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Why Did Current Fellows Choose a Fellowship in Minimally Invasive Gynecology? A Qualitative Evaluation
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Abstracts / Journal of Minimally Invasive Gynecology 23 (2016) S1–S252 Plenary 8 - Basic Science/Research/Education (3:25 PM - 5:05 PM) 4:15 PM – GROUP B
Why Did Current Fellows Choose a Fellowship in Minimally Invasive Gynecology? A Qualitative Evaluation Dave A, Yi J. Mayo Clinic, Phoenix, Arizona Study Objective: Summarize and assess qualitative perceptions of AAGL Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS) Program Directors (PD), Associate Program Directors (APD) and first-year fellows
Measurements and Main Results: Response rates to the survey instrument were 50% (37/74) and 66% (26/39) for PDs/APDs and F1s, respectively. Responses were categorized into four themes, in order of prevalence: 1) desire for more skills/experience, 2) career goals, 3) insufficient residency training, and 4) other reasons including program reputation, improving outcomes and addressing specific subjects such as urogynecology or pelvic pain. Two responses from PDs/APDs and one response from a fellow were too vague to be categorized. 37% of PD/ APD and 33% of F1 responses contained more than one common theme. Within the ‘‘career goals’’ theme, four separate goals were identified with at least 2 respondents. These were 1) pursue MIGS, 2) pursue gynecology as a specialty 3) academia/research and 4) lifestyle concerns. Conclusion: Current FMIGS fellows chose to pursue fellowship for a variety of reasons with the desire for more skills/experience being the most common. Program directors’ perceptions as to why fellows pursue fellowship were concordant with the fellows’ stated responses. Understanding why fellows pursue post-residency training will help improve the quality of the education of FMIGS fellowships. 47
Plenary 8 - Basic Science/Research/Education (3:25 PM - 5:05 PM) 4:24 PM – GROUP C
Fig. 1. Reasons for Pursuing AAGL Fellowship. Note: 37% of PDs/ APDs’ and 33% of fellows’ responses fell into more than one category.
Fig. 2. Specific Career Goals. Subcategories of post-fellowship career goals among fellow (n=12) and PDs/APDs (n=14). (F1) about fellows’ reasons for choosing an AAGL fellowship. Design: Anonymous electronic survey (Google Forms, Mountain View, CA). Setting: National survey. Patients: PDs, APDs, and F1s of the AAGL FMIGS. Intervention: Participants were contacted through AAGL-maintained listservs, and completed surveys about their perceptions of F1s readiness for fellowship training. They were also presented with an open-ended query regarding the reason the participant believed the F1 chose an AAGL fellowship. F1s were asked about their own reason. The query required a response in order to complete the survey. Responses were iteratively reviewed by the primary author to identify common themes.
Meta-Analysis and Systematic Review to Determine the Optimum Imaging Modality for the Detection of Posterior Vaginal Fornix Deep Infiltrative Endometriosis Gerges B,1 Nadim B,1 Martins W,2 Condous G.1 1Acute .aecology, Early Pregnancy and Advanced Endosurgery, Nepean Hospital, Nepean Medical School, University of Sydney, Kingswood, NSW, Australia; 2Medical School of Ribeirao Preto, Department of Obstetrics and Gynecology, University of Sao Paulo, Sao Paulo, Brazil Study Objective: To review the accuracy and determine the optimum imaging modality for the detection of posterior vaginal fornix deep infiltrative endometriosis (DIE) in women with a clinical history of endometriosis. Design: A systematic review was conducted using MEDLINE, Embase, PubMed and Google Scholar to identify studies published between January 1990 and March 2016. Studies were considered eligible if they were prospective and used any imaging modality preoperatively to assess for the presence of DIE, specifically the posterior vaginal fornix, which was then correlated with the laparoscopic gold standard. Posterior vaginal fornix DIE was defined as any vaginal site. We restricted the eligibility to studies having at least 10 affected and 10 unaffected women. Setting: N/A. Patients: N/A. Intervention: N/A. Measurements and Main Results: The electronic searches retrieved 1034 records. After excluding the records that were clearly not eligible by reading title and abstracts, we completely evaluated 106 study groups for eligibility: 55 were excluded because they were related to studies that included less than 10 affected/unaffected women; and 12 were excluded due to potential redundant information with regards to the same population. We included 22 study groups in the analyses and the main results are reported on Table 1.
Table 1. Diagnostic test accuracy of imaging techniques in assessing posterior vaginal fornix DIE. Method
Studies
N
Affected
Sens.
95%CI
Heterog.
Spec.
95%CI
Heterog.
MRI MRI with gel SVG TRU TVS TVS with WC
4 3 3 2 9 1
295 129 300 232 739 90
126 39 61 64 218 69
74% 90% 71% 71% 62% 97%
57-91 81-99% 42-100% 66-76% 45-79% 90-99%
Very Low Very Very Very N/A
93% 100% 99% 100% 94% 100%
88-99% 98-100% 96-100% 96-100% 90-98% 85-100%
High Low Low Low Very high N/A
high high high high
MRI = Magnetic resonance imaging, SVG = Sonovaginography, TRU = Transrectal ultrasound, TVS = Transvaginal ultrasound, WC = Water contrast
Abstracts / Journal of Minimally Invasive Gynecology 23 (2016) S1–S252 Plenary 8 - Basic Science/Research/Education (3:25 PM - 5:05 PM) 4:15 PM – GROUP B
Why Did Current Fellows Choose a Fellowship in Minimally Invasive Gynecology? A Qualitative Evaluation Dave A, Yi J. Mayo Clinic, Phoenix, Arizona Study Objective: Summarize and assess qualitative perceptions of AAGL Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS) Program Directors (PD), Associate Program Directors (APD) and first-year fellows
Measurements and Main Results: Response rates to the survey instrument were 50% (37/74) and 66% (26/39) for PDs/APDs and F1s, respectively. Responses were categorized into four themes, in order of prevalence: 1) desire for more skills/experience, 2) career goals, 3) insufficient residency training, and 4) other reasons including program reputation, improving outcomes and addressing specific subjects such as urogynecology or pelvic pain. Two responses from PDs/APDs and one response from a fellow were too vague to be categorized. 37% of PD/ APD and 33% of F1 responses contained more than one common theme. Within the ‘‘career goals’’ theme, four separate goals were identified with at least 2 respondents. These were 1) pursue MIGS, 2) pursue gynecology as a specialty 3) academia/research and 4) lifestyle concerns. Conclusion: Current FMIGS fellows chose to pursue fellowship for a variety of reasons with the desire for more skills/experience being the most common. Program directors’ perceptions as to why fellows pursue fellowship were concordant with the fellows’ stated responses. Understanding why fellows pursue post-residency training will help improve the quality of the education of FMIGS fellowships. 47
Plenary 8 - Basic Science/Research/Education (3:25 PM - 5:05 PM) 4:24 PM – GROUP C
Fig. 1. Reasons for Pursuing AAGL Fellowship. Note: 37% of PDs/ APDs’ and 33% of fellows’ responses fell into more than one category.
Fig. 2. Specific Career Goals. Subcategories of post-fellowship career goals among fellow (n=12) and PDs/APDs (n=14). (F1) about fellows’ reasons for choosing an AAGL fellowship. Design: Anonymous electronic survey (Google Forms, Mountain View, CA). Setting: National survey. Patients: PDs, APDs, and F1s of the AAGL FMIGS. Intervention: Participants were contacted through AAGL-maintained listservs, and completed surveys about their perceptions of F1s readiness for fellowship training. They were also presented with an open-ended query regarding the reason the participant believed the F1 chose an AAGL fellowship. F1s were asked about their own reason. The query required a response in order to complete the survey. Responses were iteratively reviewed by the primary author to identify common themes.
Meta-Analysis and Systematic Review to Determine the Optimum Imaging Modality for the Detection of Posterior Vaginal Fornix Deep Infiltrative Endometriosis Gerges B,1 Nadim B,1 Martins W,2 Condous G.1 1Acute .aecology, Early Pregnancy and Advanced Endosurgery, Nepean Hospital, Nepean Medical School, University of Sydney, Kingswood, NSW, Australia; 2Medical School of Ribeirao Preto, Department of Obstetrics and Gynecology, University of Sao Paulo, Sao Paulo, Brazil Study Objective: To review the accuracy and determine the optimum imaging modality for the detection of posterior vaginal fornix deep infiltrative endometriosis (DIE) in women with a clinical history of endometriosis. Design: A systematic review was conducted using MEDLINE, Embase, PubMed and Google Scholar to identify studies published between January 1990 and March 2016. Studies were considered eligible if they were prospective and used any imaging modality preoperatively to assess for the presence of DIE, specifically the posterior vaginal fornix, which was then correlated with the laparoscopic gold standard. Posterior vaginal fornix DIE was defined as any vaginal site. We restricted the eligibility to studies having at least 10 affected and 10 unaffected women. Setting: N/A. Patients: N/A. Intervention: N/A. Measurements and Main Results: The electronic searches retrieved 1034 records. After excluding the records that were clearly not eligible by reading title and abstracts, we completely evaluated 106 study groups for eligibility: 55 were excluded because they were related to studies that included less than 10 affected/unaffected women; and 12 were excluded due to potential redundant information with regards to the same population. We included 22 study groups in the analyses and the main results are reported on Table 1.
Table 1. Diagnostic test accuracy of imaging techniques in assessing posterior vaginal fornix DIE. Method
Studies
N
Affected
Sens.
95%CI
Heterog.
Spec.
95%CI
Heterog.
MRI MRI with gel SVG TRU TVS TVS with WC
4 3 3 2 9 1
295 129 300 232 739 90
126 39 61 64 218 69
74% 90% 71% 71% 62% 97%
57-91 81-99% 42-100% 66-76% 45-79% 90-99%
Very Low Very Very Very N/A
93% 100% 99% 100% 94% 100%
88-99% 98-100% 96-100% 96-100% 90-98% 85-100%
High Low Low Low Very high N/A
high high high high
MRI = Magnetic resonance imaging, SVG = Sonovaginography, TRU = Transrectal ultrasound, TVS = Transvaginal ultrasound, WC = Water contrast