In order to improve the Family Medicine obstetrics (OB) rotation orientation and to encourage resident- resident teaching, we developed an orientation exercise that oriented FM PGY-1s to Labor and Delivery while providing a defined teaching opportunity for OB PGY-2s.

Objective: Methods:All OB PGY-2s were trained to teach one portion of a 3-part curriculum developed for a 2 hour FM PGY-1 OB orientation in July, 2010. The curriculum included: 1) sterile preparation of the table and draping of the patient for NSVD; 2) identification of surgical instruments; 3) proper instrument use and utilization during NSVD.

A game, a timed, point scored relay race, that tested and reinforced the curriculum, was created and used as well. Points were awarded for speed, accuracy, proper identification of instruments and correct answers to questions related to the delivery process.

Subjects completed the VARK (visual, aural, read/write, kinesthetic) questionnaire in advance and were divided into 3 teams with balanced learning styles. Textual, photo and video handouts were provided for reference. Teams rotated through the 3 stations in 30 minute shifts. In the last 30 minutes subjects participated in the “NSVD race.”

Conclusions:

References:

1) Baker DP, et al: The role of teamwork in the professional education of physicians: Current status and assessment recommendations. Jt Comm J Qual Patient Saf 31:185-202, Apr 2005.

2) Chakraborti, C MD, et al. A systematic review of Teamwork Training Interventions in Medical Student and Resident Education. J Gen Internal Medicine. 2008 June; 23 (6): 846-853.

3) Satterlee, Winston G. MD. Effective Medical Education: Insights from the Cochrane Library. Obstetrical & Gynecological Survey. Vol 63 (5), May 2008, pp 329-333.

4) Premkumar, K & Bonnycastle, D. Games as active learning strategies: a faculty development workshop. Med Ed 2006: 40: 1123-47.

5) ACGME. ACGME outcome project-core competencies. Chicago Il: ACGME available at:

http://www.acgme.org?outcome/comp/compMin.asp

Results:

Question* Year P Value† 2008 – 09

(n = 40) 2010

(n = 8)

Interest in Teaching 4.0 ± 0.81 4.8 ± 0.44 0.038 Performance in Teaching 4.0 ± 0.75 4.6 ± 0.52 0.030 *1=Unacceptable, 2=Poor, 3=Average, 4=Good, 5=Excellent

Data reported as mean ± SD†Independent t-test

3/3 OB/GYN PGY-2s and 8/9 FM PGY-1s participated. E values scores for Interest in Teaching (4.8 v 4.0, p=.038) and Performance of Teaching Activities (4.6 v 4.0, p=.030) were rated on a 5 point Likert scale. Independent t-test demonstrated a statistically significant difference in both categories when compared with historical controls (Table).

All participants found the program to be valuable (avg. 4.65, sd .518) and the majority felt the orientation specifically had positively impacted their E values ratings for teaching on the rotation (avg 3.86, sd 1.46) (Graph ).

We compared rotation electronic evaluation scores (E values) specific to teaching with historical controls from the 2 years prior. A survey specifically addressing the impact of the orientation program on E values scores for the rotation was completed by all participants in December, 2010 as well.

The NSVD race was a timed, point scored team relay race.

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Independent responses to electronic evaluations (E values) ratings

specific to the orientation and to teaching on the rotation for each participant.

A resident run orientation program provides an opportunity for interdepartmental resident –resident education and can improve FM resident perceptions of teaching. Moreover, it creates a learning experience that reinforces Accreditation Council for Graduate Medical Education (ACGME) core competencies of Professionalism (encouraging teamwork) and Practice Based Learning (facilitating the learning of others). As a result of the success of this orientation, we plan to implement the program as part of our future orientation programs.

Background:Historically in our institution the obstetrics rotation is, for many Family Medicine residents, the least favorite rotation of the intern year. While electronic evaluations (E values) ratings of the rotation fall in the average/above average range (3-4 on 5 point Likert scale), the lowest scores are consistently in the areas of Interest in Teaching and Performance of Teaching Activities. While positive narrative comments extol the hands on opportunities for learning, negative comments consistently report that FM interns feel that resident to resident teaching is not a priority. As a result of these evaluations, we created a 2-tiered OB orientation program which provided a defined teaching opportunity for OB residents and promoted a positive interaction between the 2 groups in a low stakes environment.

Fostering Interdepartmental Resident-Resident Teaching with an OB Orientation Curriculum and Game

Matthew A. Nash, MD; Michael Moen, MD; Lee A. Learman, MD, PhD; Nancy Davis; Linda Griffith- Brown Department of Obstetrics and Gynecology, Advocate Lutheran General Hospital

Break-out sessions for identification and utilization of surgical instruments for NSVD.