Resident Operative Vaginal Delivery Volume after Educational Curriculum Implementation

Academic Article

Abstract

  • Objective â The percentage of operative vaginal deliveries (OVDs) in the United States has sharply declined. In May 2016, our institution's obstetrics and gynecology (OB/GYN) residency programimplemented a twice-yearly OVD curriculum consisting of didactics and simulation. We sought to evaluate the impact of this curriculum. Study Design â We performed a retrospective cohort study of all deliveries at our institution from July 2011 to May 2018. Deliveries were evaluated quarterly forthe pre-(July 2011-April 2016) and postcurriculum (July 2016-May 2018) periods. Forceps-assisted vaginal delivery (FAVD), vacuum-assisted vaginal delivery (VAVD), and total OVD percentages, and theratio of forceps to vacuums were calculated. Pre- A nd postcurriculum percentages were compared using Wilcoxon's rank-sum test. Cubic regression curves were fit to quarterly percentages to illustratetrends over time. Results The quarterly OVD percentage was unchanged following curriculum implementation (mean 3.2 [Q 1-Q3: 2.6-3.5] pre-vs. 3.1 [2.5-3.8] post-, p > 0.99).The FAVD percentage was increased (1.2 [0.8-1.5] vs. 2.0 [1.4-2.6], p = 0.027) and the VAVD percentage was decreased (2.0 [1.6-2.2] vs. 1.2 [0.9-1.3], p < 0.001). This was accompanied by an increase in the ratio of FAVD to VAVD (0.6 [0.4-0.8] vs. 1.7 [1.3-2.2], p < 0.001). FAVD percentage (3.1) was higher in the last quarter than any other quarter in the 7-year study period, and total OVD percentage (3.9) was higher in 2018 than any other calendar year. Conclusion The implementation of an OVD curriculum in our OB/GYN residency program resulted in an increase in the percentage of FAVD and the ratio of FAVD to VAVD. Key Points OVD utilization in the United States continues todecline. We demonstrate real-world impact of an OVD curriculum. OVD curriculum implementation increases usage of FAVD.
  • Digital Object Identifier (doi)

    Author List

  • Becker DA; Blanchard CT; Szychowski JM; Rogers SL; Brumfield CG; Subramaniam A
  • Start Page

  • 1296
  • End Page

  • 1300
  • Volume

  • 37
  • Issue

  • 13