OB/GYN Clerkship Learning Environment Themes Identified on Qualitative Review of End-of-Clerkship Evaluations

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Abstract

Local Mentor:

Ruth Anne Queenan, MD, MBA

APGO Advisor:

Lee,Learman, MD, PhD

PROBLEM:

The OB/GYN learning environment presents unique challenges to learners and educators. Consistent with national trends, the University of Rochester (UR) OB/GYN clerkship ranks lower than other clerkships.

INTERVENTION:

To evaluate clerkship strengths and weaknesses, and narrative themes regarding the student experience, content analysis was performed on 2016-2017 end-of-clerkship evaluations. The evaluation asks students to comment on clinical site “strengths and weaknesses” and “positive and/or negative experiences about the learning environment” of the clerkship.

CONTEXT:

Since 2010, clerkship resources pertaining to learning objectives, expectations, reference resources, orientation materials, weekly didactics, and feedback mechanisms have expanded. Residents participate in yearly teaching, learning, and feedback didactics. Despite updates, student feedback remains consistent that integration into clinical teams and learning in the clinical environment is challenging.

OUTCOME/LESSONS LEARNED:

Consistent with previous literature, negative feedback themes include inconsistent teaching, insufficient hands-on experiences, lack of clarity regarding expectations, and difficulty integrating into clinical teams. Positive themes include diversity of experiences in OB/GYN, relationships with patients and families, and procedural learning. Each UR site possesses unique strengths, including exposure to sub-specialists and care of complex patients, for continuity relationships with nurses, and for interdisciplinary learning with family medicine and midwifery. Open ended questions led to varying lengths and level of detail in students' responses. Feedback themes varied over the course of the academic year. These findings precluded accurate statistical analysis of the content. Faculty development interventions, including a faculty educator series addressing narrative themes, will be developed to guide improvement in the OB/GYN clerkship educational experience.

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