Medical Student Mistreatment-an Obstetrics and Gynecology Perspective: a Pilot Study.

OBJECTIVE: To determine if perception of mistreatment and severity in each of the professional videotaped vignettes was similar between participants of differing professional status (Ob/Gyn attending physicians, resident physicians, and medical students), previous mistreatment status, ethnic minority status, and gender. METHODS: Three video vignettes were filmed portraying possible medical student mistreatment during an obstetrics and gynecology clerkship. Prior to watching the videos, all participants were asked to complete a questionnaire related to their prior experience with mistreatment as a medical student along with other demographic details. After viewing each video, participants were asked to rate the video as representing mistreatment (yes/no) and, if yes, the severity of medical student mistreatment. RESULTS: Eight attending physicians, ten resident physicians, and ten medical students participated in this study. Professional status, previous mistreatment status, ethnic minority status, and gender did not affect how participants perceived mistreatment or the severity of the video vignettes. Fifty percent (14/28) of participants reported previous mistreatment as a medical student, all of which occurred during their third year of medical school. CONCLUSION: Medical students, resident physicians, and attending physicians generally agreed which video vignettes represented medical student mistreatment and the level of severity of the event.

Bladder Calculus at Cesarean Delivery in a Patient with Previous Cystotomy Repair.

BACKGROUND: The cesarean delivery rate continues to rise in the United States. The majority of cesarean deliveries are performed secondary to a previous cesarean delivery. Bladder injury at the time of a repeat cesarean delivery is a known risk. CASE: A 28-year-old woman sustained an incidental cystotomy during her second cesarean delivery, which was repaired at that time. During her third cesarean delivery she was noted to have a 6x5-cm calculus in her bladder. This large bladder calculus was removed through a cystotomy and her bladder was repaired without incident. CONCLUSION: Women with a previous bladder injury undergoing repeat cesarean delivery should have their bladder carefully inspected for any further urologic complications.

Impact of a Pediatric and Adolescent Gynecology Curriculum on an Obstetrics and Gynecology Residency.

STUDY OBJECTIVE: To determine the effectiveness of a new pediatric and adolescent gynecology (PAG) curriculum for improving obstetrics/gynecology resident physician knowledge and comfort level in patient management and to describe the current deficiencies in resident physician knowledge and comfort level in PAG. DESIGN: A PAG curriculum was implemented for the obstetrics/gynecology resident physicians (n = 20) at the University of South Florida in July 2013. Before and after the curriculum was introduced, resident physicians and recent graduates of the residency program completed a survey to assess their comfort level and a knowledge assessment consisting of 20 case-based questions. SETTING: University-based residency program. PARTICIPANTS: Resident physicians and recent resident physician graduates in the Department of Obstetrics and Gynecology. INTERVENTIONS: Introduction of a PAG curriculum during the 2013-2014 academic year. MAIN OUTCOME MEASURES: Improvement in resident physicians' comfort level and knowledge in PAG. RESULTS: After the curriculum was introduced, comfort increased in examining the genitals of a pediatric gynecology patient (median difference = 1.5; P = .003) and history-taking, physical examination skills, and management (median difference = 1; P = .002) compared with before the curriculum. There was no significant difference in overall quiz score (15.5 ± 1.87 vs 15.8 ± 1.3; P = .78). CONCLUSION: A curriculum in PAG did improve resident comfort level in managing PAG patients, but did not significantly improve knowledge of this topic.

Simulation training in an obstetric clerkship: a randomized controlled trial.

OBJECTIVE: To estimate the effect of simulation training on the confidence of medical students to perform a vaginal delivery. METHODS: Medical students on 12 consecutive rotations were recruited and randomly assigned to a traditional lecture on performing a vaginal delivery or a lecture plus hands-on vaginal delivery simulation. Participants completed confidence assessment questionnaires at baseline and 4 weeks after training. End-of-rotation examination scores were also compared. RESULTS: One-hundred thirteen students participated (94.9% of those eligible). Students receiving simulation training were significantly more confident in their ability to perform a vaginal delivery immediately after assessment than students who did not receive the simulation training (P<.01); however, these differences narrowed over time. Compared with lecture-only students, simulation students scored significantly higher on their oral (P=.004) and written examinations (P=.009) 4 weeks after the intervention. CONCLUSION: A single obstetric simulation is more effective than lecture only for increasing students' end-of-rotation oral and written examination scores. LEVEL OF EVIDENCE: I.