AuduBon-Bons: Bite-Sized Learning for Residents in the Ambulatory Obstetrics and Gynecology Clinic.

Background: While most medical education happens in the inpatient setting, the vast majority of medicine is practiced in the outpatient setting. Graduates from our obstetrics and gynecology (OB/GYN) program consistently report lower confidence and comfort in the ambulatory, as opposed to inpatient, setting. Objective: To describe and evaluate a novel curriculum, delivered in an ambulatory clinic covering ambulatory care topics, and to assess its feasibility in a single site OB/GYN residency program. Methods: We created an ambulatory curriculum, comprising short modules delivered in the ambulatory clinic during the first 15 minutes of every half-day clinic session. Modules were delivered using a flipped classroom format with pre-session assignments during the 2019-2020 academic year. Outcomes were residents' pre- and post-session comfort and confidence and module developers' time to create the curriculum. Time tracking was performed. Results: On average, 11 residents were present for the teaching session weekly. Twenty-four residents and 6 faculty were eligible to complete pre- and post-session surveys. For every weekly session, the average resident comfort level and the average resident confidence level with the module's topic increased from the pre-module survey to the post-module survey. Residents completed pre-module assignments 64.8% (236 of 364) of the time, and of residents who completed the pre-work, 89.4% (211 of 236) reported it was useful. Average survey completion rate was 70.5% (1398 of 1984). Conclusions: We showed that it is feasible to create and implement an ambulatory curriculum for residents in OB/GYN, and this curriculum increased resident's comfort and confidence with ambulatory practice.

Telehealth Uptake into Prenatal Care and Provider Attitudes during the COVID-19 Pandemic in New York City: A Quantitative and Qualitative Analysis.

OBJECTIVE: This study aimed to (1) determine to what degree prenatal care was able to be transitioned to telehealth at prenatal practices associated with two affiliated hospitals in New York City during the novel coronavirus disease 2019 (COVID-19) pandemic and (2) describe providers' experience with this transition. STUDY DESIGN: Trends in whether prenatal care visits were conducted in-person or via telehealth were analyzed by week for a 5-week period from March 9 to April 12 at Columbia University Irving Medical Center (CUIMC)-affiliated prenatal practices in New York City during the COVID-19 pandemic. Visits were analyzed for maternal-fetal medicine (MFM) and general obstetrical faculty practices, as well as a clinic system serving patients with public insurance. The proportion of visits that were telehealth was analyzed by visit type by week. A survey and semistructured interviews of providers were conducted evaluating resources and obstacles in the uptake of telehealth. RESULTS: During the study period, there were 4,248 visits, of which approximately one-third were performed by telehealth (n = 1,352, 31.8%). By the fifth week, 56.1% of generalist visits, 61.5% of MFM visits, and 41.5% of clinic visits were performed via telehealth. A total of 36 providers completed the survey and 11 were interviewed. Accessing technology and performing visits, documentation, and follow-up using the telehealth electronic medical record were all viewed favorably by providers. In transitioning to telehealth, operational challenges were more significant for health clinics than for MFM and generalist faculty practices with patients receiving public insurance experiencing greater difficulties and barriers to care. Additional resources on the patient and operational level were required to optimize attendance at in-person and video visits for clinic patients. CONCLUSION: Telehealth was rapidly implemented in the setting of the COVID-19 pandemic and was viewed favorably by providers. Limited barriers to care were observed for practices serving patients with commercial insurance. However, to optimize access for patients with Medicaid, additional patient-level and operational supports were required. KEY POINTS: · Telehealth uptake differed based on insurance.. · Medicaid patients may require increased assistance for telehealth.. · Quick adoption of telehealth is feasible..