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Pilot Study to Assess the Impact of the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum on OBGYN Resident Education
Poster Abstracts / J Pediatr Adolesc Gynecol 30 (2017) 275e298
5. Improving Ob-Gyn Resident Knowledge and Skills With the Pre-Pubertal Exam and Vaginoscopy Using a Self-Study Elearning Module P.S. Huguelet MD 1,2, L. Palacios-Helgeson MD, MSc 1, Learman L MD, PhD 3, Guiahi M MD, MSc*1 1 2 3
University of Colorado Hospital Children’s Hospital Colorado Florida Atlantic University, Aurora, Colorado
Key Words: eLearn module, pre-pubertal bleeding, vaginoscopy, residents
Background: Obstetrics and Gynecology (Ob-Gyn) residents receive minimal training in performing a pre-pubertal pelvic exam and vaginoscopy and many are unprepared to provide these services following graduation. The objective of this study was to develop and assess a selfstudy module for Ob-Gyn residents at the University of Colorado (UCH) to improve their knowledge and skills with the pre-pubertal exam and vaginoscopy. Methods: We utilized the CREOG learning objectives to inform an interactive module on the evaluation of a patient with pre-pubertal vaginal bleeding. The module included specific instruction on how to (1) evaluate a patient with pre-pubertal vaginal bleeding, (2) conduct a pre-pubertal exam, (3) obtain a vaginal culture, (4) perform office lavage, and (5) perform vaginoscopy. The module was supplemented with narration, animation, and video demonstrations, incorporating brief examinations throughout the module to reinforce learning. We obtained IRB approval for evaluation of the module. We piloted the module with chief residents and recent graduates and subsequently held a focus group with these informants to solicit feedback. We then made appropriate revisions to the module. We launched the module to the current Ob-Gyn residents at UCH (n¼37) in August 2016. Residents were solicited by e-mail communication and offered a small incentive to participate. They were given a 12-week period for completion of the module and evaluation tool. The evaluation tool consisted of a pre and post-module survey. The survey queried knowledge, satisfaction, and confidence in the evaluation and treatment of pre-pubertal vaginal bleeding. We plan to evaluate change in knowledge using paired t-tests. Additionally, descriptive statistics will be used to report time for module completion, satisfaction and confidence levels. Results: During the focus group sessions, we received detailed and critical feedback on the module. The majority of attendees reported limited exposure to patients with pre-pubertal bleeding during residency, and the modules provided a useful learning tool to review the topic. Focus group attendees noted the following deficiencies in the modules: (1) poor image quality, (2) inadequate details on both management and treatment of prepubertal bleeding, and (3) need to expand the volume of exam questions to reinforce learning. Revisions were then made to the module. The module is currently being viewed by our residents and final evaluation tools will be completed by November 2016. We will analyze survey results in January 2017 and report our findings. Conclusions: We have developed an eLearning module to improve education of Ob-Gyn residents in the evaluation and management of prepubertal vaginal bleeding. This also has the potential to teach learners at other institutions with similar barriers to education in pediatric and adolescent gynecology.
6. Pilot Study to Assess the Impact of the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum on OBGYN Resident Education O. Myint MD, MS, L. Nathan MD* Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, California
Background: Teaching Pediatric and Adolescent Gynecology (PAG) is one of the CREOG educational objectives. However many OBGYN residency
277
programs do not have a dedicated PAG curriculum, and resident exposure to this topic may be lacking. The main purpose of this study was to evaluate if a teaching module based on the NASPAG short curriculum on PAG can improve OBGYN residents’ knowledge and comfort level with this topic, as reflected by self assessment surveys and CREOG scores. Methods: The study was conducted at a single academic residency program involving all OB/GYN residents PGY 1-4 from November 2015 to April 2016. A teaching module based on the NASPAG short curriculum was designed and implemented over a two month span prior to the CREOG exams in 2016. The curriculum consisted of two 90 minute PowerPoint didactics divided between pediatric topics and adolescent topics, as well as two articles that were presented and reviewed during weekly journal clubs for thirty minutes each. A peer-validated online Redcap survey instrument was used to assess the four following areas of interest: 1) resident comfort with treating and counseling PAG patients, 2) resident exposure to PAG, 3) satisfaction with PAG training and 4) interest in PAG fellowship. The responses were graded on a Likert scale from 1-5, with one indicating strongly disagree with and five indicating strongly agree with the statement. The survey was given to residents prior to the teaching curriculum as well as 3 months post teaching curriculum. Responses to the two surveys were analyzed using two-sided paired Wilcoxon rank sum test. CREOG performance on PAG questions was analyzed by comparing the average number of questions answered correctly in 2015 and 2016. Results: A total of 28 residents took the pre, and 21 residents took the post survey. Following the teaching curriculum there was a statistically significant increase in resident self-reported comfort with 1) performing a pelvic exam on a pediatric patient, 2) distinguishing abnormal and normal pediatric female anatomy, 3) screening for sexual abuse, 4) treating common pediatric gynecology complaints such as vaginal itching, 5) and distinguishing etiology of straddle injury. There was no difference in pre and post surveys regarding resident comfort level with counseling and establishing rapport with pediatric and adolescent patients and their parents. The survey showed that residents had minimal exposure to PAG but that they were more satisfied with their training in PAG after the teaching module. There was no increase in resident interest in PAG fellowship training in the post as compared to the pre survey. There was no improvement in the average number of PAG-related CREOG questions answered correctly by residents between 2015 and 2016. The average number of questions answered correctly did not differ by resident year of training. Conclusion: An inexpensive, easily replicated teaching curriculum based on the NASPAG short curriculum can improve OBGYN residents’ comfort with their ability to provide gynecological care for PAG patients, and satisfaction with training. Additional teaching efforts are needed to increase knowledge in PAG.
7. Sexual Health Education in Primary and Secondary Schools of the Children’s Hospital of Eastern Ontario (CHEO) Catchment Area: A Survey and Needs Assessment of School Principals Elise Farmer MD 1, Nathalie Fleming MD, FRCSC 1,2,3,4, Amanda Black MD, MPH, FRCSC 1,2,3, Tania Dumont MD, FRCSC*1,2,3,4 1
Department of Obstetrics and Gynecology, The University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada 2 Division of Gynecology, The Children’s Hospital of Eastern Ontario 3 Ottawa Hospital Research Institute 4 CHEO Research Institute
Background: The Canadian Guidelines for Sexual Health Education states that “sexual health is a key aspect of personal health and social welfare that influences individuals across their lifespan”. Multiple studies show that sexual health education programs help to prevent negative sexual health outcomes such as sexually transmitted infections and unplanned pregnancies. The objectives of this study are to determine: (1) If sexual health education programs are available to youth in our region; (2) If the structure and content of sexual health education programs are following Canadian guidelines for sexual health education;
5. Improving Ob-Gyn Resident Knowledge and Skills With the Pre-Pubertal Exam and Vaginoscopy Using a Self-Study Elearning Module P.S. Huguelet MD 1,2, L. Palacios-Helgeson MD, MSc 1, Learman L MD, PhD 3, Guiahi M MD, MSc*1 1 2 3
University of Colorado Hospital Children’s Hospital Colorado Florida Atlantic University, Aurora, Colorado
Key Words: eLearn module, pre-pubertal bleeding, vaginoscopy, residents
Background: Obstetrics and Gynecology (Ob-Gyn) residents receive minimal training in performing a pre-pubertal pelvic exam and vaginoscopy and many are unprepared to provide these services following graduation. The objective of this study was to develop and assess a selfstudy module for Ob-Gyn residents at the University of Colorado (UCH) to improve their knowledge and skills with the pre-pubertal exam and vaginoscopy. Methods: We utilized the CREOG learning objectives to inform an interactive module on the evaluation of a patient with pre-pubertal vaginal bleeding. The module included specific instruction on how to (1) evaluate a patient with pre-pubertal vaginal bleeding, (2) conduct a pre-pubertal exam, (3) obtain a vaginal culture, (4) perform office lavage, and (5) perform vaginoscopy. The module was supplemented with narration, animation, and video demonstrations, incorporating brief examinations throughout the module to reinforce learning. We obtained IRB approval for evaluation of the module. We piloted the module with chief residents and recent graduates and subsequently held a focus group with these informants to solicit feedback. We then made appropriate revisions to the module. We launched the module to the current Ob-Gyn residents at UCH (n¼37) in August 2016. Residents were solicited by e-mail communication and offered a small incentive to participate. They were given a 12-week period for completion of the module and evaluation tool. The evaluation tool consisted of a pre and post-module survey. The survey queried knowledge, satisfaction, and confidence in the evaluation and treatment of pre-pubertal vaginal bleeding. We plan to evaluate change in knowledge using paired t-tests. Additionally, descriptive statistics will be used to report time for module completion, satisfaction and confidence levels. Results: During the focus group sessions, we received detailed and critical feedback on the module. The majority of attendees reported limited exposure to patients with pre-pubertal bleeding during residency, and the modules provided a useful learning tool to review the topic. Focus group attendees noted the following deficiencies in the modules: (1) poor image quality, (2) inadequate details on both management and treatment of prepubertal bleeding, and (3) need to expand the volume of exam questions to reinforce learning. Revisions were then made to the module. The module is currently being viewed by our residents and final evaluation tools will be completed by November 2016. We will analyze survey results in January 2017 and report our findings. Conclusions: We have developed an eLearning module to improve education of Ob-Gyn residents in the evaluation and management of prepubertal vaginal bleeding. This also has the potential to teach learners at other institutions with similar barriers to education in pediatric and adolescent gynecology.
6. Pilot Study to Assess the Impact of the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum on OBGYN Resident Education O. Myint MD, MS, L. Nathan MD* Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, California
Background: Teaching Pediatric and Adolescent Gynecology (PAG) is one of the CREOG educational objectives. However many OBGYN residency
277
programs do not have a dedicated PAG curriculum, and resident exposure to this topic may be lacking. The main purpose of this study was to evaluate if a teaching module based on the NASPAG short curriculum on PAG can improve OBGYN residents’ knowledge and comfort level with this topic, as reflected by self assessment surveys and CREOG scores. Methods: The study was conducted at a single academic residency program involving all OB/GYN residents PGY 1-4 from November 2015 to April 2016. A teaching module based on the NASPAG short curriculum was designed and implemented over a two month span prior to the CREOG exams in 2016. The curriculum consisted of two 90 minute PowerPoint didactics divided between pediatric topics and adolescent topics, as well as two articles that were presented and reviewed during weekly journal clubs for thirty minutes each. A peer-validated online Redcap survey instrument was used to assess the four following areas of interest: 1) resident comfort with treating and counseling PAG patients, 2) resident exposure to PAG, 3) satisfaction with PAG training and 4) interest in PAG fellowship. The responses were graded on a Likert scale from 1-5, with one indicating strongly disagree with and five indicating strongly agree with the statement. The survey was given to residents prior to the teaching curriculum as well as 3 months post teaching curriculum. Responses to the two surveys were analyzed using two-sided paired Wilcoxon rank sum test. CREOG performance on PAG questions was analyzed by comparing the average number of questions answered correctly in 2015 and 2016. Results: A total of 28 residents took the pre, and 21 residents took the post survey. Following the teaching curriculum there was a statistically significant increase in resident self-reported comfort with 1) performing a pelvic exam on a pediatric patient, 2) distinguishing abnormal and normal pediatric female anatomy, 3) screening for sexual abuse, 4) treating common pediatric gynecology complaints such as vaginal itching, 5) and distinguishing etiology of straddle injury. There was no difference in pre and post surveys regarding resident comfort level with counseling and establishing rapport with pediatric and adolescent patients and their parents. The survey showed that residents had minimal exposure to PAG but that they were more satisfied with their training in PAG after the teaching module. There was no increase in resident interest in PAG fellowship training in the post as compared to the pre survey. There was no improvement in the average number of PAG-related CREOG questions answered correctly by residents between 2015 and 2016. The average number of questions answered correctly did not differ by resident year of training. Conclusion: An inexpensive, easily replicated teaching curriculum based on the NASPAG short curriculum can improve OBGYN residents’ comfort with their ability to provide gynecological care for PAG patients, and satisfaction with training. Additional teaching efforts are needed to increase knowledge in PAG.
7. Sexual Health Education in Primary and Secondary Schools of the Children’s Hospital of Eastern Ontario (CHEO) Catchment Area: A Survey and Needs Assessment of School Principals Elise Farmer MD 1, Nathalie Fleming MD, FRCSC 1,2,3,4, Amanda Black MD, MPH, FRCSC 1,2,3, Tania Dumont MD, FRCSC*1,2,3,4 1
Department of Obstetrics and Gynecology, The University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada 2 Division of Gynecology, The Children’s Hospital of Eastern Ontario 3 Ottawa Hospital Research Institute 4 CHEO Research Institute
Background: The Canadian Guidelines for Sexual Health Education states that “sexual health is a key aspect of personal health and social welfare that influences individuals across their lifespan”. Multiple studies show that sexual health education programs help to prevent negative sexual health outcomes such as sexually transmitted infections and unplanned pregnancies. The objectives of this study are to determine: (1) If sexual health education programs are available to youth in our region; (2) If the structure and content of sexual health education programs are following Canadian guidelines for sexual health education;