Problem While many medical schools have implemented bootcamps or specialized curricula to prepare medical students for residency, these programs are neither universal nor consistent in their content. Approach The authors created an electronic, multimodal, short messaging service (SMS)-distributed curriculum, called the #ObGynInternChallenge, to improve learners’ medical knowledge, based on the Council on Resident Education in Obstetrics and Gynecology educational objectives. The curriculum was open to all fourth-year medical students who matched into obstetrics and gynecology (Ob/Gyn). Daily messages were delivered to participants’ mobile devices via SMS for 25 consecutive weekdays, May 3–June 4, 2021. Each day’s message included an introduction with key facts, an infographic, a website link with a podcast and additional reference materials, and at least one question. The authors assessed its reach, adoption, implementation, and effectiveness. Outcomes For reach and adoption, total enrollment for the curriculum was 1,057 (72.0%) of 1,469 filled Ob/Gyn residency positions in the 2021 Match. The total cost of the intervention was $2,503.20 or $2.37 per participant. For implementation, all participants who signed up for the course received the daily messages, and 858/1,057 (81.2%) completed the course. Participants felt the curriculum was an excellent resource for studying (391/426, 91.8%) and the course was enjoyable to use (395/424, 93.2%). For effectiveness, mean score improvement was 11.6% (pre-test: 62.4%, post-test: 74.0%; P < .001). In the multivariate linear regression analysis, high podcast (P = .02) and website use (P = .002) were associated with greater score improvement. High social media use was associated with less improvement (P = .02). Next Steps This study suggests promise for a low-cost, largely satisfying SMS-distributed curriculum in terms of offering some benefit for short-term knowledge gain. Next steps include expanding such a curriculum to meet standard learning objectives for all fourth-year medical students entering residency.
Objective: To evaluate the effect of a physician-created educational infographic on the knowledge and attitudes of patients undergoing antenatal fetal surveillance. Study Design: This single-center prospective cohort study evaluated the impact of implementing an electronic educational infographic about antenatal fetal surveillance. English-speaking women receiving antenatal surveillance between the ages of 18-50 were approached for inclusion. The pre-implementation group enrolled women receiving antenatal surveillance between March 8, 2021 - April 2, 2021, who received usual care. Post-implementation, from April 5 – May 6, 2021 patients at our site received the infographic about antenatal fetal surveillance at their first antenatal testing appointment. Both pre-implementation and post-implementation groups received a 5-question multiple-choice knowledge and 12-question attitude survey between 32w0d-33w6d at baseline (prior to receipt of infographic in post-implementation group) and again between 35w0d-36w6d. Patients were included in the analysis only if they completed both surveys. Differences from initial to final survey were compared between groups. Results: Of 106 patients who completed the initial survey, 74 (69.8%) participants finished both surveys (pre-implementation=39, post-implementation=35). There were no significant differences in demographics between the two groups, including in baseline knowledge (p=0.58) or attitude tests (p=0.57). There was no significant difference in knowledge on final surveys between groups (p=0.79). However, utilization of the infographic was associated with a significant increase in attitude survey score from initial to final survey in the post-implementation group as compared to usual care (median difference Pre: 0, IQR[-1 to +4] vs. Post: +3, IQR[+1 to +6], p=0.016). Conclusion: A physician-created infographic on antepartum fetal testing was associated with overall improved patient attitude toward fetal testing, showing that small education interventions can increase patient satisfaction with care.
Objective: To evaluate the reported amount of American College of Obstetricians and Gynecologists (ACOG) recommended nutrients in commercially available, over-the-counter prenatal vitamins (PNVs) in the United States, to assess their adequacy compared to ACOG guidelines, and to compare them by cost Study Design: The top 30 online Amazon and Google Shopping items found using “prenatal vitamins” in September 2022 were included for analysis if they included the words “prenatal” and “vitamin” in the label and contained multiple nutrients. Duplicates between Amazon and Google were excluded. The reported amounts of 11 key nutrients, as recommended by ACOG, for each product were recorded, as well as supplemental form and cost per 30-day supply. A cost analysis was done of PNVs that met ACOG recommendations for the highlighted nutrients compared to those that did not. Five out of the eleven key nutrients (folic acid, iron, DHA, vitamin D, and calcium) were specifically highlighted, as deficiencies in these nutrients are known to correlate with significant clinical outcomes in pregnancy. Results: 48 unique PNVs were included for final analysis. Of these, none were compliant with suggested amounts of all five key vitamins and nutrients. No products met daily recommendations for calcium. Only five PNVs were compliant with recommendations with 4/5 key nutrients. 27% of PNVs did not have the recommended amount of folic acid (13/48). The median cost of PNVs that were not compliant with the four nutrients mentioned above was $18.99 (IQR $10.00-$30.29), which was not statistically different from the median cost of the PNVs that did meet compliance with the four nutrients, which was $18.16 (IQR $9.13 - $26.99), p=0.55. Conclusion: There were significant variations in the level of nutrients and cost of commercially available, over-the-counter PNVs in the United States. This raises concern that there should be more regulation of PNVs.
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