Experience of an online course on sexuality during pregnancy for residents.

Many obstetrics and gynecology (Ob/Gyn) residents report insufficient knowledge about female sexuality and this has a negative impact on their capacity to manage their patients. The aim of this study was to describe an online course about sexuality during pregnancy for Brazilian Ob/Gyn residents and evaluate their knowledge acquisition. This longitudinal educational intervention study involved 219 Brazilian Ob/Gyn residents. The online course lasted 24h (10 video lectures and discussion chats). Upon enrollment, the participants answered a questionnaire in regard to their training, attitudes and practices about sexuality during pregnancy. Participants' knowledge acquisition was assessed using a pre- and post-course test about sexuality during pregnancy. At the end of the course, participants were asked to evaluate their educational experience. Student's t and chi-square tests were used to analyze the pre- and post-course test scores. P values<0.05 were considered statistically significant. A total of 143 Ob/Gyns (65.3% of those enrolled) completed the course. At baseline, most participants reported that they did not have any sexology classes as undergraduates (62.5%) or in their residency (52.1%), and that they lacked specific knowledge in this area to manage their patients. Mean test scores increased significantly at the end of the course: 4.4 (±1.6) versus 6.0 (±1.3) (out of a maximum score of 10), before and after the course, respectively (p<0.0001). Most of the residents rated the overall quality of the course as "higher than expected". An online course for Ob/Gyn residents was associated with a significant increase in knowledge about sexuality during pregnancy.

Vieira TCSB ，Nakamura MU ，da Silva I ，Torloni MR ，Ribeiro MC ，Scanavino MT ，de Souza E ... -  《-》

Dealing with female sexuality: training, attitude, and practice of obstetrics and gynecology residents from a developing country.

There is little research on how obstetrics and gynecology (Ob/Gyn) residents deal with female sexuality, especially during pregnancy. The aim of this study was to assess the training, attitude, and practice of Ob/Gyn residents about sexuality. A cross-sectional survey of Brazilian Ob/Gyn residents enrolling in an online sexology course was conducted. A questionnaire assessed their training in sexuality during medical school and residency and their attitude and practice on sexual issues during pregnancy. Training, attitude, and practice of Ob/Gyn residents regarding sexuality were the main outcome measures. A total of 197 residents, from 21 different programs, answered the online questionnaire. Mean age was 27.9 ± 2.2, most were female (87%), single (79%), and had graduated in the last 5 years (91%). Almost two-thirds (63%) stated that they did not receive any training at all and 28% reported having only up to 6 hours of training about sexuality in medical school. Approximately half of the respondents (49%) stated that they had received no formal training about sexuality during their residency up to that moment and 29% had received ≤6 hours of training. Over half (56%) never or rarely took a sexual history, 51% stated that they did not feel competent or confident to answer their pregnant patients' questions about sexuality, and 84% attributed their difficulties in dealing with sexual complaints to their lack of specific knowledge on the topic. The vast majority of Brazilian Ob/Gyn residents enrolling in a sexuality course had little previous formal training on this topic in medical school and during their residency programs. Most residents do not take sexual histories of pregnant patients, do not feel confident in answering questions about sexuality in pregnancy, and attribute these difficulties to lack of knowledge. These findings point to a clear need for additional training in sexuality among Brazilian Ob/Gyn residents.

Vieira TC ，de Souza E ，da Silva I ，Torloni MR ，Ribeiro MC ，Nakamura MU ... -  《-》

Distance Education Course about Sexuality for Obstetrics and Gynecology Residents.

Purpose To describe the experience of a distance education course on sexual issues during pregnancy and after birth for residents. Methods This prospective educational intervention study was conducted by investigators from the Universidade Federal de São Paulo, Brazil, between April and September 2014. The participants were 219 physicians (residents from the 1st to the 6th years). The duration of the course was of 24 hours (10 video lectures and online chats). At baseline, the participants answered questions about their training, attitude and experience regarding sexual issues during pregnancy and after birth; before and after the course, they answered questions to assess their knowledge about the topic; at the end of the course, they answered questions on the quality of the course. The Student t-test was used to compare the before and after scores of the knowledge tests; values of p < 0.05 were considered statistically significant. Results A total of 143 residents concluded the course; most were in their 1st (27.2%) or 3rd (29.4%) years of residency. There was a significant increase in the mean scores of the questionnaires that assessed the knowledge of the topic: 4.4 (±1.6) versus 6.0 (±1.3; maximum score: 10), before and after the course respectively (p < 0.0001). Most of the participants (74.1%) declared that the quality of the course as a whole reached their expectations, and 81.1% would recommend the course to a friend. Conclusions The online Sexology course for Obstetrics and Gynecology residents increased their knowledge about the sexual issues during pregnancy and after birth, and fulfilled the participants' expectations. The experience described here may serve as a model for other sexuality courses targeting similar audiences.

Vieira TCSB ，Nakamura MU ，Silva ID ，Torloni MR ，Ribeiro MC ，Souza E ... -  《-》

Knowledge, attitudes, and intentions toward fertility awareness and oocyte cryopreservation among obstetrics and gynecology resident physicians.

What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients? Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines. Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients. A cross-sectional online survey was conducted during the fall of 2014 among residents in American Council for Graduate (ACOG) Medical Education-approved OB/GYN residency programs. Program directors were emailed via the ACOG Council on Resident Education in Obstetrics and Gynecology server listing and asked to solicit resident participation. Participants included 238 residents evenly distributed between post-graduate years 1-4 with varied post-residency plans; 90% of residents were women and 75% were 26-30 years old. The survey was divided into three sections: demographics, fertility awareness, and attitudes toward discussing fertility preservation options with patients. Descriptive and inferential statistics were conducted. A strong majority of residents (83%) believed an OB/GYN should initiate discussions about age-related fertility decline with patients (mean patient age 31.8), and 73% percent believed these discussions should be part of an annual exam. One third of residents overestimated the age at which there is a slight decline in female fertility, while nearly half of residents overestimated the age at which female fertility markedly declines. Over three-quarters of residents (78.4%) also overestimated the likelihood of success using assisted reproductive treatments (ARTs). Residents were likely to support oocyte cryopreservation in cancer patients irrespective of the woman's age, but much less likely to support elective oocyte cryopreservation. For elective oocyte cryopreservation, 40% believed OB/GYNs should initiate discussions with patients (mean age 31.1), while only 20% believed this topic should be part of an annual exam. Because the study invitation was sent through US OB/GYN residency program directors rather than directly to residents, it is possible that some residents did not receive the invitation to participate. This limits the generalizability of the findings. Within the USA, there appears to be a critical need for improved education on fertility decline in OB/GYN residency programs. To promote informed reproductive decision-making among patients, efforts should be made to help OB/GYNs provide comprehensive fertility education to all women, while also respecting patient choices. None.

Yu L ，Peterson B ，Inhorn MC ，Boehm JK ，Patrizio P ... -  《-》

Resident education and training in female sexuality: results of a national survey.

Considering the prevalence of female sexual dysfunction, the lack of education and training in female sexual function and dysfunction (FSF&D) during and obstetrics and gynecology residency highlights a need for greater focus on this topic. To assess understanding and confidence among third and fourth year Ob/Gyn residents with respect to FSF&D. An Internet-based survey was constructed to evaluate third and fourth year residents in American Council for Graduate Medical Education-approved Ob/Gyn programs. Residents were asked about familiarity, knowledge, and confidence in treating various aspects of FSF&D, based on the Council on Resident Education in Obstetrics and Gynecology (CREOG) Educational Objectives for Ob/Gyn training. They were also queried regarding areas of improvement for their education.   Responses to survey instrument. Two hundred thirty-four residents responded. The majority (91.5%) reported attending ≤5 didactic activities on FSF&D. Only 19.6% reported often or always screening women for sexual function problems; most had very little or no knowledge in administering or interpreting screening questionnaires. While many (82.8%) felt confident about obtaining a complete sexual history, only 54.7% felt able to perform a targeted physical exam. Although most residents had cared for women with dyspareunia (55.1%), a minority had managed many women with low desire (18.4%), arousal problems (8.1%), anorgasmia (5.6%), or vaginismus (16.7%). In treating patients, 34-56% reported rarely or never suggesting ancillary therapy such as counseling and medications. However, the majority believed that their confidence would increase through FSF&D lectures (97.9%), FSF&D patient observations (97.4%), rotating with a urogynecologist (94.4%), and online modules (90.6%). Despite CREOG requirements for Ob/Gyn training in female sexuality, most residents feel ill-equipped to address these problems. Additional evidence-based educational and didactic activities would enhance residents' knowledge and confidence in treating these common, quality-of-life issues.

Pancholy AB ，Goldenhar L ，Fellner AN ，Crisp C ，Kleeman S ，Pauls R ... -  《-》