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Biomedical subjects

M S Wolkomir

Publications and source records attributed to M S Wolkomir.

6 recordsLinked to original sources
PubMed1998

Why family physicians deliver babies.

BACKGROUND: Numerous factors have been hypothesized to explain the steady decline of family physicians providing maternity care. Rather than exploring reasons for departure, we sought to learn why many family physicians choose to deliver babies. METHODS: A previously piloted questionnaire was mailed to 1300 family physicians who had attended continuing education programs related to pregnancy. The respondents were classified as: those who had always delivered babies (group 1: "Always Did"); those who had previously not delivered babies, but had started or planned to start doing deliveries (group 2: "Started Later or Plan"); and those who had never delivered babies or had previously delivered but stopped (group 3: "Will Not Do"). The study focused on the reasons respondents in the first two groups decided to deliver babies and contrasted their views with those of the third group. RESULTS: Five hundred seventy-five valid responses were returned (421 "Always Did"; 92 "Started Later or Plan"; 62 "Will Not Do"). Response patterns were similar for all geographic regions. Reasons for delivering babies that appeared with statistically significant frequency included personal enjoyment, adequate obstetrical training in residency, desire to care for younger families, and supportive obstetricians during residency. Reasons for not delivering babies included unacceptable lifestyle, a community's saturation of maternity caregivers, fear of law-suit, and absence of need to build a practice. CONCLUSIONS: Family physicians who deliver babies appear to be primarily motivated by personal enjoyment, followed by a desire to care for younger patients and adequate training in residency. Those who do not perform deliveries primarily cite the unacceptability of a maternity caregiver's lifestyle. The expectation of the practice and a lack of community need are also important influences on the decision of family physicians to deliver babies.

Adult↗
PubMed1997

The effects of the ALSO course as an educational intervention for residents. Advanced Life Support in Obstetrics.

BACKGROUND AND OBJECTIVES: Previous descriptions of the Advanced Life Support in Obstetrics (ALSO) course have indicated increases in physician comfort in managing obstetric emergencies and in their intentions to continue offering maternity care after taking the course. No previous studies have been done about the educational outcomes of the ALSO course on family practice residents. This study compared residents' pre- and post-ALSO course confidence to manage obstetrical emergencies and their intention to provide maternity care when they enter practice. METHODS: A self-selected group of 55 family practice residents completed questionnaires before and after ALSO training. The questionnaire was designed to measure confidence, using Bandura's model of self efficacy, and future intention, using Ajzen's Theory of Planned Behavior. RESULTS: Residents' confidence in their abilities to manage obstetrical emergencies increased significantly after the ALSO course. Residents' intent to provide maternity care when the residents enter practice did not change. CONCLUSIONS: The ALSO course is a valuable teaching intervention that can improve family practice residents' perceived self-confidence in managing obstetric emergencies. The study had sufficient power to detect a moderate effect size of the ALSO course on resident intention to provide maternity care but did not do so.

Analysis of Variance↗
PubMed1995

Influences on teaching colposcopy and treatment modalities in family practice programs.

BACKGROUND: Colposcopy and related therapeutic modalities are taught in many family practice residency programs. The role of the following two factors in a family practice residency program's decision to teach these procedures was evaluated: 1) the coexistence of an obstetrics and gynecology (OB-GYN) residency program at the affiliated hospital and 2) the perceived attitude of community obstetrician-gynecologists toward family physicians performing the procedures. METHODS: In 1993, all 399 accredited family practice residency programs were surveyed, with a response rate of 86.5%. RESULTS: Ninety-three percent of responding programs taught colposcopy. All programs that rated community obstetrician-gynecologists' attitudes as positive taught colposcopy, and 91% taught cryotherapy. In programs rating local obstetrician-gynecologists' attitudes as negative, 85.5% taught colposcopy, and 71% taught cryotherapy. A co-located OB-GYN program did not influence a family practice program's likelihood of teaching colposcopy or treatment modalities. CONCLUSION: A perception that community obstetrician-gynecologists have negative attitudes about family physicians performing colposcopy may dissuade some family practice programs from teaching colposcopy and related treatment modalities. This influence was not seen in programs with a co-located OB-GYN residency.

Clinical Competence↗