Resident and supervisor perceptions of gaining obstetrical competency in Family Medicine: a qualitative descriptive study
DOI:
https://doi.org/10.36834/cmej.78131Abstract
Introduction: Canadian Family Medicine (FM) residents, upon graduation, are disinclined to provide intrapartum care. The FM resident experience with obstetrical training has not been studied in over a decade while the FM landscape has changed. This study explored the FM resident experience in working towards their obstetrical competencies as one of the chief influences on their career decision to provide intrapartum care or not.
Methods: Using a qualitative descriptive design, we conducted semi-structured interviews with second-year FM residents (n = 7) and obstetrical supervisors (n = 8) from one Ontario FM program. We coded and interpreted the transcripts for common themes.
Results: FM residents working towards their intrapartum skills are influenced by the following themes: the learners’ unique and individual experience and expectations; opportunities in the training environment; and learning obstetrics in the changing FM landscape. Notably, the influence of FM maternity care role models permeated all themes.
Conclusion: This study offers insight into potential areas of intervention to improve the FM residency training experience in intrapartum care. Investment in FM maternity education, in the undergraduate and postgraduate medical curricula, with continued support in practice, is critical to maintain comprehensive education and patient care, especially while Canada faces a maternity care crisis.
Metrics
References
Popadiuk C. The changing landscape of obstetrical care in Canada. J Obs Gyn Can. 2020;42(11):1305-1306. https://doi.org/10.1016/j.jogc.2020.09.005 DOI: https://doi.org/10.1016/j.jogc.2020.09.005
Dove M, Dogba MJ, Rodríguez C. Exploring family physicians’ reasons to continue or discontinue providing intrapartum care. Can Fam Phys. 2017;63(8):e387-e393.
de Leeuw S. The missing of mums and babes. Can Fam Phys. 2016;62(7):580-583.
Godwin M, Hodgetts G, Seguin R, MacDonald S. The Ontario family medicine residents cohort study: factors affecting residents’ decisions to practise obstetrics. CMAJ. 2002;166(2):179-184.
Marshall EG, Horrey K, Moritz LR, et al. Influences on intentions for obstetric practice among family physicians and residents in Canada: an explorative qualitative inquiry. BMC Preg Childbirth. 2022;22(1):857. https://doi.org/10.1186/s12884-022-05165-1 DOI: https://doi.org/10.1186/s12884-022-05165-1
Buchman S. It’s about time: 3-year FM residency training. Can Fam Phys. 2012;58(9):1045-1045.
Fowler N, Oandasan I, Wyman R, eds. Preparing our future family physicians. an educational prescription for strengthening health care in changing times. Published online 2022.
Hansen ER, Eden AR, Peterson LE. A qualitative study of trainee experiences in Family Medicine-Obstetrics fellowships. Birth. 2019;46(1):90-96. https://doi.org/10.1111/birt.12388 DOI: https://doi.org/10.1111/birt.12388
Biringer A, Almond R, Dupuis K, et al. Report of the Working Group on Family Medicine Maternity Care Training. College of Family Physicians of Canada; 2012. Available from https://www.cfpc.ca/report_maternity_care_training/ [Accessed Dec 22, 2019].
Fowler N, Wyman R, eds. Residency training profile for family medicine and enhanced skills programs leading to certificates of added competence. Published online May 2021. Available from https://www.cfpc.ca/CFPC/media/Resources/Education/Residency-Training-Profile-ENG.pdf. [Accessed June 30, 2023].
Koppula S, Brown JB, Jordan JM. Experiences of family medicine residents in primary care obstetrics training. Fam Med. 2012;44(3):178-182.
Ruderman J, Holzapfel SG, Carroll JC, Cummings S. Obstetrics anyone? How family medicine residents’ interests changed. Can Fam Phys. 1999;45:638-647.
Reid AJ, Carroll JC, Ruderman J, Murray MA. Differences in intrapartum obstetric care provided to women at low risk by family physicians and obstetricians. CMAJ. 1989;140(6):625-633.
Buckle D. Obstetrical practice after a family medicine residency. Can Fam Phys. 1994;40:261-268.
Sakornbut EL, Dickinson L. Obstetric care in family practice residencies: a national survey. J Am Board Fam Pract. 1993;6(4):379-384.
Ratcliffe SD, Newman SR, Stone MB, Sakornbut E, Wolkomir M, Thiese SM. Obstetric care in family practice residencies: a 5-year follow-up survey. J Am Board Fam Pract. 2002;15(1):20-24.
Kabir M, Randall E, Mitra G, et al. Resident and early-career family physicians’ focused practice choices in Canada: a qualitative study. Br J Gen Pract. 2022;72(718):e334-e341. https://doi.org/10.3399/BJGP.2021.0512 DOI: https://doi.org/10.3399/BJGP.2021.0512
Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23(4):334-340. https://doi.org/10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G DOI: https://doi.org/10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G
Schulich Medicine and Dentisty. Obstetrical Log. Available from https://www.schulich.uwo.ca/familymedicine/postgraduate/current_residents/curriculum/obstetrical_log.html [Accessed May 13, 2024].
Saunders B, Sim J, Kingstone T, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52(4):1893-1907. https://doi.org/10.1007/s11135-017-0574-8 DOI: https://doi.org/10.1007/s11135-017-0574-8
Morse JM. The significance of saturation. Qual Health Res. 1995;5(2):147-149. https://doi.org/10.1177/104973239500500201 DOI: https://doi.org/10.1177/104973239500500201
Busetto L, Wick W, Gumbinger C. How to use and assess qualitative research methods. Neurol Res Pract. 2020;2(1):14. https://doi.org/10.1186/s42466-020-00059-z DOI: https://doi.org/10.1186/s42466-020-00059-z
Berger R. Now I see it, now I don’t: researcher’s position and reflexivity in qualitative research. Qual Res. 2015;15(2):219-234. https://doi.org/10.1177/1468794112468475 DOI: https://doi.org/10.1177/1468794112468475
Dodgson JE. Reflexivity in qualitative research. J Hum Lact. 2019;35(2):220-222. https://doi.org/10.1177/0890334419830990. DOI: https://doi.org/10.1177/0890334419830990
Dini Y, Avolio J, Forte M. The medical learner perspective: family medicine obstetrics as a specialty choice. Canadian Family Physician. Published online November 9, 2022. Available from https://www.cfp.ca/news/2022/11/09/11-09 [Accessed Nov 13, 2022].
Reid AJ, Carroll JC. Choosing to practise obstetrics. Can Fam Phys. 1991;37:1859-1867.
Sutter MB, Prasad R, Roberts MB, Magee SR. Teaching maternity care in family medicine residencies: what factors predict graduate continuation of obstetrics? A 2013 CERA program directors study. Fam Med. 2015;47(6):459-465.
Mahtani R, Kurahashi AM, Buchman S, Webster F, Husain A, Goldman R. Are family medicine residents adequately trained to deliver palliative care? Can Fam Phys. 2015;61(12):e577-582.
Passi V, Johnson S, Peile E, Wright S, Hafferty F, Johnson N. Doctor role modelling in medical education: BEME Guide No. 27. Med Teach. 2013;35(9):e1422-1436. https://doi.org/10.3109/0142159X.2013.806982 DOI: https://doi.org/10.3109/0142159X.2013.806982
Sud S, Wong JP, Premji L, Punnett A. Career decision making in undergraduate medical education. Can Med Educ J. 2020;11(3):e56-e66. https://doi.org/10.36834/cmej.69220. DOI: https://doi.org/10.36834/cmej.69220
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Nisha Arora, Sudha Koppula, Judith Brown
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Submission of an original manuscript to the Canadian Medical Education Journal will be taken to mean that it represents original work not previously published, that it is not being considered elsewhere for publication. If accepted for publication, it will be published online and it will not be published elsewhere in the same form, for commercial purposes, in any language, without the consent of the publisher.
Authors who publish in the Canadian Medical Education Journal agree to release their articles under the Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 Canada Licence. This licence allows anyone to copy and distribute the article for non-commercial purposes provided that appropriate attribution is given. For details of the rights an author grants users of their work, please see the licence summary and the full licence.
