APGO

Objective: Introducing the CenteringPregnancy model of prenatal care as a part of continuity clinic for OB/GYN residents in order to enhance both patient continuity and resident satisfaction with weekly clinic.

Methods: CenteringPregnancy was initiated as the obstetrical component of continuity clinic in a 12 resident Obstetrics and Gynecology residency. Six junior residents were automatically assigned Centering groups at the beginning of the academic year. Senior residents could elect to participate in Centering as part of their continuity clinic or maintain the traditional model. Each Centering group consisted of 6 to 12 obstetrical patients with the same EDD (± 2 weeks) and was led by a resident with an attending physician or nurse practitioner serving as co-facilitator. After initial traditional intake visits, individual Centering clinics began at approximately 14-16 weeks gestation, with appointments every 4 weeks until 26 weeks gestation followed by appointments every 2 weeks until delivery. Centering clinics lasted for two hours with different educational topics covered at each gathering using established Centering techniques. Patients and resident facilitators remained within the same group throughout the entire pregnancy and post-partum, allowing for 100% continuity. At the end of the academic year, residents were surveyed on their satisfaction with continuity clinic regardless of their participation.

Results: 11 out of 12 residents were surveyed (6 junior residents and 5 senior residents) using a 10-point Likert scale to assess overall satisfaction with the continuity clinic experience. Prior to introduction of Centering, both groups of residents reported similar average satisfaction levels with the traditional continuity clinic model. Those who did not participate in Centering (4 senior residents) reported an average satisfaction level of 5.5/10, while the participating residents (6 junior residents and 1 senior resident) reported an average satisfaction level of 5.4/10 with traditional continuity clinic. At the end of the academic year, after participating in Centering as their weekly clinic, residents reported an average satisfaction level of 7.9/10 while non-participating residents reported an average satisfaction level of 5.75/10.

Conclusion: CenteringPregnancy allows for 100% continuity in an Obstetrics and Gynecology residency clinic with increased resident satisfaction in their overall continuity clinic experience.