Experiences in Electronic Consultation (eConsult) Service in Gynecology from a Quaternary Academic Medical Center.

To evaluate an academic institution's implementation of a gynecologic electronic consultation (eConsult) service, including the most common queries, turnaround time, need for conversion to in-person visits, and to demonstrate how eConsults can improve access and convenience for patients and providers. This is a descriptive and retrospective electronic chart review. We obtained data from the UCSF eConsult and Smart Referral program manager. The medical system provided institution-wide statistics. Three authors reviewed and categorized gynecologic eConsults for the last fiscal year. The senior author resolved conflicts in coding. The eConsult program manager provided billing information and provider reimbursement. A total of 548 eConsults were submitted to the gynecology service between July 2017 and June 2020 (4.5% of institutional eConsult volume). Ninety-five percent of the eConsults were completed by a senior specialist within our department. Abnormal pap smear management, abnormal uterine bleeding, and contraception questions were the most common queries. Over half (59.3%) of all inquiries were answered on the same day as they were received, with an average of 9% declined. Gynecology was the 10th largest eConsult provider at our institution in 2020. The present investigation describes one large university-based experience with eConsults in gynecology. Results demonstrate that eConsults permit appropriate, efficient triaging of time-sensitive conditions affecting patients especially in the time of the COVID-19 pandemic. eConsult services provide the potential to improve access, interdisciplinary communication, and patient and provider satisfaction.

Emergency obstetrics knowledge and practical skills retention among medical students in Rwanda following a short training course.

OBJECTIVE: To describe rates of improved knowledge following a structured 2-day emergency obstetrics training course. METHODS: Quantitative assessments to evaluate emergency obstetrics knowledge and practical skills were administered before, immediately after, and 3-9 months following the training course for 65 final-year medical students at the National University of Rwanda. A survey was administered during the final assessment. RESULTS: In total, 52 (80.0%) students demonstrated knowledge improvement after training. Fifty-seven (87.7%) students improved or maintained their scores from the post-training written test to the final assessment, and 32 (49.2%) retained practical skills. Twenty-one (32.3%) of the class demonstrated competency in both written and practical skills. According to multivariable logistic regression analysis, female gender was associated with overall competency (P=0.01), and use of the internet for academic purposes more than 3-5 times per week tended toward competency (P=0.11). CONCLUSION: A 2-day emergency obstetrics training course increased knowledge among medical students. Because educational policies are tailored to address high rates of maternal mortality in resource-poor settings, workshops dedicated to emergency obstetrics should be promoted.

Interviews with senegalese commercial sex trade workers and implications for social programming.

The purpose of the study was to assess the efficacy of the Senegalese pubic policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviews at the Institute d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for successful strategies in the fight against the global spread of HIV/AIDS.