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Introducción: El bienestar médico ha cobrado relevancia en la atención de la salud, especialmente frente a la "epidemia de burnout". Este estudio se propone evaluar la implementación y efectividad de un programa para mejorar el bienestar del personal de la Unidad Académica de Ginecología y Obstetricia A de la Facultad de Medicina de la Universidad de la República, Uruguay. Método: Se desarrolló un estudio descriptivo siguiendo un modelo lógico de evaluación de programas. Se implementó una estrategia organizacional focalizada en la identificación de factores de estrés y la promoción del bienestar. La intervención incluyó encuestas cualitativas, grupos focales y la conformación de un Equipo de Referentes de Bienestar (ERB), capacitado para guiar el proceso de mejora continua. Resultados: Se identificaron prioridades en las dimensiones de carga laboral y exigencias en el trabajo, eficiencia y recursos, comunidad en el trabajo, cultura organizacional e integración trabajo-vida personal. A lo largo del proceso, se implementaron acciones clave para mejorar el ambiente laboral y la efectividad del equipo. El compromiso de los líderes de la unidad y el trabajo colaborativo con consultores externos fueron fundamentales para el éxito del programa. Discusión: Las intervenciones organizacionales, aunque más complejas, parecen ser más efectivas en la promoción del bienestar. Los cambios alcanzados en esta etapa inicial sugieren un impacto positivo, aunque se requiere un seguimiento a largo plazo para asegurar la sostenibilidad de las mejoras. Conclusiones: La experiencia innovadora presentada ofrece una hoja de ruta para la mejora del bienestar del personal de salud en contextos académicos y asistenciales, destacando la importancia del liderazgo y colaboración en estos procesos.
Introdução: O bem-estar médico ganhou relevância na área da saúde, especialmente face à "epidemia de esgotamento". Este estudo tem como objetivo avaliar a implementação e eficácia de um programa para melhorar o bem-estar do pessoal da Unidade Acadêmica de Ginecologia e Obstetrícia A da Faculdade de Medicina da Universidade da República, Uruguai. Método: Foi desenvolvido um estudo descritivo seguindo um modelo lógico de avaliação de programas. Foi implementada uma estratégia organizacional focada na identificação de fatores de stress e na promoção do bem-estar. A intervenção incluiu pesquisas qualitativas, grupos focais e a formação de uma Equipe de Referência em Bem-Estar (ERB), treinada para orientar o processo de melhoria contínua. Resultados: Foram identificadas prioridades nas dimensões carga de trabalho, recursos, comunidade no trabalho, cultura organizacional e equilíbrio entre vida pessoal e profissional. Ao longo do processo, foram implementadas ações-chave para melhorar o ambiente de trabalho e a eficácia das equipes. O compromisso dos líderes das unidades e o trabalho colaborativo com consultores externos foram fundamentais para o sucesso do programa. Discussão: As intervenções organizacionais, embora mais complexas, parecem ser mais eficazes na promoção do bem-estar. As mudanças alcançadas nesta fase inicial sugerem um impacto positivo, embora seja necessário um acompanhamento a longo prazo para garantir a sustentabilidade das melhorias. Conclusões: A experiência inovadora apresentada oferece um roteiro para melhorar o bem-estar do pessoal de saúde em contextos académicos e de saúde, destacando a importância da liderança e da colaboração nestes processos.
Introduction: Physician well-being has gained relevance in health care, especially in the face of the "burnout epidemic." This study aims to evaluate the implementation and effectiveness of a program to improve the well-being of the staff of the Academic Unit of Gynecology and Obstetrics A of the Faculty of Medicine of the University of the Republic, Uruguay. Method: A descriptive study was developed following a logical model of program evaluation. An organizational strategy focused on identifying stress factors and promoting well-being was implemented. The intervention included qualitative surveys, focus groups, and the formation of a Well-Being Referent Team (ERB), trained to guide the continuous improvement process. Results: Priorities were identified in the dimensions of workload, resources, community at work, organizational culture, and work-life balance. Throughout the process, key actions were implemented to improve the work environment and team effectiveness. The commitment of unit leaders and collaborative work with external consultants were fundamental to the success of the program. Discussion: Organizational interventions, although more complex, appear to be more effective in promoting well-being. The changes achieved at this initial stage suggest a positive impact, although long-term monitoring is required to ensure the sustainability of improvements. Conclusions: The innovative experience presented offers a roadmap for improving the well-being of health personnel in academic and healthcare contexts, highlighting the importance of leadership and collaboration in these processes.
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Humans , Schools, Medical/organization & administration , Students, Medical/psychology , Occupational Health Program , Burnout, Professional/prevention & control , Education, Graduate , Gynecologists/psychology , Obstetricians/psychology , UruguayABSTRACT
Background: The World Health Organization (WHO) defines drug utilization as “the marketing, distribution, prescription, and use of drug in a society with special emphasis on resulting medical, social, and economic consequences.” Prescription monitoring and drug utilization patterns should be taken care, so it will provide better efficacy and reduce the adverse drug reactions. Aim and Objective: The aim of the study was to assess the prescribing pattern (using the WHO prescription Indicators). Materials and Methods: A retrospective drug utilization study was conducted in the post-operative patients of obstetrics and gynecology (OBG) department over a period of 4 months after getting approval from Institutional Ethics Committee. Name, sex, age, diagnosis, and treatment were recorded from patient’s case sheet of post-operative patients. The data were analyzed using descriptive analysis with the help of Statistical Package for the Social Sciences software. Result: A total of 238 cases were recorded. The average number of drugs per encounter was seven. Antacids, analgesics, antibiotics, and intravenous fluids were common. About 99.57% of encounters were prescribed an antibiotic. Average number of injections prescribed was 95.8% and 525 (31.47%) were prescribed by their generic name. About 99.8% were from the National list of essential medicine-2015. Conclusion: It was observed that most of the drugs were prescribed according to the national essential list of medicines. Major advantage in of the study is to prevent irrational prescription and reduce health-care burden in the community.
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Wunderlich syndrome is a rare and life-threatening disease characterized by nontraumatic renal hemorrhage in the subscapular and perinephritic space. It is a very rare clinical entity in pregnancy and so far there is no clear guidance on how to manage this condition during pregnancy. We report the case of a 34-year-old patient with a 29+2-week pregnancy who developed a Wunderlich syndrome, which was successfully treated, preserving the pregnancy until its end.
El síndrome de Wunderlich es una enfermedad con poca incidencia y potencialmente mortal que se caracteriza por una hemorragia renal no traumática en el espacio subescapular y perinefrítico. Es una entidad clínica muy rara en el embarazo y hasta el momento no existe una guía clara sobre el manejo de esta afección durante el embarazo. Reportamos el caso de una paciente de 34 años cursando embarazo de 29+2 semanas quien manifestó un síndrome de Wunderlich el cuál fue tratado con éxito logrando preservar el embarazo hasta su término.
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Humans , Female , Pregnancy , Adult , Pregnancy Complications, Neoplastic/pathology , Angiomyolipoma/pathology , Kidney Neoplasms/pathology , Pregnancy Complications, Neoplastic/surgery , Pregnancy Complications, Neoplastic/diagnosis , Shock, Hemorrhagic/etiology , Syndrome , Magnetic Resonance Imaging , Angiomyolipoma/surgery , Angiomyolipoma/diagnostic imaging , Flank Pain/etiology , Delivery, Obstetric , Embolization, Therapeutic , Kidney Neoplasms/surgery , Kidney Neoplasms/diagnostic imagingABSTRACT
Objective:To investigate and analyze the status quo of work stress and its influencing factors among residents in the standardized training of obstetrics and gynecology.Methods:A questionnaire survey was carried out among 232 training residents by random sampling from a standardized training base of a tertiary hospital in Beijing from June 2019 to May 2020. The collected general information included gender, age, specialty, education background, work experience, time of training, income satisfaction and recognition of the necessity of training. The current situation and influencing factors of pressure were analyzed through the work pressure source scale. The lower the score means the greater stress. SPSS 22.0 was used to process the data by performing t-test and Chi-square test. Results:The total points of work stress (67.02±12.65) of the residents was lower among all the departments ( P<0.001). The most important work stressors were workload and time allocation (7.11±2.42), job situation and resources (7.21±2.34), management and personal relationship (15.66±3.69), and those were significantly different in any other departments ( P=0.003). One-way analysis of variances showed that job stress scores were significantly different among types of income satisfaction ( P=0.003). Combined with the results of logistic regression equation, the total scores of work stressors in such three aspects as "specialty and career", "workload and time allocation", and "job situation and resources" decreased with the satisfaction, and the lower the score, the greater the pressure, with statistical significance ( P=0.006, 0.008, 0.012, respectively). However, in terms of "patient diagnosis and treatment", and "management and interpersonal relationship", there was no significant difference between the groups ( P=0.067, 0.057, respectively). Conclusions:The stress of obstetrics and gynecology residents is generally high. Clinical and medical affairs are the main sources of their work stress, and income satisfaction is the major influencing factor of the work stress.
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Abstract Objective This study analyzes the role of clinical simulation in internal medical residency programs (IMRP) in Obstetrics and Gynecology (OB/GYN), attributed by the supervisors, in the training of residents in the city of São Paulo (SP). Methods Cross-sectional descriptive, qualitative, and exploratory approach. Semi-structured interviews were performed with ten supervisors of Medical Residency programs in Obstetrics and Gynecology. Interviews were analyzed by means of content analysis under the thematic modality, starting with the core the role of clinical simulation in Obstetrics and Gynecology Medical Residency Programs. Results Supervisors view Clinical simulation as: a complementary tool for the teaching and learning process, a possibility of a safe teaching and learning environment, an opportunity to learn from mistakes, a support for professional practice committed to patient safety, a learning scenario for teamwork, a scenario for reflection on the work process in Obstetrics and Gynecology, a scenario for evaluative processes in the medical residency. Still according to supervisors, Clinical Simulation favors decision-making and encourages the resident participation in activities. Conclusion Supervisors recognize Clinical Simulation as a powerful pedagogical tool in the learning process of resident doctors in Obstetrics and Gynecology Residency Programs.
Resumo Objetivo O presente estudo analisa o papel da Simulação Clínica em programas de Residência Médica (PRM) de Obstetrícia e Ginecologia, atribuído pelos supervisores, na formação do residente no município de São Paulo (SP). Métodos Abordagem qualitativa, transversal, de natureza exploratória e descritiva. Foram realizadas entrevistas semiestruturadas com dez supervisores de programas de Residência Médica de Obstetrícia e Ginecologia. Para análise das entrevistas foi realizada análise de conteúdo na modalidade temática partindo do seguinte núcleo: o papel da simulação clínica nos Programas de Residência Médica de Obstetrícia e Ginecologia. Resultados A Simulação Clínica, na visão dos supervisores, emerge como: ferramenta complementar para o processo de ensino e aprendizagem; possibilidade de um ambiente de ensino e aprendizagem seguro; possibilidade de aprendizagem a partir do erro; suporte para prática profissional comprometida com a segurança do paciente; cenário de aprendizagem para o trabalho de equipe; cenário de reflexão sobre o processo de trabalho em Obstetrícia e Ginecologia; favorecimento na tomada de decisão; cenários de processos avaliativos na residência; e, por fim, estímulo à participação dos residentes nas atividades. Conclusão Os supervisores reconhecem a Simulação Clínica como uma ferramenta pedagógica potente no aprendizado dos médicos residentes em Obstetrícia e Ginecologia.
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Humans , Obstetrics and Gynecology Department, Hospital , Health Human Resource Training , Patient Safety , Simulation Training , Internship and ResidencyABSTRACT
In view of the problems existing in the probation teaching of obstetrics and gynecology, such as patients' non-cooperation, few cases and few practical opportunities. This study discusses the application effect of case teaching based on "Rain Classroom" and standardized patients in the obstetrics and gynecology probation course. The teaching is carried out by carefully selecting cases, refining pre-class preparation, adopting various teaching forms, and carrying out evaluation after class. In order to evaluate the teaching effect, an anonymous survey was carried out among 330 undergraduate interns majoring in clinical medicine, prevention, and forensic medicine in Batch 2015. The results showed that 210 (93.8%) of 224 (67.9%) students who participated in the survey believed that this method could promote learning enthusiasm and 200 students (89.3%) thought it could activate classroom atmosphere more than traditional teaching; most students thought it improved students' communication ability (163, 72.8%), clinical practice ability (189, 84.4%), and ability to analyze and solve problems (171, 76.3%) and deepening the understanding, mastery and application of knowledge (158, 70.5%). It shows that this method can improve the teaching effect of obstetrics and gynecology probation course to a certain extent.
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Targeted to the junior nursing students in our university, we applied experiential teaching in the course of Obstetrics and Gynecology Nursing to carry out humanistic care infiltration education, which mainly included three parts: aesthetic activities in theoretical class, experiential activities in experimental class and enlightenment after class. After class, compared with the nursing students who were educated by traditional teaching methods, the quality of humanistic care of nursing students who accepted experiential teaching was improved more obviously. It is suggested that the application of experiential teaching is effective in infiltrating humanistic care education in nursing professional courses, which is also in line with the development of nursing discipline.
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Objective:The cluster analysis method was applied to evaluate the scientific research performance evaluation index system of departments in an obstetrics and gynecology hospital, and analyze the weaknesses of scientific research work of various departments, to provide a basis for the improvement of scientific research strength of departments.Methods:On the basis of the scientific research performance evaluation index system of departments in the obstetrics and gynecology hospital, the indicators and weights of the system were optimized through expert consultation, and the scientific research values from 2019 to 2021 were brought into the optimized scientific research performance evaluation index system to calculate the scientific research scores of each department, and then the cluster analysis method was applied to evaluate the index system.Results:Before and after the optimization of the scientific research performance evaluation index system of departments, the conformity with the discipline classification was 76.00% and 96.67% respectively ( P=0.039). In total of 30 departments were clustered into 4 categories: excellent (7), good (7), medium (4), and concerned (12). The average score of the total scientific research performance evaluation indicators of the 4 categories of departments was 15.022. The highest average score was for papers and monographs, and the lowest was for awards. Conclusions:This study applied the cluster analysis method to evaluate the scientific research performance evaluation index system of departments in the obstetrics and gynecology hospital and replaced quantitative indicators with quality indicators. It will optimize and improve the hospital hierarchical management methods, provide data support and classified guidance for the scientific research development of different categories of departments, and provide a reference basis for hospitals to formulate scientific research management policies such as achievement transformation, award, industry standard guidelines, etc.
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Objective:Bibliometric analysis of SCI papers in Shanghai tertiary obstetrics and gynecology specialized hospitals from 2017 to 2021 was conducted to provide reference for further improving management measures and optimizing the quality of SCI papers in specialized hospitals.Methods:The Web of Science database was used to retrieve SCI papers published by tertiary obstetrics and gynecology specialized hospitals in Shanghai from 2017 to 2021. Based on bibliometric methods VOSviwer 1.6.17 and Scimago Graphica 1.0.23 was adopted to analyze the number, journals, domestic and international cooperation, and hot research areas.Results:2 721 papers were published by Shanghai Tertiary A obstetrics and Gynecology hospitals from 2017 to 2021. These papers published in 765 journals. The number of papers published and publication journals increased year by year. The number of papers and journals with an impact factor of 3~5 is the largest, accounting for 37.96% and 35.95% of the total number of papers and journals respectively. However, papers and journals with more than 10 points accounted for only 7.98% and 10.20% respectively. Scientific Reports, a comprehensive journal, published the largest number of papers. International cooperation is concentrated in the United States. Domestic cooperation is concentrated in universities and research institutions in Jiangsu, Zhejiang and Shanghai. The hot research areas focused on Oncology, Obstetrics & Gynecology, Genetics, Reproductive Biology and other basic medical fields.Conclusions:The number of papers published by Shanghai's tertiary obstetrics and gynecology specialized hospitals has increased year by year, but there are fewer highly influential journals. Domestic and international scientific research cooperation is limited to several institutions. The achievements in the field of basic research are far more than those in clinical research.
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Under the new situation of rapid development of medical science and technology, how to effectively cultivate medical students’ humanistic spirit and comprehensively improve medical quality is an important responsibility of medical college teachers. Blend-learning can guide students to immersive learning in multiple dimensions and forms. Obstetrics and Gynecology is one of the main compulsory courses for clinical medical students, which is faced more sensitive and vulnerable female patients, and required higher humanistic quality training for medical students. Through the construction of the blend-learning platform, medical humanities can be better integrated into the content and teaching design of medical education, and students can be more appropriately imperceptibly trained in medical humanities in obstetrics and gynecology teaching, so as to enhance medical students’ medical humanities quality in the process of obstetrics and gynecology diagnosis and treatment, and improve doctor-patient relationship.
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Objective:To construct the core indicators for entrustable professional activities in specialists in obstetrics and gynecology.Methods:A study group was formed by the specialists in obstetrics and gynecology and the experts in medical education. The core indicators for entrustable professional activities were constructed for the specialists in obstetrics and gynecology based on literature review and clinical practice, and then the Delphi method was used to conduct two rounds of expert letter consultation for screening and optimization from March 2021 to January 2023 to further identify the core indications.Results:The expert positive coefficient was 100% for the two rounds of consultation, with an expert authority coefficient of 0.82, and the Kendall's coefficient of concordance was 0.221 and 0.213, respectively (both P<0.01). Ten core indicators and their content descriptions were constructed for entrustable professional activities in obstetrics and gynecology specialists, and the experts had a degree of recognition of more than 80% for the importance of these ten entrustable professional activities, with a coefficient of variation of <0.25. This study determined the expected entrustable level of each indicator for specialists at the completion of the course, which ranged from grade 3 to 5; the highest level of 4.48 was observed for the diagnosis and treatment of outpatients, which was between the levels of mastery and expert; the lowest level of 3.52 was observed for laparoscopic hysterectomy, which was between the levels of competency and mastery. Conclusion:This study preliminarily constructs the core indicators for entrustable professional activities in specialists in obstetrics and gynecology, which provides a new exploration for the standardized training of specialists.
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Objective:To summarize the construction and practice of the compulsory postgraduate course "reproductive genetics in gynecology and obstetrics" in Department of Gynecology and Obstetrics, Peking University, and to evaluate the teaching effect of this course.Methods:A total of 139 postgraduates who studied in Department of Obstetrics and Gynecology, Peking University, from 2019 to 2021 were enrolled as subjects, and a syllabus was constructed through a top-level design based on the "biological-psychological-social medicine pattern", with the teaching objectives of reproductive genetics theory, clinical translation, genetic counseling methods, and research advances. The teaching effect was evaluated by analyzing teaching assessment results, teaching evaluation feedback, and teaching achievements. SPSS 26.0 software was used to perform the t-test and the chi-square test. Results:The written test score, usual performance score, and total score of the postgraduate students in 2021 were higher than those in 2019 and 2020 [(73.50±8.19) vs. (70.94±14.90); (68.60±2.82) vs. (68.22±4.58); (90.58±4.18) vs. (89.49±7.60)], with significant differences in written test score and total score ( P<0.05). There was a high degree of satisfaction with the feedback of teaching, and 85.61% (119/139) of the students selected "great satisfaction"; in particular, there were increases in the degree of satisfaction with expanding research ideas and reflecting the advances in this discipline, but with no significant difference. There was a significant increase in the number of published articles. Conclusion:For the active implementation of the course of "Reproductive Genetics in Obstetrics and Gynecology", improving the teaching process in a planned and step-by-step way through a top-level design in advance can help to expand research ideas for future research work among postgraduates in obstetrics and gynecology and promote the sustainable development and improvement of the teaching of the emerging interdisciplinary discipline of reproductive genetics in obstetrics and gynecology.
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Objective:To observe the effects of virtual reality (VR) technology combined with scenario-based simulation training in obstetrics and gynecology internship teaching.Methods:Ninety-eight medical students interned in the department of obstetrics and gynecology from June 2021 to May 2022 were included. Among them, 49 students received conventional clinical internship teaching of obstetrics and gynecology in the control group, while the other 49 students received scenario-based simulation training with VR technology in the observation group. The two groups were compared in terms of test scores, learning ability assessed by the Self-Rating Scale of Self-Directed Learning, post competency, and the degree of satisfaction with teaching quality. The data were analyzed through the chi-squared test and t test with the use of SPSS 20.00. Results:The observation group had significantly higher scores than the control group in theoretical knowledge [(35.51±2.21) vs. (32.17±3.22)], case analysis[ (16.52±1.51) vs. (13.37±2.03)], and practical operation skills (all P<0.05). After teaching, the learning ability and post competency were significantly improved in both groups (both P<0.05), which were significantly better in the observation group than in the control group (both P<0.05). The degree of satisfaction with teaching of the observation group was significantly higher than that of the control group ( P<0.05). Conclusion:VR technology combined with scenario-based simulation training can help improve teaching quality and enhance medical students' learning ability and post competency, with a high degree of satisfaction with teaching quality, which is worth promotion and application.
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Traditional theoretical learning and clinical practice training are currently the main teaching model for ultrasound in obstetrics and gynecology, and with the increase in the difficulties in the diagnosis and treatment of related diseases and the complicated doctor-patient relationship, this model is facing many problems, such as noncooperation of patients, change in position of the fetus, difficult diagnosis of fetal congenital diseases, and limited conditions of pregnant women. This study designs and prepares an imaging database of abnormal cases, and teachers of corresponding levels are equipped according to the different learning stages of students. A total of 26 students received training and the evaluation of theoretical knowledge and clinical operation skills, and the results showed that all the students reached the level of standardized residency training in Beijing. The combination of case-based teaching and hierarchical teaching has the advantages of mutual integration and step-by-step promotion in the clinical teaching of ultrasound in obstetrics and gynecology, which has a positive impact on improving the communication skills of students in future clinical practice.
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Background: After any kind of surgery, many drugs are prescribed for prevention of infection, analgesic purpose, nausea, vomiting, gastritis and to maintain the hemodynamic status. Drug utilization studies are conducted for a variety of reasons, including consumption, off-label use, medication errors, misuse, and treatment dynamics. It is done to identify the problems associated and help the prescribers to optimize resource allocation and utilization. Aim and Objectives: This study was conducted with the objective to reconnoiter the utilization pattern of various medications in obstetrics and gynecological post-operative cases for assessment of various medications prescribed, their route of administration, their duration of use, and the World Health Organization (WHO) core drug indicators. Materials and Methods: This was a Prospective Observational study conducted after obtaining approval from the Institutional Ethics Committee. Data were collected from patients case sheets during the period of April 2019 to June 2019, in the post-operative wards of obstetrics and gynecology department using a structured pro forma. Results: A total of 100 patients were prescribed with different medications such as antimicrobials, analgesics antacids, with an average of 7.48 drugs per encounter. Injectable drug encounters was up to 92 %. Antimicrobials were prescribed upto 88 %) and the most common being metronidazole which was prescribed to 80% of patients. The most common analgesic prescribed was diclofenac for 73% of patients. Out of 41 different types of drugs prescribed, 45 (45%) were prescribed by their generic name and 91 (91%) were from the Essential Medicines WHO Model List (2021). Conclusions: The present study provides a valuable insight about the overall pattern of drugs prescribed in postoperative patients in the obstetrics and gynecology unit of a tertiary care hospital. Though only one half of the medications prescribed were by the generic name, a very good proportion of medications were prescribed from the Essential Medicine List. This report is mainly intended to be a step in the wider assessment of safety and efficacy of drugs prescribed in post-operative wards.
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Background: After any surgery, drugs are prescribed for analgesia, prevention of infection, nausea, vomiting, and to maintain the hemodynamic status. Drug utilization studies identify the associated problems and aid prescribers to optimize resource allocation and utilization. Aim and Objectives: This study was done to explore the utilization pattern of medications in obstetrics and gynecology post-operative cases for assessment of the following: (1) Various medications prescribed, (2) their route of administration, (3) duration of usage, and (4) the World Health Organization (WHO) core drug indicators. Materials and Methods: A retrospective observational case-sheet based study was conducted after obtaining approval from the Institutional Ethics Committee. Data were collected from case sheets dated May 1, 2018, to October 31, 2018, in the obstetrics and gynecology department using a structured pro format. Results: A total of 240 patients (247 encounters) were prescribed antimicrobials, analgesics, antacids, and intravenous (IV) fluids with an average of 7.25 drugs per encounter. Injectable drug was prescribed to 222 (89.88%) patients. Antimicrobials were prescribed to 168 patients (68.01%); most common being metronidazole which was prescribed to 120 patients (48.58%). Diclofenac was prescribed to 232 patients (93.93%) and Ranitidine to 239 patients (96.76%); these were the most commonly prescribed analgesic and antacid, respectively. Out of 68 different types of drugs prescribed, 16 (23.53%) were prescribed by their generic name and 51 (75%) were from the Essential Medicines WHO Model List (EML) (2015). Conclusions: Antimicrobials were moderately used in management of post-operative cases. Although only about a quarter of medications were prescribed by generic name, nearly three-fourths were from EML.
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SUMMARY OBJECTIVE: This study aimed to evaluate the knowledge of the obstetricians and gynecologists in the care of women victims of violence in the public health system and the existence of institutional mechanisms to support them. METHODS: A cross-sectional and observational study was conducted with an electronic questionnaire by physicians who provided care in the obstetrics and gynecology emergency unit of the public health system. This study aimed to identify the care for victims of violence who received the institutional mechanisms of support, the difficulties encountered in determining the appropriate care, and estimates of the prevalence of violence against women. RESULTS: Notably, 92 physicians responded to the questionnaire. Of these, 85% had already provided care in one or more cases of violence, and 60% believed that <20% of the women received adequate care in these cases, mainly due to the short-time frame of the consultation, lack of team preparation, and lack of institutional resources. A total of 61% of the participants believed that they were not prepared to provide adequate care in those cases. CONCLUSIONS: Most of the physicians interviewed, although reported to have sufficient knowledge to adequately treat victims of violence, did not provide such care due to lack of institutional support.
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This paper discussed the guiding significance of "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) for dealing with ovulation disorder infertility caused by hyperprolactinemia(HPRL). FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) concentrates on the disease entities, main symptoms, pathogenesis, and syndrome differentiation, based on which the prescriptions are prescribed. This reflects the "disease-syndrome-symptom" mode, with the core lying in the "combination of disease with syndrome". The contained Discussion on Menstruation Regulation(Tiao Jing Pian) and Discussion on Getting Pregnant(Zhong Zi Pian) have important reference significance for later doctors in the diagnosis and treatment of inferti-lity, and many prescriptions are still in use due to good effects. It is believed in traditional Chinese medicine(TCM) that HPRL results from kidney deficiency and liver depression, among which kidney deficiency is the main cause. Liver depression accelerates the onset of HPRL, so the kidney-tonifying and liver-soothing herbs were mainly selected. The "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) sheds enlightenment on the diagnosis and treatment of ovulation infertility caused by HPRL, in that it is not confined to disease entity and syndrome type. The integration of "disease-syndrome-symptom" highlights the main complaint of patients and emphasizes the main pathogenesis, thus giving full play to the overall advantage of syndrome differentiation. For multiple diseases in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) such as infertility due to liver depression, infertility due to obesity, delayed menstruation, and irregular menstruation, although the typical lactation symptom of HPRL is not mentioned, the medication can still be determined according to the chief complaint, syndrome type, and symptoms and signs, making up for the defects of excessive reliance on serum biochemical indicators in modern Chinese medicine. We should learn its diagnosis and treatment thoughts of paying attention to liver, spleen, kidney, and heart, holism, and strengthening body resistance to eliminate pathogenic factors.
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Female , Humans , Pregnancy , Gynecology , Hyperprolactinemia/drug therapy , Infertility , Obstetrics , OvulationABSTRACT
This paper introduces the historical development, training contents, the inspection mechanism and management regulations of obstetrics and gynecology residents training in Taiwan region, China. Drawing lessons from the experience and ideas of the standardized residency training system of obstetrics and gynecology in Taiwan region, combined with the present situation and deficiencies of the training system in the mainland China, this paper puts forward constructive suggestions for the standardized residency training of obstetrics and gynecology, so as to obtain more efficient and satisfactory training results and provide ideas for cultivating excellent obstetrics and gynecology specialists in mainland China.
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Objective:To evaluate the standardized residency training of obstetrics and gynaecology in Shengjing Hospital of China Medical University with Milestones evaluation system of obstetrics and gynecology, and to evaluate the feedback effect of the system.Methods:An improved Milestones evaluation form was developed to evaluate the self-evaluation and clinical tutor's scores, collect the results and make a statistical analysis of the 1-3 years standardized training residents of the Shengjing Hospital of China Medical University in September 2019. GraphPad Prism 8 software was used for data collection and statistical analysis, and Box-Plots software was used for drawing analysist. Descriptive statistics method was used for the general situation of the research objects. After the students' self-evaluation and tutor's scores passed the normal distribution and variance homogeneity test, paired t test was performed, and the scores of residents from different sources were analyzed by variance analysis. Results:A total of 164 residents of obstetrics and gynaecology were evaluated, and there were significant differences between self-evaluation and teacher's evaluation in medical knowledge, learning ability and system work ( P<0.05). The competency scores of the first year residents ranged from 3.003 to 4.556, and at the end of the course they increased to 4.921 to 5.974, showing statistically significant differences in each item compared with the first year ( P<0.001). After three years of training, residents from different sources showed significant improvement ( P<0.001). Conclusion:The Milestones evaluation system of the obstetrics and gynecology can be used for the training assessment and feedback of the residents in obstetrics and gynecology specialty. The self-assessment of residents helps to understand the level of self-assessment, and the teacher's evaluation helps to correct the bias generated by self-assessment. The systematic and staged Milestones evaluation system can instruct the clinical tutors to instruct the residents in accordance with their aptitude, and give feedback on the training effect of the residency training base.