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Obstetrics and Gynecology at a Glance 4th Edition PDF - If you found this book helpful then please like, subscribe and share. Editorial Reviews. From the Back Cover. The market-leading at a Glance series is used world-wide by medical students, residents, junior doctors and health. Title Slide of Obstetrics and gynecology at a glance. The reproductive system at a glance pdf. LaureneChacko · English · Español · Português.
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Conclusions Additional subheadings - may be included by the authors if appropriate and will facilitate reading. Examples of a structured discussion can be found in the following papers: 1 Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis. Am J Obstet Gynecol. Epub Jan The full length article is the official version and is linked to search engines.
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Translational Science Translational science is typically presented in the form of an original research manuscript; however, the only type of non-clinical research considered must be translational in nature and contain biological implications for obstetrics and gynecology.
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Include a structured abstract containing no more than words and as many alphabetized key words or short phrases as needed for indexing. Studies examining medical student specialty selection note that clinical clerkships greatly influence students' career decision-making processes. In contrast, those who chose to enter obstetrics and gynecology reported the clerkship made the specialty more attractive.
Hammoud and colleagues 11 assessed the effect of the obstetrics and gynecology clerkship on students' interest in pursuing the field in a survey of students of 3 US medical schools. They found that students' sex and preclerkship interest in obstetrics and gynecology were the main factors associated with postclerkship interest in entering the field.
Studies show that perceptions of lifestyle, work hours, malpractice costs, and income influence specialty choice, 12 — , 18 and factors specific to obstetrics and gynecology, such as continutiy of patient care, surgical opportunities, and a healthy patient population, can make the field more attractive.
We hypothesized that 2 aspects of the clerkship have the greatest potential to influence student interest in obstetrics and gynecology: exposure to quality teaching and direct participation in examinations and procedures. We designed this study to address 2 main research questions: 1 Does the quantity and quality of teaching during the clerkship affect medical student interest in obstetrics and gynecology?
Methods We conducted an anonymous, self-administered written survey of all third-year medical students rotating through a required obstetrics and gynecology clerkship from November to May at a single, large, urban medical university in the eastern United States. For content validity, survey questions were developed with input from obstetrics and gynecology faculty and residents, as well as recently graduated and current fourth-year medical students. In a similar fashion, students were asked about their level of career interest in obstetrics and gynecology at the time of survey distribution, which occurred during the last week of their 4-week clerkship.
We used univariate statistics to describe participant characteristics.
Student factors assessed were male or female sex and the student's top 5 career choices. Teaching factors included 8 questions regarding faculty teaching and 15 questions regarding resident teaching. Experiential learning factors included 5 questions assessing number of breast and pelvic examinations performed and location of the examination eg, operating room, labor and delivery ward, clinic , 12 questions assessing performance of specific procedural tasks during a cesarean delivery, and 13 questions assessing performance of specific procedural tasks during gynecologic surgery.
One confounding variable—prior clerkships completed—was also assessed. Using bivariate analyses, we examined these factors for associations between preclerkship and postclerkship career interest. We also examined factors associated with changes in levels of career interest in obstetrics and gynecology before and after the clerkship. Resident activities and students' perceptions of the residents were also associated with career interest at the end of the rotation.
Table Open in a separate window In general, hands-on experience suturing, using the Bovie instrument was not associated with postclerkship career interest. Students' sex, number of deliveries, and the teaching quality of the attending physicians were not associated with postclerkship career interest in obstetrics and gynecology. Student perception of quality of teaching, number of deliveries, feeling part of a team, and having clear rotation expectations were not associated with change in level of career interest.
Hands-on experiences did not significantly affect career interest in obstetrics and gynecology. Students who had a preclerkship interest in obstetrics and gynecology were more likely to seek greater pelvic examination experience, which could explain the slight nonsignificant trend associating a higher number of pelvic examinations with postclerkship career interest.
Students who described more interest in obstetrics and gynecology were less likely to have had other types of hands-on experiences, such as participation in cesarean deliveries, stapling skin, and suctioning the airway of the newborn during cesarean deliveries, and retracting soft tissue or bladder and using Bovie cautery in gynecologic surgeries. Students possibly felt less involved and more tangential during cesarean deliveries and viewed skin stapling or tissue retraction as lower-skill, less interesting tasks.
Discussion Clerkship factors associated with greater postclerkship interest include a higher satisfaction with resident professional behavior and students' sense of inclusion in the clinical team. A larger number of study participants reported a career interest in obstetrics and gynecology at the end of the clerkship than at the beginning of the clerkship, with more men reporting an increase in interest postclerkship than preclerkship.
Teaching attributes were associated with preclerkship career interest, suggesting that neither residents nor faculty favored, with more intensive or higher quality teaching, those students who wished to pursue obstetrics and gynecology. Students' interactions with and perceptions of the residents were more consistently influential than either the quality or quantity of faculty interactions or the amount and type of participation in deliveries and surgical procedures.
Students' feelings of being part of a team were likely the result of a sense of inclusion and camaraderie from the residents within that clinical team. The high association between perception of residents as good professional role models and postclerkship career interest suggests that students may be placing value on the personalities and characteristics of the practitioners and advanced learners in the specialty. Should a student choose to enter into the field of obstetrics and gynecology, residents would represent the most immediate colleagues and peers.
When considering whether to pursue a career in obstetrics and gynecology, students may be making judgments regarding whether they share qualities, characteristics, and values with this group. Students' perceptions of the residents' teaching behavior eg, their inclusion of students in the clinical team, the clarity with which they communicated what they expected from the students, and their professionalism were significantly associated with career interest at the end of the clerkship.
Our study has several limitations. Our participants consisted of one class of medical students at a single medical school, and thus our results cannot be generalized to other institutions with clerkships differing in characteristics and structure. Despite our attempts to implement multiple methods of protecting participants' identity, the timing of survey completion—after a practice-based learning session and before the end of the clerkship—may have introduced some reporting bias.
Time and funding limitations did not allow us to compare these clerkship experiences and students' interest levels with those of other clerkships and other specialties. Finally, owing to the anonymous nature of the surveys, we could not follow up with participants to assess their final career choices and determine whether their postclerkship interest was associated with entry into the field of obstetrics and gynecology.
We do know that 9 female students from that class did match in obstetrics and gynecology. Our study contributes to the literature in the field because, to our knowledge, no prior study has examined with the same level of detail the association between clerkship experience and specialty choice; instead, prior research has focused primarily on students' characteristics and the number and type of other clerkships completed. Conclusion Residents and faculty should make students feel that they are part of the clinical team.
Helping clerkship students to become invested in the care of the patients in the obstetrics and gynecology service may in turn generate greater student interest for the specialty. This can be achieved by providing the student with an active and contributing role in the clinical team as well as allowing the student to participate more directly in patient examinations and procedures.
We offer 2 recommendations. Obstetrics and gynecology clerkship directors and residency program directors need to emphasize to residents their role as educators and professional role models for medical students. As suggested by leaders of the Association of Professors of Gynecology and Obstetrics, medical student educators—residents as well as attending physicians—need to be rewarded and recognized for their contributions and efforts. Residents may also benefit from attending training workshops on how to be effective teachers.
Student clerkship evaluations have been shown to significantly improve after residents participate in teaching skills workshops. Footnotes Judy C.