Resident Operative Vaginal Delivery Volume after Educational Curriculum Implementation

Area of Science:

• Reproductive Medicine & Perinatal Care
• Medical Education & Training
• Surgical Procedures & Outcomes

Background:

• Operative vaginal delivery (OVD) rates have significantly declined in the United States.
• A gap in training for OVDs may contribute to this decline.
• Residency programs are crucial for maintaining procedural skills in obstetrics.

Purpose of the Study:

• To evaluate the impact of a newly implemented operative vaginal delivery (OVD) curriculum on delivery statistics.
• To assess changes in forceps-assisted vaginal delivery (FAVD) and vacuum-assisted vaginal delivery (VAVD) rates.
• To determine if the curriculum influenced the overall utilization of OVDs.

Main Methods:

• Retrospective cohort study analyzing deliveries from July 2011 to May 2018.
• Data collected quarterly, comparing pre-curriculum (July 2011-April 2016) and post-curriculum (July 2016-May 2018) periods.
• Calculated percentages for FAVD, VAVD, total OVDs, and the FAVD to VAVD ratio; statistical comparison using Wilcoxon's rank-sum test.

Main Results:

• Total OVD percentage remained unchanged post-curriculum (3.2% vs. 3.1%, p > 0.99).
• Forceps-assisted vaginal delivery (FAVD) percentage significantly increased (1.2% vs. 2.0%, p = 0.027).
• Vacuum-assisted vaginal delivery (VAVD) percentage decreased (2.0% vs. 1.2%, p < 0.001), leading to a higher FAVD to VAVD ratio (0.6 vs. 1.7, p < 0.001).

Conclusions:

• Implementation of an OVD curriculum in an OB/GYN residency program increased the utilization of FAVD.
• The curriculum shifted the OVD method mix towards forceps, increasing the FAVD to VAVD ratio.
• The study demonstrates a real-world impact of targeted obstetric training on procedural outcomes.