Senior Obstetrician Supervision Improves Resident Labor and Delivery Rotation Experience

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Abstract

BACKGROUND:

In December 2012, the Mount Sinai Hospital implemented a program to have senior obstetricians, with experience in forceps-assisted vaginal delivery, supervise residents on labor and delivery during the day hours. The objective of this study was to estimate the effect of this program on resident satisfaction with the Labor and Delivery rotation.

METHODS:

This was a retrospective cohort study from July 2011 to June 2015. We compared resident satisfaction prior to and after December 2012 using Student's t test. Over the course of the study period, residents were routinely surveyed regarding their rotation experience. Each rotation block was 6 weeks for the PGY-1, and 7 weeks for PGY-2 and PGY-4 residents who rotated. Surveys were sent anonymously through an online program. Surveys consisted of eight questions (scaled 1–5) including whether the rotation fostered development of relevant medical knowledge, an improvement in physical examination skills, whether the rotation improved residents’ ability to manage relevant problems and the overall quality of the educational experience.

RESULTS:

Ninety-four percent of the residents completed the rotation evaluations. Comparing responses prior to and after December 2012, resident overall satisfaction for the rotation significantly improved (2.3–4.2, P<.05), with increased reporting of meeting the intended goals and objectives in the senior level residents (2.1–4.7, P<.05). Additionally, PGY-1 residents reported a significant increase in their physical exam skills (2.0–4.1, P<.05) and the ability to formulate a differential diagnosis (2.1–4.0, P<.5). After December 2012, there was a significant increase in forceps deliveries among residents from 0.6% to 2.6% of all deliveries (aOR 8.41, 95% CI 3.1, 23.0).

DISCUSSION:

Implementing a program with senior obstetrician supervision of residents on Labor and Delivery significantly increases the resident satisfaction and overall educational experience. This may be partly due to increased training in operative deliveries. Our data suggest that a small change in resident supervision can have a major impact on resident education.

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