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.