessary resources to undertake, in an innovative way, the functions and tasks for which they have been trained from the theoretical point of view. However, this preparation, as an isolated link, does not guarantee the generation of competent individuals. The quality of health services is measured by the level of competence of workers. The general aspects of the higher education system maintain that workers will continuously improve professionally. It is necessary to design didactic strategies for the Obstetrics and Gynecology subject aimed at training based on performance competencies. Objective: To design the didactic processes for the formation of competencies in Obstetrics and Gynecology. Author's stand: It is necessary to design didactic strategies for the Obstetrics and Gynecology subject in view of training based on performance competencies, for which a documentary and historical-logical analysis of its syllabus was carried, prior to 2010, in order to propose the relevant transformations in the didactic processes of the subject. Conclusions: The results showed the transformations made to the syllabus of the subject from 2010 to 2020. The design was based on the performance competency model, due to the need to increase the quality of health services, based on the principles of Cuban medical education as part of the national health system(AU)

Medical Residents, the Group and the Formation of Professional Identity During the COVID-19 Pandemic.

Residency is still considered the gold standard for quality medical training, and acquiring a professional identity as a specialist is one of its central elements. Residents obtain this identity through both the educational environment and direct interaction with peers and supervisors. However, modifications in health care and educational routines during the recent coronavirus disease 2019 (COVID-19) pandemic have significantly impaired these channels. This study is part of a qualitative research project to analyze professional identity formation in a medical residency program in obstetrics and gynecology at a public hospital in southern Brazil. The authors conducted 28 semi-structured interviews with medical residents and preceptors, as well as a focus group with the residents, which was recorded, transcribed, and analyzed in an effort to construct major analytical categories. Restricted movement and physical contact have forced the use of alternative means of interpersonal interaction, such as communication through social media or instant messaging applications. This has also affected educational activities, such as morning rounds, lectures, and seminars. These changes represent a significant impact, especially in Brazil, where physical proximity is an important cultural feature, even in the work and school environments. We speculate that this new type of virtual interaction will also affect the formation of professional identity among obstetrician-gynecologists. These findings suggest that medical residency programs should be attentive to changes in resident training to ensure that the specialist profile and the expected skills, which are consolidated over many years, are not lost.

A residência médica ainda é considerada o padrão-ouro para a formação médica de qualidade, sendo o processo de construção da identidade profissional de um médico especialista um de seus elementos centrais. Os residentes obtêm essa identidade, entre outros fatores, por meio do ambiente educacional e da interação direta com colegas e supervisores. No entanto, as modificações nas rotinas assistenciais e educacionais durante a recente pandemia de coronavirus disease 2019 (Covid-19) prejudicaram significativamente esses canais. Este estudo faz parte de um projeto de pesquisa qualitativa com o objetivo de analisar a formação da identidade profissional em um programa de residência médica em ginecologia e obstetrícia em um hospital público do sul do Brasil. Os autores realizaram 28 entrevistas semiestruturadas com médicos residentes e preceptores, bem como um grupo focal com residentes. Tanto as entrevistas como as reuniões com o grupo focal foram gravadas, transcritas e analisadas no esforço de construir categorias analíticas. Foi identificado que o movimento restrito e o contato físico forçaram o uso de meios alternativos de interação interpessoal, como a comunicação por meio de mídias sociais ou aplicativos de mensagens instantâneas. Isso também afetou as atividades educacionais, como as rounds, palestras e seminários. Essas mudanças representam um impacto significativo, principalmente no Brasil, onde a proximidade física é uma importante característica cultural, mesmo em ambientes de trabalho e de estudo. Conjectura-se que esse novo tipo de interação virtual também afetará a formação da identidade profissional entre os ginecologistas-obstetras. Esses achados sugerem que os programas de residência médica devem estar atentos às mudanças na formação dos residentes para garantir que o perfil do especialista e as competências esperadas, consolidadas ao longo de muitos anos, não sejam perdidos.

Natural contraception apps knowledge among Brazilian women and Obstetrics and Gynaecology residents.

BACKGROUND: Our objectives were to determine the knowledge and interest in apps for natural contraception among women and Obstetrics and Gynaecology (OBGYN) residents. STUDY DESIGN: An online survey was sent to Brazilian women to gather sociodemographic data, knowledge and interest towards fertility-awareness contraceptive methods and smartphone apps for this purpose. Also, we sent an online survey to OBGYN residents to evaluate the reproductive physiology knowledge of natural contraception and interest in improving it and knowledge and smartphone apps for this purpose. RESULTS: A total of 730 women answered the survey, and 638 were included in the study and 94 OBGYN residents answered the survey. Among the respondent women 386 (60.5%) were interested in more information about natural contraception, 226 (35.5%) showed interest in use natural contraception, 85 (13.3%) indicated that they were users of natural contraception, 15 (16.8%) of this group currently uses an app for this purpose and 485 (76%) considers a practical option to have an app for natural contraception. Regarding the respondent residents all answers were included in the study; 62 (65.9%) knew the right definition of 'Natural Contraception', 52 (55.3%) showed interest in information about this topic and 78 (82.9%) considers a practical option to have an app for natural contraception. CONCLUSIONS: Less than 15% of the respondent women use natural contraception although about 60% expressed some interest in learning more, and that among OBGYN residents, half showed interest.