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Development of an Effective Comprehensive Curriculum Regarding the Patient and Provider Experience of Stillbirth

Purpose: To develop and evaluate a comprehensive curriculum about stillbirth focused on both the patient and the provider experience with this difficult topic.

Background: Pilot data from our institution showed that OB/GYN residents felt ill prepared to care for patients with stillbirth, and that training about the patient experience of stillbirth was impactful but emotionally distressing. We sought to develop a comprehensive stillbirth curriculum that included knowledge, communication skills, and emotional domains.

Methods: A four-part curriculum was created including: 1.  Medical management, 2. A stillbirth panel discussion with patients/families, 3. Simulation training in delivering serious news, and 4. Workshop on resiliency. OB/GYN residents completed pre- and post-testing for each session. Five-point Likert scales were compared using the Wilcoxon signed rank test (alpha = 0.05).

Results: All 28 residents participated in parts of the curriculum, with 85% attending two or more sessions.  Following the curriculum, we found statistically significant self-reported improvements in multiple aspects of the stillbirth training: general knowledge (p<0.01), appropriate tests to order (p<0.05), interpretation of placental pathology (p<0.01), genetic evaluation (p<0.01), comfort conveying sympathy (p<0.05), expressing emotion (p<0.01), and confidence in delivering serious news (p<0.001).  In the resiliency workshop, residents shared ideas about how faculty can support them during difficult clinical situations.

Discussions: A comprehensive stillbirth curriculum which addressed the cognitive, emotional, and skills aspects of this topic was well received and effective. Long-term data is needed to evaluate whether these improvements persist and can enhance resident satisfaction with other challenging topics within OB/GYN.

Topics: General Ob-Gyn, Maternal-Fetal Medicine, Standardized Patient, Lecture, Simulation, UME, CME, GME, Practice-Based Learning & Improvement, Interpersonal & Communication Skills, Systems-Based Practice & Improvement, Professionalism, Medical Knowledge, Patient Care, Residency Director, Osteopathic Faculty, Clerkship Coordinator, Clerkship Director, Faculty, Resident, Student, 2018, CREOG & APGO Annual Meeting,

General Information


Intended
Audience
Student,Resident,Faculty,Clerkship Director,Clerkship Coordinator,Osteopathic Faculty,Residency Director,
Competencies
Addressed
Patient Care,Medical Knowledge,Professionalism,Systems-Based Practice & Improvement,Interpersonal & Communication Skills,Practice-Based Learning & Improvement,
Educational
Continuum
GME,CME,UME,
Educational
Focus
Simulation,Lecture,Standardized Patient,
Clinical Focus
Maternal-Fetal Medicine,General Ob-Gyn,

Author Information

Emily Fay, MD, University of Washington; Josephine Amory, MD; Michael Gravett, MD; Sarah Alexander; Shani Delaney, MD; and Alyssa Stephenson-Famy, MD

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