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Decel Defense! Teaching Interns to Tackle Category II Fetal Heart Rate Tracings
Purpose: To teach interns a
standardized approach to management of Category II fetal heart rate (FHR)
interns feel trepidation when facing Category II FHR tracings. We
designed a workshop to allay initial anxiety interns may feel at the start of
Orientation we conducted a flipped classroom workshop. Interns practiced
applying a novel mnemonic device when managing FHR tracings in a variety of
common clinical scenarios.
level managing Category II FHR tracings was assessed pre and
post-workshop. Mean baseline confidence level was 1.83 on a 1-4 scale
of “not confident to very confident”. Mean confidence level increased
to 3 immediately post-workshop. Evaluations of the workshop were very
positive, mean rating 5.0 out of 5.0. Residents appreciated the
opportunity to manage FHR decelerations in a simulated, low-risk setting prior
to caring for actual patients.
A follow up survey one month
after the workshop found that 33% of interns used the mnemonic ”sometimes” and
33% reported “often” use when managing Category II FHR tracings in real
time. Mean confidence level rose to 2.83 on the 1-4 scale. On average,
participants recalled 7.67 of 13 elements in the mnemonic tool. At six
months, 66% of interns used the mnemonic ”sometimes” and 33% “often” when
managing FHR tracings. Mean confidence level rose to 3.33 and interns
recalled 8.33 of 13 elements.
Discussions: Interns found coaching
in a small group setting with simulated cases and a mnemonic device to be an
effective method for building confidence in managing Category II FHR tracings.
Problem-Based Learning, Simulation, Virtual Patient, GME, Practice-Based Learning & Improvement, Medical Knowledge, Patient Care, Residency Coordinator, Residency Director, Faculty, Resident, 2019, CREOG & APGO Annual Meeting,