Does Participation in Obstetrics and Gynecology Subspecialties Improve Clerkship Outcomes?

Objective: The primary objective is to determine if participation in subspecialty rotations during Ob/Gyn core clerkships improves student performance as measured by National Board of Medical Examiners (NBME) Ob/Gyn clinical science subject exam scores, clinical evaluations, and final clerkship summative grades when compared to students without focused subspecialty time.

Methods: This is a retrospective study of third-year Alpert Medical School of Brown University (AMS) Ob/Gyn core clerkship students at a single institution (Women and Infants Hospital in Providence, RI) from 2012 to 2017. Participation in Maternal Fetal Medicine (MFM) and/or Gynecologic oncology (Gyn Onc) subspecialty track (a one-week focused experience), NBME Ob/Gyn clinical science subject exam raw score, clinical evaluation score, final clerkship summative grade, and decision to pursue Ob/Gyn as a career were analyzed.

Feasibility of a Regional Approach to an Obstetrics and Gynecology Transition to Residency Course.

Objective: To demonstrate the feasibility of a regional Obstetrics and Gynecology (Ob/Gyn) Transition to Residency Course (TRC) through compliance, satisfaction, and sustainability.

Methods: We implemented a two-week, multi-institutional regional TRC (RTRC) for fourth-year medical students matched in Ob/Gyn or Family Medicine from four New England medical schools. Curriculum was developed to meet Ob/Gyn Milestone One (M1) and Core Entrustable Professional Activity (CEPA) objectives.

Urinary fistula and incontinence.

It is estimated that as many as 3.5 million women worldwide suffer from obstetric urinary fistula. This public health tragedy is a result of obstructed labor and inadequate access to health care, and its eradication lies in prevention and treatment.

Implementation and evaluation of a novel operating room curriculum for the obstetrics and gynecology clerkship.

Objective: Primary objective is to estimate the effect of an operating room (OR) curriculum on obstetrics and gynecology (Ob/Gyn) students' clinical knowledge related to the OR. Secondary objective is to estimate the effect of the curriculum on student confidence and satisfaction related to the OR experience.

Study Design: Prospective cohort study of 6 Ob/Gyn clerkship groups from September 2011 to June 2012.

Improving patient knowledge about sacral nerve stimulation using a patient based educational video.

Purpose: We developed a patient based educational video to address the information needs of women considering sacral nerve stimulation for overactive bladder.

Materials And Methods: Five semistructured focus groups were used to identify patient knowledge gaps, information needs, patient acceptable terminology and video content preferences for a patient based sacral nerve stimulation educational video. Each session was transcribed, independently coded by 2 coders and examined using an iterative method.

Unrecognized bladder perforation leading to severe progressive cellulitis and candidal infection.

Background: Retropubic midurethral slings are a minimally invasive surgical procedure used in the treatment of stress urinary incontinence and are typically associated with high cure rates and low complication rates. Bladder perforation is a known intraoperative complication that, if left unrecognized, can have significant morbidity.

Case: A 47-year-old underwent a retropubic midurethral sling, anterior colporrhaphy, and cystoscopy.

Midurethral sling shortening for persistent stress urinary incontinence.

We describe techniques and objective and subjective outcomes for women who underwent midurethral sling (MUS) shortening for persistent stress urinary incontinence (SUI). This is a case series of women who underwent MUS shortening for SUI within 8 weeks of initial MUS placement. Objective and subjective findings including Urinary Distress Inventory (UDI)-6 and Urinary Impact Questionnaire (UIQ)-7 scores are reported, and shortening techniques are described.

Perceptions of operating room learning experiences during the obstetrics and gynecology clerkship.

Background: There is little published describing curriculum development for the medical student in the operating room (OR).

Purpose: Explore student and faculty perceptions of learning experiences in the OR during the Obstetrics and Gynecology (Ob/Gyn) clerkship as a prelude to defining OR-specific learning objectives and curriculum.

Methods: Fourth year students and Obstetrics and Gynecology faculty participated in structured, audiotaped focus groups aimed at defining OR educational objectives and curriculum content.

A randomized trial to estimate the effect of an interactive computer trainer on resident knowledge of female pelvic floor dysfunction and anatomy.

Objectives: : To estimate the effect of a computer trainer on improving knowledge and attitudes of Obstetrics and Gynecology residents regarding female pelvic anatomy (PA) and pelvic floor dysfunction (PFD) compared to usual teaching.

Methods: : A randomized trial was conducted between April and June 2008. Obstetrics and Gynecology residents randomized by year of training participated in a 1-hour session with a computer trainer for individual-based learning of female PA and PFD or usual teaching.

Improving medical student knowledge of female pelvic floor dysfunction and anatomy: a randomized trial.

Objective: The objective of the study was to estimate the effect of an interactive computer trainer on improving medical student knowledge and attitudes regarding female pelvic anatomy (PA) and pelvic floor dysfunction (PFD).

Study Design: Forty-three students were randomized to the trainer and usual teaching vs usual teaching alone. Pre- and postintervention knowledge and attitude questionnaires were completed.

Epidemiology of pelvic floor dysfunction.

The epidemiology of female pelvic floor disorders, including urinary incontinence, pelvic organ prolapse, anal incontinence, and interstitial cystitis/painful bladder syndrome is reviewed. The natural history, prevalence, incidence, remission, risk factors, and potential areas for prevention are considered.

Magnetic resonance imaging of pelvic organ prolapse: comparing pubococcygeal and midpubic lines with clinical staging.

Introduction And Hypothesis: The aim of the study was to determine which magnetic resonance imaging (MRI) reference line for staging pelvic organ prolapse, the pubococcygeal line (PCL) vs. the midpubic line (MPL), has the highest agreement with clinical staging.

Methods: A retrospective study of women with pelvic floor complaints who underwent dynamic pelvic MRI from January 2004 to April 2007 was conducted.

Pelvic organ prolapse.

Pelvic organ prolapse can encompass a range of disorders, from asymptomatic, altered anatomy to complete eversion of the vagina and may present with associated urinary, defecatory, and sexual dysfunction. Patient symptoms are important to elicit, because many patients with prolapse are asymptomatic. Ascertaining patient treatment goals is necessary when discussing options for management, and patients can choose from conservative, noninvasive treatment and prevention to surgical reconstruction.

The impact of multichannel urodynamics upon treatment recommendations for female urinary incontinence.

The aim of this study was to evaluate whether multichannel urodynamic testing changes a physician's treatment recommendations when managing women with urinary incontinence. In this prospective reader study, four fellowship-trained urogynecologists reviewed 39 abstracted cases of urinary incontinence on two occasions: first without and subsequently with urodynamic data. Treatment recommendations were made for each case after each review.

Vesicouterine fistula presenting with urinary incontinence after primary cesarean section: a case report.

Background: Vesicouterine fistula is a rare complication most commonly associated with cesarean section. Though conservative management has been reported, surgical intervention is usually required to treat the condition.

Case: A 32-year-old woman presented with urinary incontinence following a primary cesarean section; it was initially thought to be a vesicovaginal fistula.

Long-term follow-up of a transvaginal Burch urethropexy for stress urinary incontinence.

Objective: The objective of the study was to describe long-term objective and subjective success rates and complications following transvaginal Burch urethropexy for stress urinary incontinence.

Study Design: A case series of 66 women who underwent vaginal Burch urethropexy for urodynamic stress urinary incontinence with urethral hypermobility using a suture carrier device is presented. Concurrent prolapse repairs were performed as indicated.

Pelvic arterial embolization in the setting of acute hemorrhage as a result of the anterior Prolift procedure.

Acute hemorrhage following pelvic reconstructive surgery is a complication requiring immediate evaluation and treatment. Therapeutic options include fluid resuscitation, tamponade techniques, exploratory surgical intervention, and, more recently, pelvic vessel embolization. New approaches to pelvic organ prolapse have been evolving rapidly with little reported on safety and efficacy.

Shigellosis complicating preterm premature rupture of membranes resulting in congenital infection and preterm delivery.

Background: The association of chorioamnionitis with preterm birth is well established. Intra-amniotic infection complicates 13-60% of preterm premature rupture of membranes (PROM) with enteric gram-negative pathogens accounting for 20-40% of recoverable organisms. However, the source of enteric pathogens leading to premature birth has been poorly characterized.