title: Episiotomy and perineal repair. An evaluation of resident education and experience.
abstract: OBJECTIVE
  To describe current training practices and experience with episiotomy and perineal repair in obstetrics and gynecology residency programs in the United States.
  
  
  METHODS
  A questionnaire mailed to all directors of accredited programs in the United States for distribution to fourth-year residents in their last four months of training included 30 questions regarding formal teaching, supervision, experience and repair techniques.
  
  
  RESULTS
  A total of 297 of 1,177 (25.2%) residents, representing 47% of programs, responded. The response rates for the various program sizes were: 32.0% for < or = 12 residents, 29.5% for 13-19 residents, 24.6% for 20-24 residents and 18% for > or = 25 residents. Of the residents, 59.9% received no didactics on episiotomy repair techniques; 59.3% had no formal teaching on pelvic floor anatomy; and 27.7% of third-degree repairs were supervised by attending physicians. Of the respondents, 6.8% had repaired > 20 fourth-degree lacerations and 40.3%, > 20 third-degree lacerations. Ten percent of the graduates felt inadequately trained in perineal repair.
  
  
  CONCLUSIONS
  This survey of fourth-year residents from 47% of obstetric programs indicated that the majority of residents received no formal training in pelvic floor anatomy, episiotomy or perineal repair and, when engaged in such activities, had limited supervision.
authors.affiliation: Department of Obstetrics, Gynecology and Women's Health, St. Louis University, 6420 Clayton Road, Suite 290, St. Louis, MO 63117, USA. mclennan@slucare1.sluh.edu
authors.forename: Mary T
authors.initials: MT
authors.lastname: McLennan
authors.forename: Clifford F
authors.initials: CF
authors.lastname: Melick
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Clancy
authors.forename: Raul
authors.initials: R
authors.lastname: Artal
mesh_terms: D000328:Adult; D004841:Episiotomy / Q000379:methods* / Q000592:standards; D005260:Female; D006176:Gynecology / Q000193:education*; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D007744:Obstetric Labor Complications / Q000628:therapy; D009774:Obstetrics / Q000193:education*; D017773:Pelvic Floor / Q000033:anatomy & histology; D010502:Perineum / Q000293:injuries* / Q000601:surgery*; D011247:Pregnancy; D011361:Professional Competence; D014481:United States