Creating an ideal objective structured clinical exam for an obstetrics and gynecology medical student clerkship.

OBJECTIVE: The objective of the study was to describe our experience with the Objective Structured Clinical Exam during the third-year obstetrics/gynecology clerkship. STUDY DESIGN: Our 8-station Objective Structured Clinical Exam is described in detail. We analyzed grades from the Objective Structured Clinical Exam for overall distribution, comparing among and between groups by year and among exam sites and correlating with the National Board of Medical Examiners subject exam and the final clerkship grades. RESULTS: The Objective Structured Clinical Exam is provided at 3 sites, 1 at a technically advanced simulation center. Most students (54.6%) received a grade of A; however, the mean grade from the Objective Structured Clinical Exam at the simulation center (3.41 on a 4-point grade-point average scale) was lower than that at the clinic sites (3.60, P = .005; 3.73, P < .001). Effect of rotation order was identified only in the first year. Grades from the Objective Structured Clinical Exam were positively but weakly correlated with National Board of Medical Examiners subject exam and final clerkship grades. CONCLUSION: An Objective Structured Clinical Exam in the obstetrics/gynecology clerkship can be administered with limited resources and provides a valuable assessment method.

Early intervention for perinatal depression.

OBJECTIVE: This study was undertaken to design a process that effectively identifies and facilitates early intervention for women in an obstetrics clinic who are at risk for postpartum depression. STUDY DESIGN: Under this new program, labeled ISIS (Identify, Screen, Intervene, Support), we educated our new obstetric patients and clinic staff about postpartum depression through patient education classes, departmental lectures, and handouts. Then, we implemented simple procedures to identify risk factors for depression at intake and screened for depressive symptoms at the 32-week visit using the Edinburgh Postnatal Depression Scale (EPDS). In addition, we facilitated treatment of at-risk or symptomatic patients with the introduction of a social work consultant in the clinic setting. RESULTS: In an obstetric chart review, 75% of our patients were screened for depression in pregnancy. Ten percent of these women demonstrated symptoms of depression warranting further evaluation. CONCLUSION: Preliminary data from our multidisciplinary approach suggest that educating, screening, and appropriately treating or referring these women can take place in a busy obstetric clinic.

Incorporating problem-based learning into an obstetrics/gynecology clerkship: impact on student satisfaction and grades.

OBJECTIVE: The purpose of this study was to describe the effect of the problem-based learning method on student grade and on student and faculty satisfaction. STUDY DESIGN: The problem-based learning method was instituted at 2 of 5 obstetrics/gynecology clerkship sites. Students and faculty were surveyed, with the use of a Likert scale, regarding aspects of satisfaction with the clerkship. Responses were compared according to problem-based learning usage. Student performance was also assessed according to problem-based learning usage, with a comparison of several grade components. Statistical analysis involved t-tests and Kendall's tau-C. RESULTS: For the year that was assessed, 54 of 156 students used the problem-based learning method. Mean student satisfaction responses were significantly higher for students who used the problem-based learning method. Faculty satisfaction was also significantly higher for the problem-based learning method, compared with other teaching methods. Mean scores on the National Board of Medical Examiners subject examination were higher for problem-based learning but did not reach statistical significance. Grade distribution was not significantly different for the groups. CONCLUSION: The problem-based learning method was associated with improved student and faculty satisfaction and did not affect student grades negatively.

Variation in medical student grading criteria: a survey of clerkships in obstetrics and gynecology.

OBJECTIVE: Our purpose was to assess how obstetrics/gynecology clerkships incorporate methods of student assessment into grades. STUDY DESIGN: A survey that included a broad range of assessment methods was distributed to obstetrics/gynecology clerkship directors registered with the Association of Professors of Gynecology and Obstetrics. Respondents were asked to indicate the methods used for assessment and to indicate the weight assigned to these methods in determining a student grade. RESULTS: Of the 146 surveys distributed, there were 53 respondents (36.4%). The most common methods of subjective assessment included evaluation of patient presentation skills and performance on ward rounds. The 2 most commonly used objective methods, general assessment of cognitive knowledge and the National Board of Medical Examiners Subject Examination in Obstetrics and Gynecology, generally accounted for 75% of the final grade, although these same 2 components also had the widest range of assigned weights reported. CONCLUSION: Assessment methods and incorporation into a final grade vary widely across obstetrics/gynecology clerkships.