A Conceptual Model for Residents as Teachers in Obstetrics and Gynecology

Med Sci Educ. 2020 May 27;30(3):1169-1176. doi: 10.1007/s40670-020-00985-2. eCollection 2020 Sep.


Background: The learning environment in obstetrics and gynecology (OB/GYN) may have intrinsic differences that require modifying existing resident as teacher models for high-quality teaching.

Objective: To explore medical students' views of resident teaching on the OB/GYN clerkship in order to develop more effective educators.

Methods: Between October 2017 and June 2018, we performed medical student focus groups at the end of the 2-month OB/GYN clerkship. Topics discussed included positive and negative teaching interactions with residents, barriers specific to the OB/GYN clerkship, and best methods for resident teaching. Qualitative analysis utilizing 3 reviewers and N-Vivo software were used to identify themes.

Results: A total of 37 students participated in five focus groups. The most common barriers were a learning environment that was less predictable than on other rotations and lack of autonomy due to patient advocacy concerns. The three main contributors to positive learning experiences were team inclusion, clear expectations, and feedback. Negative interactions were passive learning experiences and inconsistent expectations. The best methods for resident teaching were verbalization of cognitive processes, preparation to use common patient encounters as teaching moments, and modeling skills needed for proficient patient care.

Discussion: The learning environment on OB/GYN is unpredictable and influenced by four Ps: patient autonomy, passive experiences, procedures, and preconceived notions. The strategy of a resident teacher should focus on medical student inclusion and preparation for teaching role. We thus suggest a TEAM (Thinking Aloud, Expectations, Advanced Preparation, Modeling) approach to improve resident teaching on the OB/GYN clerkship.

Keywords: Clinical learning environment; Obstetrics & gynecology; Residents as teachers.