Purpose: Describe the impact of a novel rotation on residents’ self-identified knowledge of ambulatory topics.
Background: We found several challenges with our existing model of weekly continuity clinics within inpatient rotations. After considering alternative models, we created a dedicated Ambulatory Rotation.
Methods: An anonymous survey was distributed at the beginning of the Ambulatory Rotation and at the end of the academic year, rating knowledge of ambulatory topics. Responses were recorded on a 1-10 Likert scale (limited - strong knowledge). Responses were evaluated using descriptive statistics. Differences in mean responses were calculated using the Wilcoxon-Mann-Whitney test.
Results: Surveys were completed by 31 of 33 (94%) residents pre-rotation and 28 of 33 (85%) post-rotation. Pre-rotation, residents preferred the new rotation compared to the prior model (7.6 vs 4.4, p< 0.0001). Preference for the new rotation increased after the rotation (8.3, p=0.05), while preference for the prior model further decreased (3.8, p=0.30). Pre-rotation, residents felt most knowledgeable about contraception (mean 7.5) and least knowledgeable about pediatric and adolescent gynecology (PAG) (3.0). Post-rotation, residents felt most knowledgeable about contraception, postpartum care (8.3) and abnormal uterine bleeding (8.3). Mean scores increased across all topics with an average increase of 1.6 points per question (p=0.0003). The greatest improvement was in knowledge of prenatal care (+2.1 points, p=0.0007) and PAG (+2.2, p=0.0009).
Discussions: Residents strongly preferred a dedicated ambulatory rotation. This may be an effective way to improve knowledge. Longitudinal evaluation is needed to understand knowledge patterns across years and to assess objective measures such as impact on CREOG and ABOG exams.
Topics: CREOG & APGO Annual Meeting, 2020, Resident, Faculty, Residency Director, Medical Knowledge, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME, Team-Based Learning, General Ob-Gyn,
Lauren Meiss, MD, Yale School of Medicine; Shefali Pathy, MD, MPH; Sangini Sheth, MD, MPH; Sarah Bjorkman, MD; Julia Cron, MD