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Biomedical subjects

W H Haffner

Publications and source records attributed to W H Haffner.

11 recordsLinked to original sources
PubMed2001

Effect of gender on the obstetric-gynecologic work force.

As increasing numbers of female physicians enter the specialty of obstetrics and gynecology, their productivity (defined as producing goods and services) as compared with male physicians becomes important. Data from the American Medical Association socioeconomic survey and from a survey of ACOG Fellows indicate that, as a group, female physicians in the specialty are approximately 85% as productive as male physicians in the specialty. ACOG data for physician net income validate the productivity calculations (P <.03). The increasing numbers of female physicians in the specialty will lead to a decreasing aggregate productivity. At the same time, the increasing numbers of women of all ages in the United States will lead to a decline in the available obstetrician-gynecologist work force beginning in the year 2010.

Age Factors↗
PubMed2000

Hand-held computer operating system program for collection of resident experience data.

OBJECTIVE: To describe a system for recording resident experience involving hand-held computers with the Palm Operating System (3 Com, Inc., Santa Clara, CA). PROGRAM DESCRIPTION: Hand-held personal computers (PCs) are popular, easy to use, inexpensive, portable, and can share data among other operating systems. Residents in our program carry individual hand-held database computers to record Residency Review Committee (RRC) reportable patient encounters. Each resident's data is transferred to a single central relational database compatible with Microsoft Access (Microsoft Corporation, Redmond, WA). Patient data entry and subsequent transfer to a central database is accomplished with commercially available software that requires minimal computer expertise to implement and maintain. The central database can then be used for statistical analysis or to create required RRC resident experience reports. As a result, the data collection and transfer process takes less time for residents and program director alike, than paper-based or central computer-based systems. CONCLUSION: The system of collecting resident encounter data using hand-held computers with the Palm Operating System is easy to use, relatively inexpensive, accurate, and secure. The user-friendly system provides prompt, complete, and accurate data, enhancing the education of residents while facilitating the job of the program director.

Computer Communication Networks↗
PubMed2000

Videoteleconferencing for administration of a multisite obstetrics and gynecology core clerkship.

Recent changes and trends in health care delivery have required medical schools to use multiple sites to obtain adequate patient exposure for their students. Decentralization of clinical undergraduate medical education may lead to a lack of continuity in curricula, evaluation, and feedback. We describe the use of interactive videoteleconferencing as a tool to link and improve a multi-site undergraduate core clerkship in obstetrics and gynecology. The Uniformed Services University of the Health Sciences, Bethesda, Maryland, currently utilizes five geographically separate sites for its 6-week core clerkship in obstetrics and gynecology. The site coordinators, clerkship director, and administrative personnel from the parent institution meet approximately 3 weeks after the completion of each core clerkship for live, real-time, and interactive broadcast to complete student evaluations, review curricula, and discuss problems with current students and other pertinent educational issues. Videoteleconferencing provides a mechanism to ensure consistency in curriculum and student evaluations and provides administrative support to distant sites. Furthermore, it enables site coordinators to keep the clerkship director abreast of students and clerkship issues.

Clinical Clerkship↗
PubMed1999

Effect of residency program merger on undergraduate medical student education in obstetrics and gynecology.

OBJECTIVE: To evaluate the effect of residency program merger on third-year medical student clerkships using student evaluations of their experiences and standardized subject examination scores. METHODS: End-of-clerkship ratings from student evaluations and National Board of Medical Examiners standardized subject examination scores in obstetrics and gynecology were used from clerkship sites where three separate military residency programs in obstetrics and gynecology recently merged into two new programs. Mean student evaluation scores and subject examination scores for the year preceding and the year following the merger were compared. RESULTS: The mean differences in medical student evaluation scores before and after merger of the residency programs were 0.1 (Mann-Whitney rank sum, P = .1), -0.1 (Mann-Whitney rank sum, P = .8), and 0.2 (Mann-Whitney rank sum, P = .3). The mean differences for subject examination scores before and after merger of the residency programs were -3.5 (95% confidence interval [CI] -33.2, 26.2; paired t test), -30.1 (95% CI -58.9, -1.4; paired t test), and -35.3 (95% CI -74.8, 4.3; paired t test). CONCLUSION: Merger of residency programs in obstetrics and gynecology does not appear to have a deleterious effect on medical students' satisfaction with the clerkship or their performance on standardized subject examinations at our institution.

Clinical Clerkship↗
PubMed1999

A survey of military residencies regarding 4th-year medical school clerkships.

OBJECTIVE: To determine the value of 4th-year medical student clerkships assessed by military obstetric and gynecologic program directors and residents. METHODS: A questionnaire was sent to all Department of Defense obstetric and gynecologic residency program directors and residents. All of the program directors and 124 of 194 (64%) residents responded, reporting the value of 4th-year medical student clerkships for students entering their programs. Descriptive statistics are reported. RESULTS: Primary care clerkships were valued most highly by program directors who valued obstetric and gynecologic clerkships at their program sites or audition electives higher than those done at other sites. Residents most highly valued obstetric and gynecologic and intensive care clerkships. Most surgical subspecialties were believed to be of minimal or no value. CONCLUSION: For students entering their programs, military program directors placed the highest value on primary care clerkships. Program directors also highly valued obstetric and gynecologic clerkships at their programs, whereas residents considered obstetric and gynecologic and intensive care clerkships to be most helpful.

Clinical Clerkship↗
PubMed1999

Development and use of military-unique standardized gynecology patients in military undergraduate medical education.

Performance-based testing using standardized patients is becoming increasingly popular as a means to assess the clinical competence of medical students. Medical students entering postgraduate training in military treatment facilities have the additional responsibility of military readiness. The increasing number of women in the active armed forces and the diverse missions encountered by the military today necessitate inclusion of military-unique standardized gynecologic patients and scenarios into curricula. We developed a military-unique standardized gynecology patient and scenario and an objective structured clinical examination to evaluate medical students' skills in data gathering and synthesis, development of differential diagnoses, problem solving, and working through military-unique issues of the patient scenario. Integration of an objective structured clinical examination of military-unique gynecology standardized patient scenarios into the obstetrics and gynecology curriculum at the Uniformed Services University of the Health Sciences can lead to successful assessment of student clinical skills and provide a means of ongoing military readiness training.

Adult↗
PubMed1998

Development and use of military-unique standardized gynecology patients for military residents in obstetrics and gynecology training programs.

Focused military curricula and readiness training are often inadequate for military resident physicians. We developed a standardized gynecologic military-unique patient scenario and examination to assess obstetrics and gynecology residents' clinical and operational problem-solving abilities. Integration of military-unique gynecologic standardized patients, clinical scenarios, and objective structured clinical examinations into obstetrics and gynecology curricula is a novel approach for realistic medical readiness training for resident physicians. This tool can become a cornerstone in the ongoing development of needed military-unique curricula.

Clinical Competence↗
PubMed1989

Sociocultural factors in puerperal infectious morbidity among Navajo women.

From 1980 to 1982, a sample of 968 pregnant Navajo women in New Mexico was enrolled in a prospective study of biologic and sociocultural factors in puerperal infectious morbidity. Past studies have independently implicated both genital infection and psychosocial stressors in perinatal complications, but, to the authors' knowledge, no previous work has concurrently investigated the interactive effects of genital pathogens and psychosocial processes. Endocervical cultures for Mycoplasma hominis and Chlamydia trachomatis were obtained during prenatal visits, and structured interviews were conducted assessing social support and the degree of cultural traditionality, in this context a proxy measure of acculturative stress. The incidences of postpartum fever, endometritis, and premature rupture of membranes were significantly associated with the concurrence of two factors: the presence of genital tract M. hominis and a highly traditional cultural orientation. When demographic and conventional obstetric risk factors were controlled for, women with both M. hominis and high traditionality experienced infectious complications at a rate twice that of women with either factor alone. Among the plausible explanations for this result is the possibility that acculturative stress undermines physiologic resistance to infectious genital tract disease.

Adolescent↗
PubMed1986

Social and cultural factors in pregnancy complications among Navajo women.

A population of 968 pregnant Navajo women was followed in a prospective study conducted from 1980 to 1983 at the Indian Health Service Hospitals in Gallup and Crownpoint, New Mexico. The purpose of the study was to examine social and cultural influences on obstetric and neonatal complications. The extent of traditional cultural practices and the availability of social support were ascertained in structured interviews completed during each woman's first prenatal visit. In a subsample of women, the occurrence of stressful life events was also measured during a final prenatal visit in the third trimester of pregnancy. Controlling for a variety of conventional risk factors and other potential confounders, traditional women sustained complications at a rate greater than twice that of the least traditional, most acculturated women (approximate relative risk = 2.1; p = 0.001). Social support and life events were modestly associated with maternal complications (approximate relative risk = 0.7, 0.8, respectively; p = 0.07), with poorer outcomes found among those with low social support and low numbers of life events. It is proposed that the relationship of maternal complications to all three sociocultural variables--traditionality, social support, and life events--may reflect the influences of social isolation on the course and outcomes of pregnancy.

Adolescent↗
PubMedDate not supplied

The prevalence of genital Chlamydia trachomatis and mycoplasmal infections during pregnancy in an American Indian population.

The epidemiology of cervical infection with Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum among a group of pregnant American Indian women was investigated. The prevalences of these microorganisms were 24-30% for C. trachomatis, 50% for M. hominis, and 80% for U. urealyticum. These rates are unusually high for an unselected sample. Infection with C. trachomatis was correlated with younger age but not with primigravidity or educational level. Neither M. hominis nor U. urealyticum infection was correlated with younger age, primigravidity, or level of education. The possible consequences of the increased prevalences of C. trachomatis, M. hominis, and U. urealyticum in this group of American Indians are of concern and are being investigated.

Chlamydia Infections↗