Virginia Sheffield, Mary Finta, Abigail Erinc, Tammy L Sonn, Jennifer Reilly Lukela
{"title":"Advancing Equity: Understanding, Addressing, and Mitigating Bias in Assessment in Medical Education.","authors":"Virginia Sheffield, Mary Finta, Abigail Erinc, Tammy L Sonn, Jennifer Reilly Lukela","doi":"10.1097/GRF.0000000000000870","DOIUrl":"10.1097/GRF.0000000000000870","url":null,"abstract":"<p><p>Despite the growing presence of women and historically underrepresented groups in academic medicine, significant disparities remain. This article examines a key aspect of these disparities: biases in assessment and learning environments. Reviewing current literature, including in OBGYN, reveals persistent gender and racial biases in subjective clinical narrative assessments. The paper then outlines a 2-pronged approach for change: first, enhancing the learning environment, and subsequently, providing targeted recommendations for individuals, academic leaders, and healthcare institutions to effectively address these biases.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"512-523"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fei Cai, Sarah Santiago, Elizabeth Southworth, Alyssa Stephenson-Famy, Emily Fay, Eileen Y Wang, Ralph Nicholas Burns
{"title":"Taking the Express Lane: Student Attitudes Towards Tracking in Ob/Gyn Residency.","authors":"Fei Cai, Sarah Santiago, Elizabeth Southworth, Alyssa Stephenson-Famy, Emily Fay, Eileen Y Wang, Ralph Nicholas Burns","doi":"10.1097/GRF.0000000000000873","DOIUrl":"10.1097/GRF.0000000000000873","url":null,"abstract":"<p><p>We sought to determine the subspecialty interests of fourth-year medical students (MS4s) matched to Ob/Gyn and evaluate their attitudes towards residency tracking. Matched MS4s completed a survey regarding subspecialization, confidence in that choice, and desire for tracking. A total of 922 MS4s completed the survey. Of these, 474 (51.4%) desired subspecialty training, but were less confident in their choice compared with those desiring generalist careers (60.0/100 vs. 64.9/100, P =0.003). Those seeking subspecialty training were more likely to desire tracking (15.2% vs. 39.5%, P <0.001). In conclusion, 51% of MS4s desired subspecialty training over generalist careers. Almost 40% of these students are interested in tracking.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"465-473"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie A Fisher, Nigel Madden, Mariana Espinal, Patricia M Garcia, Jennifer K Jao, Lynn M Yee
{"title":"Clinical Trials That Have Changed Clinical Practice and Care of Pregnant People With HIV.","authors":"Stephanie A Fisher, Nigel Madden, Mariana Espinal, Patricia M Garcia, Jennifer K Jao, Lynn M Yee","doi":"10.1097/GRF.0000000000000860","DOIUrl":"10.1097/GRF.0000000000000860","url":null,"abstract":"<p><p>Over the last 4 decades, significant advances in the care of HIV during pregnancy have successfully reduced, and nearly eliminated, the risk of perinatal HIV transmission. The baseline risk of transmission without intervention (25% to 30%) is now <1% to 2% in the United States with contemporary antepartum, intrapartum, and postnatal interventions. In this review, we discuss 3 landmark clinical trials that substantially altered obstetric practice for pregnant individuals with HIV and contributed to this extraordinary achievement: 1) the Pediatric AIDS Clinical Trials Group 076 Trial determined that antepartum and intrapartum administration of antiretroviral drug zidovudine to the pregnant individual, and postnatally to the newborn, could reduce the risk of perinatal transmission by approximately two-thirds; 2) the European Mode of Delivery Collaboration Trial demonstrated performance of a prelabor cesarean birth before rupture of membranes among pregnant people with viremia reduced the risk of perinatal transmission compared with vaginal birth; and 3) the International Maternal Pediatric Adolescent AIDS Clinical Trials Network 2010 Trial identified that dolutegravir-containing, compared with efavirenz-containing, antiretroviral regimens during pregnancy achieved a significantly higher rate of viral suppression at delivery with shorter time to viral suppression, with fewer adverse pregnancy outcomes. Collectively, these trials not only advanced obstetric practice but also advanced scientific understanding of the timing, mechanisms, and determinants of perinatal HIV transmission. For each trial, we will describe key aspects of the study protocol and outcomes, insights gleaned about the dynamics of perinatal transmission, how each study changed clinical practice, and relevant updates to current practice since the trial's publication.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"381-398"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Teeter-Totter or Tapestry: A Life in Academic Medicine.","authors":"Kirtly Parker Jones","doi":"10.1097/GRF.0000000000000852","DOIUrl":"10.1097/GRF.0000000000000852","url":null,"abstract":"<p><p>Constructing a career in academic medicine involves more than a focus on work-life balance. That image of a teeter-totter suggests that life is what happens when you are not working. The nature of the scope of interests (clinical, research, teaching) and values (service, leadership, curiosity, transparency, and honesty) creates a larger framework through which home life and work life become one interwoven tapestry. The author reflects on these perspectives as she looks back on a career in academic medicine.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"291-297"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antenatal Late Preterm Steroids: The Evolution of the ALPS Trial.","authors":"Cynthia Gyamfi-Bannerman","doi":"10.1097/GRF.0000000000000865","DOIUrl":"https://doi.org/10.1097/GRF.0000000000000865","url":null,"abstract":"<p><p>The Antenatal Late Preterm Steroids (ALPS) trial was designed to address respiratory morbidity common in infants born late preterm. The study was published in April, 2016 and, shortly thereafter, changed clinical practice in obstetrics in the United States. The following chapter describes the ALPS trial study design in detail, including the background leading to the trial, the study outcomes, and the initial findings of the long-term follow-up study. The ALPS story would not be complete without Elizabeth Thom, PhD, who died before her time. Her brilliance largely contributed to the design of the ALPS trial.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":"67 2","pages":"399-410"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11068095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving the Lives of Women With Ovarian Cancer.","authors":"Beth Y Karlan","doi":"10.1097/GRF.0000000000000851","DOIUrl":"10.1097/GRF.0000000000000851","url":null,"abstract":"<p><p>Being a gynecologic oncologist is a privilege. Women with cancer address their challenges with grit and resilience. Their most basic questions motivated my career-long search for scientific answers hidden in genetics, novel therapeutics, and cancer prevention. But medicine is a team sport. Working alongside gifted colleagues and mentoring trainees to assume starring roles on the team has sustained and enriched my career. Advocating for patients and the specialty of gynecologic oncology provided another means to advance research and cancer awareness to improve patient outcomes. The author believe the most exciting times are yet to come.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"347-351"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11047303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Road Well Traveled: Making Choices, Ensuring Progress While Heeding the \"Clarion Call\".","authors":"E Albert Reece","doi":"10.1097/GRF.0000000000000853","DOIUrl":"10.1097/GRF.0000000000000853","url":null,"abstract":"<p><p>The career path of everyone is quite unique based on the goals and the choices we make, and success can take time to unfold. My career choices have been greatly influenced by remarkable mentors and opportunities. Reciprocally I have had the pleasure, as a faculty member, department chair, and medical school dean to mentor promising young physicians and scientists to launch successful careers. We need to continue to attract physicians and scientists to academic medicine to ensure that our field continues to innovate and improve the lives of our patients. To influence positive change, we must stay relentlessly focused and have faith that success will come.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"335-346"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139511874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Career Reflections: The Winding Path From County Mayo, Ireland to New York City.","authors":"Mary D'Alton","doi":"10.1097/GRF.0000000000000862","DOIUrl":"10.1097/GRF.0000000000000862","url":null,"abstract":"<p><p>Dr. Mary D'Alton's career journey intertwines her upbringing in County Mayo, Ireland, with impactful contributions to Obstetrics and Gynecology in New York City. From childhood lessons in community care to transformative experiences in Canada and prestigious mentorships, her leadership at Columbia University and NewYork-Presbyterian has fostered innovative initiatives addressing maternal health. Philanthropy plays a pivotal role in realizing her vision, including mental health integration within women's health care. International reach, exemplified by a successful fellowship program with Ireland, underscores her commitment to collaboration Dr. D'Alton's reflections illuminate the transformative power of teamwork, mentorship, and innovation in advancing women's health worldwide.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"286-290"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"When Change Chooses You: My Journey With Paralysis.","authors":"Dale B Hull","doi":"10.1097/GRF.0000000000000855","DOIUrl":"10.1097/GRF.0000000000000855","url":null,"abstract":"<p><p>Life sometimes provides unannounced challenges that threaten the structure of our existence. This personal account of an ob-gyn's encounter with paralysis will illustrate the impact of one such experience.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"304-314"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Into the Unknown: Navigating a Path as an Early-stage Physician-scientist in Obstetrics and Gynecology.","authors":"Sarah A Wernimont","doi":"10.1097/GRF.0000000000000850","DOIUrl":"10.1097/GRF.0000000000000850","url":null,"abstract":"<p><p>This piece is a reflection of one early-stage physician-scientist's professional journey. It highlights a few challenges of navigating this path while calling for continued investment and support for physician-scientists to enhance maternal and child lifelong health.</p>","PeriodicalId":10415,"journal":{"name":"Clinical obstetrics and gynecology","volume":" ","pages":"352-356"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}