Can postgraduate courses in Maternal-Fetal Medicine change clinical attitude?
OBJECTIVE
To investigate the effect of structured didactic lectures by leaders in the field of Maternal-Fetal Medicine on reported clinical decision-making.


METHODS
An interactive survey of obstetric management was performed as part of a postgraduate course at the 2004 Annual Meeting of the Society for Maternal-Fetal Medicine. Seven controversial topics were addressed, including tocolytic therapy, progesterone supplementation for the prevention of preterm birth, screening for inherited thrombophilia, cervical cerclage for a shortened cervix, the management of preterm premature rupture of membranes, magnesium sulfate seizure prophylaxis, and dexamethasone therapy for hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. The survey was carried out before and after a series of structured didactic lectures, thereby allowing for analysis of the effect of the lectures on reported clinical decision-making.


RESULTS
A total of 298 obstetric care providers attended the postgraduate course. By report, the majority of attendees were Maternal-Fetal Medicine specialists (60.7%), less than 10 years out from specialty training (56.3%), and practicing in a university-based setting (52.9%). An average of 233 practitioners (range 157-298) answered each question. Comparison of responses to the survey given before and after the lectures demonstrated significant differences, especially in the areas of tocolytic therapy and inherited thrombophilias.


CONCLUSIONS
Postgraduate lectures by leaders in the field of Maternal-Fetal Medicine have significant immediate impact on reported clinical decision-making.
Norwitz
Errol R
ER
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale-New Haven Hospital and Yale University School of Medicine, New Haven, CT 06520, USA. errol.norwitz@yale.edu
Bahtiyar
Mert O
MO
Sibai
Baha M
BM
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D023802:Cerclage, Cervical; D003657:Decision Making; D003907:Dexamethasone / Q000627:therapeutic use; D004496:Education, Continuing; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000517:prevention & control; D005820:Genetic Testing; D006176:Gynecology / Q000193:education*; D017359:HELLP Syndrome / Q000188:drug therapy; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D008880:Midwifery / Q000193:education; D009773:Obstetric Nursing / Q000193:education; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D012640:Seizures / Q000139:chemically induced / Q000517:prevention & control; D011795:Surveys and Questionnaires; D019851:Thrombophilia / Q000175:diagnosis / Q000235:genetics; D015149:Tocolytic Agents / Q000627:therapeutic use; D014481:United States
D000893:Anti-Inflammatory Agents; D015149:Tocolytic Agents; D008278:Magnesium Sulfate; D003907:Dexamethasone