Evaluating graduating OBGYN residents' training in postpartum permanent contraceptive procedures

Area of Science:

• Reproductive Health
• Surgical Education
• Contraception

Background:

• Postpartum permanent contraception (PPPC) surgeries are effective and safe procedures.
• Minimally invasive techniques for PPPC following vaginal delivery are well-established.
• Evaluating resident training and confidence in PPPC is crucial for future provider competency.

Purpose of the Study:

• To assess the case volume of PPPC surgeries among graduating obstetrics and gynecology (OBGYN) residents.
• To evaluate resident confidence levels in performing PPPC procedures.
• To identify barriers affecting PPPC training and completion during residency.

Main Methods:

• A cross-sectional survey was administered to fourth-year OBGYN residents at Ryan Residency programs.
• Data collected included PPPC case volume, barriers to completion, and self-reported confidence.
• Statistical analyses included descriptive statistics, linear mixed-effects models, and multivariable logistic regression.

Main Results:

• A median of 10 PPPC surgeries were performed by surveyed residents.
• 78% of residents felt comfortable performing PPPC, and 86% felt prepared for emergencies.
• Higher case volumes correlated with increased confidence (p<0.0001), but confidence in managing complications and salpingectomies was lower (63-64%).

Conclusions:

• Low PPPC case volume during residency limits resident confidence and preparedness.
• Systemic barriers such as OR and nursing availability hinder training opportunities.
• Improving resident education in PPPC is vital for patient autonomy and addressing future provider shortages, especially in the current reproductive health landscape.