Variability in the learning experiences of family practice residents during an obstetrics rotation.

Abstract

BACKGROUND AND OBJECTIVES: Residency rotations do not necessarily provide the same clinical experience to each resident. This study quantified and explained the variability in participation in deliveries by family practice residents during an obstetrics rotation at a community hospital. METHODS: We collected prospectively completed resident experience logs from 17 residents and information from the hospital Summary of Delivery forms for 1,166 deliveries. The data were analyzed using methods to account for within-supervisor correlation. RESULTS: Participation and delivery rates varied markedly. In stepwise conditional regression analysis, resident participation in deliveries was positively associated with prior resident involvement during the labor and negatively associated with occurrence of the delivery on the night shift and with male gender of the resident. Resident performance of delivery was positively associated with non-instrumented vaginal delivery, prior resident involvement during the labor, and patient multiparity and negatively associated with male resident gender. CONCLUSIONS: We found substantial variability in resident experience and identified several factors associated with increased resident experience. Variability of experience among residents in clinical rotations should be assessed to ensure that all residents receive adequate training.