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Impact of the Indicated Delivery Calculator on Obstetric Residents’ Clinical Decision-Making
Purpose: Evaluating the utility
of an indicated delivery calculator (IDC) in assisting residents’ determination
of delivery timeline for complex obstetric scenarios.
American College of Obstetrics and Gynecologists (ACOG) mobile application
includes an IDC to provide decision-making support when considering conditions
that may necessitate early delivery. The utility of this IDC has not yet been
IRB exemption, obstetric residents at our academic center (n=28) were asked to
determine delivery timing for fifteen scenarios, with and without use of the
IDC. A mixed effects logistic regression model assessed the change in proportion
of test items correct. We conducted semi-structured interviews of the
residents’ experience utilizing the calculator. Their responses were subjected
to content analysis.
ability to identify the gestational age at delivery for the obstetric scenarios
significantly improved after use of IDC (47% pre to 86% post; p<0.01).
Positive feedback included the calculator being “user-friendly,” “convenient,”
and “well-organized”. The ability to enter multiple conditions was thought to
be the best feature of the application. Residents expressed desire to
incorporate this tool into their practice. Criticism about the calculator
included desire for more robust yet streamlined complication list, more
evidence-based references and elimination of prompt for estimated due
Discussions: ACOG’s IDC was
effective in improving accuracy of residents’ clinical decisions regarding
delivery timelines for complex obstetric scenarios.Users quickly adapted to the
tool and successfully navigated the features. Streamlining the input prompts
and complication choice list may improve efficiency and increase use.
CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, GME, Maternal-Fetal Medicine,