Medical simulation manikin

OB-GYN Residency Prep Courses Train Med Students for Internships

by Katie Vloet
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A medical student speaks calmly to the patient: “It looks like you’ve been bleeding a lot,” she says, and asks for permission to do a pelvic examination. “Victoria, has anyone ever told you that you have high blood pressure or asthma?” She asks several more questions, then determines that Victoria should be moved to the emergency room and treated for postpartum hemorrhage, a leading cause of maternal mortality.

The medical student, Alana Eason, looks to her instructor for feedback; he congratulates her on getting the correct diagnosis. Victoria, meanwhile, awaits the next evaluation and diagnosis by a medical student.

Victoria is a manikin, one specifically designed to simulate C-section deliveries, shoulder dystocia, breech, and other obstetric challenges. She is startlingly lifelike — she has articulated joints, and can blink and speak — and provides a valuable training opportunity for graduating M4s.

The students diagnosing Victoria are completing a month-long course in preparation for their obstetrics and gynecology residencies through a program designed to better equip them for the real-life challenges they will face during their next four years — and beyond.

“It is invaluable to get hands-on practice with physical maneuvers they will need from day one of residency (normal vaginal delivery, complicated delivery, and dealing with obstetrical emergencies such as cord prolapse and shoulder dystocia),” says Samantha Kempner (M.D. 2007), assistant professor of obstetrics and gynecology at Michigan Medicine and one of the instructors of the course. “These are things they have read about, been lectured on, and seen other people perform during the early years of medical school. Getting a chance to be in charge in a low-stakes setting is great for their confidence — and mine, if I work with them again the future.”

“We want our medical students to feel ready on the first day of their residencies,” says Helen Kang Morgan (M.D. 2002, Residency 2006), director of the Comprehensive Clinical Assessment and residency preparatory courses, and clinical associate professor of obstetrics and gynecology and of learning health sciences. “Many of our students tell us the OB-GYN Residency Prep Course is among the most useful training they receive during medical school.”

Prep courses also are available to fourth-year students seeking specialties in surgery, pediatrics, primary care, and internal medicine. They use the original clinical simulation center in the Towsley building at Michigan Medicine, as well as the new simulation center in the Medical Science Building II. The state-of-the-art, 7,500-square-foot space opened in 2017. The Medical School began offering prep courses in 2009 for soon-to-be surgical residents. The school plans to offer residency prep courses for all students by 2019, Morgan says.

Alana Eason, who diagnosed Victoria’s hemorrhage earlier in this story and received her M.D. in 2018, says the prep course was invaluable, particularly the opportunity to practice pregnancy emergencies. “I would say that was a moment when I really felt like I was getting to be a doctor,” she says, “and being what I’m going to be like in the future.” She says it was “nerve-wracking” to perform the simulations but feels much more confident about residency because of the practice. Eason recently matched to Howard University Hospital.

Cindy Lee (M.D. 2018) says the prep course was “empowering.”

“Even the most mundane or daily to-dos of being a resident, like putting on sterile gloves, draping a towel on a patient, or answering pages, seem like potential times to be embarrassingly awkward for nervous soon-to-be interns,” says Lee, who will stay at Michigan for her residency. “The faculty did an excellent job partnering with the Sim Center in giving us sessions on situations that they know we’re all nervous about, like postpartum hemorrhage and cervical checks. I truly felt much more confident in approaching these scenarios after having the structured practice and assessments during the prep course.”

Watch a video about the OB-GYN Residency Prep Course and prep courses in other fields. Read about the experience Kylie Steenbergh (M.D. 2018) had in the OB-GYN Prep Course on the Medical School’s Dose of Reality blog.

Photo courtesy of Gaumard
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