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