This presentation is derived from a series of joint residency conferences conceived, planned and presented by faculty from the departments of Family Medicine and Obstetrics and Gynecology at University Hospitals Case Medical Center in Cleveland, OH. I am Al Cadesky, the OB and Women’s Health Coordinator for out Family Medicine residency and my copresenter is Karen Ashby, the OB Gyn liaison to our department. Our other coauthors are Steve Zyzanski and Vanessa Panaite of our Family Medicine research division.
Family Medicine/OB GYN Case-Based Women’s Health Conferences: Learning From Each Other Alan Cadesky, MD† Karen Ashby, MD‡ Stephen Zyzanski, PhD † Vanessa Panaite, BA † † Department of Family Medicine ‡ Department of OBGyn
Introduction <ul><li>Collaborative residency training between family practice and other specialties occurs infrequently apart from combined residency training programs </li></ul>
Purpose/Aims <ul><li>To design, implement and evaluate joint teaching conferences of relevant women’s health topics for residents of Family Medicine and Obstetrics/Gynecology </li></ul><ul><li>To encourage collaboration and mutual respect between departments </li></ul>
Description of Conferences <ul><li>Clinical cases and discussion questions were developed based on learning objectives </li></ul><ul><li>Core faculty from both departments guided the discussion, supplemented by other content experts </li></ul><ul><li>Teaching was primarily interactive rather than didactic </li></ul><ul><li>Post-conference knowledge tests, attitudinal evaluation forms, review articles and knowledge test answers were distributed at the end of each session </li></ul>
Methods <ul><li>Created a one-page attitudinal evaluation sheet </li></ul><ul><li>Residents were asked to evaluate: </li></ul><ul><ul><li>Value of topic </li></ul></ul><ul><ul><li>Satisfaction with presentation </li></ul></ul><ul><ul><li>Increased Competence with the topic </li></ul></ul><ul><ul><li>Whether the Learning Objectives were met </li></ul></ul><ul><li>Residents completed a knowledge test </li></ul>
Post Session Attitudinal Evaluation <ul><li>4 questions using the Likert scale, with 1 best to 5 worst rating: </li></ul><ul><ul><li>How valuable was this topic to you clinically? </li></ul></ul><ul><ul><li>How satisfied were you with this presentation? </li></ul></ul><ul><ul><li>After the presentation, did you feel more competent to deal with this topic? </li></ul></ul><ul><ul><li>How satisfied are you that the learning objectives were met during the conference? </li></ul></ul>
Response Format for Attitudinal Items <ul><li>How valuable was this topic to you clinically? </li></ul>Knowledge Questionnaire <ul><li>3 to 6 questions, generally multiple choice </li></ul>1. Very 2. Moderately 3. Slightly 4. Uncertain 5. Not Valuable valuable valuable valuable at all
Analysis <ul><li>Mean attitudinal evaluation ratings between topics, departments and level of residency training were compared by effect size and t-test </li></ul>
Mean Ratings for Value of Topic and Competence Gained Combined Heart Disease 24 2.2 0.78 Sexual Dysfunction 15 2.3 0.92 Vulvodynia 17 1.6 0.39 Bariatric/Obesity 28 1.6 0.46 Chronic pelvic pain 19 1.6 0.54 Breastfeeding 28 1.7 0.74 Cancer Genetics 9 1.7 0.75 Obesity/Pregnancy 20 1.8 0.47 Hematology 15 1.8 0.49 Menopause 22 2.0 0.81 Incontinence 20 1.4 0.38 Osteoporosis 23 1.4 0.41 Topic # Residents Mean SD Attending (Value/Comp)
Mean and standard deviation of attitudinal evaluation ratings and percent correct by presentation topic Valuable 1.2±.5 1.3±.6 2.0±.9 2.1±1.1 Satisfied 1.1±.2 1.3±.4 2.0±.8 1.9±.8 Competent 1.7±.5 1.4±.5 2.4±.9 2.6±.9 Objectives 1.3±.4 1.3±.5 1.7±.9 1.9±.7 % Correct 98 %±5% 63 %±17% 56 %±15% 81%±25% Evaluation Incontinence Osteoporosis Heart Disease Sexual Dysfunction Outcomes N=20 N=23 N=24 N=15
Osteoporosis: Means of Post-Session Attitudinal Evaluation by Department Clinical value 1.75 1.14 .98 2.26 .049 Satisfaction 1.38 1.21 .43 0.79 .440 Competence 1.38 1.36 .04 0.08 .937 Objectives 1.50 1.14 .72 1.68 .121 Department Variable OB/Gyn FM ES t p N=8 N=14
Heart Disease: Means of Post-Session Attitudinal Evaluation by Resident Level Clinical value 2.21 1.80 0.45 1.11 .280 Satisfaction 2.29 1.60 0.86 2.32 .030 Competence 2.71 1.89 0.91 2.39 .026 Objectives 2.14 1.11 1.14 4.03 .001 PGY Variable (1, 2) (3, 4) ES t p N=14 N=10
Summary of Findings <ul><li>Differences were noted between levels of residency training with senior residents rating several sessions higher </li></ul><ul><li>High knowledge scores did not always correspond to high evaluation ratings </li></ul><ul><li>The clinical topics presented were equally valued by both departments </li></ul><ul><li>Both attitudinal evaluation ratings and knowledge scores can be used to improve future presentations </li></ul>
Conclusions <ul><li>These multidisciplinary conferences provide a useful forum to discuss clinical problems common to both specialties. </li></ul><ul><li>Encourage collaboration, mutual respect and trust between departments. </li></ul>
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