Post on 07-May-2015
Family Medicine/OB GYN Family Medicine/OB GYN Case-Based Women’s Case-Based Women’s Health Conferences: Health Conferences:
Learning From Each OtherLearning From Each OtherAlan Cadesky, MD†Alan Cadesky, MD†
Karen Ashby, MD‡Karen Ashby, MD‡
Stephen Zyzanski, PhD †Stephen Zyzanski, PhD †
Vanessa Panaite, BA †Vanessa Panaite, BA †
††Department of Family MedicineDepartment of Family Medicine‡‡Department of OBGynDepartment of OBGyn
IntroductionIntroduction
• Collaborative residency training between Collaborative residency training between
family practice and other specialties occurs family practice and other specialties occurs
infrequently apart from combined residency infrequently apart from combined residency
training programstraining programs
Purpose/AimsPurpose/Aims
• To design, implement and evaluate joint To design, implement and evaluate joint
teaching conferences of relevant women’s teaching conferences of relevant women’s
health topics for residents of Family health topics for residents of Family
Medicine and Obstetrics/GynecologyMedicine and Obstetrics/Gynecology
• To encourage collaboration and mutual To encourage collaboration and mutual
respect between departmentsrespect between departments
Description of Description of ConferencesConferences
• Clinical cases and discussion questions were Clinical cases and discussion questions were developed based on learning objectivesdeveloped based on learning objectives
• Core faculty from both departments guided Core faculty from both departments guided the discussion, supplemented by other the discussion, supplemented by other content expertscontent experts
• Teaching was primarily interactive rather Teaching was primarily interactive rather than didacticthan didactic
• Post-conference knowledge tests, Post-conference knowledge tests, attitudinal evaluation forms, review articles attitudinal evaluation forms, review articles and knowledge test answers were and knowledge test answers were distributed at the end of each sessiondistributed at the end of each session
MethodsMethods
• Created a one-page attitudinal evaluation Created a one-page attitudinal evaluation sheetsheet
• Residents were asked to evaluate:Residents were asked to evaluate:– ValueValue of topic of topic – SatisfactionSatisfaction with presentation with presentation– Increased Increased CompetenceCompetence with the topic with the topic– Whether the Whether the Learning ObjectivesLearning Objectives were were
metmet
• Residents completed a knowledge testResidents completed a knowledge test
Post Session Attitudinal Post Session Attitudinal EvaluationEvaluation
• 4 questions using the Likert scale, 4 questions using the Likert scale, with 1 best to 5 worst rating:with 1 best to 5 worst rating:
1.1. How valuable was this topic to you clinically?How valuable was this topic to you clinically?
2.2. How satisfied were you with this How satisfied were you with this presentation?presentation?
3.3. After the presentation, did you feel more After the presentation, did you feel more competent to deal with this topic?competent to deal with this topic?
4.4. How satisfied are you that the learning How satisfied are you that the learning objectives were met during the conference?objectives were met during the conference?
Response Format for Response Format for Attitudinal ItemsAttitudinal Items
• How valuable was this topic to you clinically?How valuable was this topic to you clinically?
1.1. Very 2. Moderately 3. Slightly 4. Uncertain 5. Not ValuableVery 2. Moderately 3. Slightly 4. Uncertain 5. Not Valuable
valuable valuable valuable at allvaluable valuable valuable at all
Knowledge Questionnaire Knowledge Questionnaire
• 3 to 6 questions, generally multiple choice3 to 6 questions, generally multiple choice
AnalysisAnalysis
• Mean attitudinal evaluation ratings between Mean attitudinal evaluation ratings between
topics, departments and level of residency topics, departments and level of residency
training were compared by effect size and training were compared by effect size and
t-testt-test
Mean Ratings for Value of Topic Mean Ratings for Value of Topic
and Competence Gained Combinedand Competence Gained Combined Topic # Residents Mean Topic # Residents Mean SD SD
Attending (Value/Comp) Attending (Value/Comp)
IncontinenceIncontinence 20 1.4 20 1.4 0.38 0.38
Osteoporosis 23 1.4 Osteoporosis 23 1.4 0.41 0.41
Vulvodynia 17 1.6 Vulvodynia 17 1.6 0.39 0.39
Bariatric/Obesity 28 1.6 Bariatric/Obesity 28 1.6 0.46 0.46
Chronic pelvic pain 19 1.6 Chronic pelvic pain 19 1.6 0.54 0.54
Breastfeeding 28 1.7 Breastfeeding 28 1.7 0.74 0.74
Cancer Genetics 9 1.7 Cancer Genetics 9 1.7 0.75 0.75
Obesity/Pregnancy 20 1.8 Obesity/Pregnancy 20 1.8 0.47 0.47
Hematology 15 1.8 Hematology 15 1.8 0.49 0.49
Menopause 22 2.0 Menopause 22 2.0 0.81 0.81
Heart Disease 24 2.2 Heart Disease 24 2.2 0.78 0.78
Sexual Dysfunction 15 2.3 Sexual Dysfunction 15 2.3 0.92 0.92
Mean and standard deviation of Mean and standard deviation of attitudinal evaluation ratings and attitudinal evaluation ratings and percent correct by presentation percent correct by presentation
topictopic Evaluation Incontinence Osteoporosis Evaluation Incontinence Osteoporosis Heart Disease Heart Disease Sexual Dysfunction Sexual Dysfunction
Outcomes N=20 N=23 Outcomes N=20 N=23 N=24 N=24 N=15 N=15
Valuable 1.2±.5Valuable 1.2±.5 1.3±.6 1.3±.6 2.0±.9 2.0±.9 2.1±1.12.1±1.1
Satisfied 1.1±.2Satisfied 1.1±.2 1.3±.4 1.3±.4 2.0±.8 2.0±.8 1.9±.81.9±.8
Competent 1.7±.5Competent 1.7±.5 1.4±.5 1.4±.5 2.4±.9 2.4±.9 2.6±.92.6±.9
Objectives 1.3±.4Objectives 1.3±.4 1.3±.5 1.3±.5 1.7±.9 1.7±.9 1.9±.71.9±.7
% Correct 98 %±5% 63 %±17%% Correct 98 %±5% 63 %±17% 56 %±15% 81% 56 %±15% 81%±25%±25%
Osteoporosis: Means of Post-Osteoporosis: Means of Post-Session Attitudinal Evaluation by Session Attitudinal Evaluation by
DepartmentDepartment DepartmentDepartment
Variable OB/Gyn FMVariable OB/Gyn FM ES ES t t p p
N=8N=8 N=14 N=14
Clinical valueClinical value 1.751.75 1.14 1.14 .98 .98 2.262.26 .049 .049
SatisfactionSatisfaction 1.381.38 1.21 1.21 .43 .43 0.79 0.79 .440 .440
CompetenceCompetence 1.381.38 1.36 1.36 .04 .04 0.08 0.08 .937 .937
ObjectivesObjectives 1.501.50 1.14 1.14 .72 .72 1.68 1.68 .121 .121
Heart Disease: Means of Post-Heart Disease: Means of Post-Session Attitudinal Evaluation by Session Attitudinal Evaluation by
Resident LevelResident Level PGYPGY
Variable (1, 2) (3, 4)Variable (1, 2) (3, 4) ES t ES t p p
N=14 N=10 N=14 N=10
Clinical valueClinical value 2.21 2.21 1.80 1.80 0.45 0.45 1.11 1.11 .280 .280
SatisfactionSatisfaction 2.29 2.29 1.60 1.60 0.86 0.86 2.322.32 .030 .030
CompetenceCompetence 2.71 2.71 1.89 1.89 0.91 0.91 2.392.39 .026 .026
ObjectivesObjectives 2.14 2.14 1.11 1.11 1.14 1.14 4.034.03 .001 .001
Summary of FindingsSummary of Findings• Differences were noted between levels of Differences were noted between levels of
residency training with senior residents residency training with senior residents rating several sessions higherrating several sessions higher
• High knowledge scores did not always High knowledge scores did not always correspond to high evaluation ratingscorrespond to high evaluation ratings
• The clinical topics presented were equally The clinical topics presented were equally
valued by both departmentsvalued by both departments
• Both attitudinal evaluation ratings and Both attitudinal evaluation ratings and knowledge scores can be used to improve knowledge scores can be used to improve future presentationsfuture presentations
ConclusionsConclusions
• These multidisciplinary conferences provide These multidisciplinary conferences provide
a useful forum to discuss clinical problems a useful forum to discuss clinical problems
common to both specialties. common to both specialties.
• Encourage collaboration, mutual respect Encourage collaboration, mutual respect
and trust between departments.and trust between departments.