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Ní hÉalaithe C, Howard A, Corcoran P, McCarthy CM, Horgan M, Bennett D, O'Donoghue K, O'Sullivan S. Factors influencing medical students' decision to pursue a career in obstetrics and gynaecology. PLoS One 2023; 18:e0288130. [PMID: 38051720 DOI: 10.1371/journal.pone.0288130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 06/20/2023] [Indexed: 12/07/2023] Open
Abstract
INTRODUCTION The career intentions of medical students can exert influence on service provision and medical staffing in the health services. It is vital for a specialty's development and sustainability that it has a constant stream of trainees into it annually. An appreciation of how a specialty is viewed by medical students can be used as an opportunity for early intervention in order to improve perception of the specialty and reduce future workforce problems, such as retention and attrition within obstetrics and gynaecology (O&G). We aimed to analyse positive and negative factors of the specialty of O&G as perceived by medical students in order to gain insight into changes that need to be made to improve recruitment and retention into the specialty. METHODS A 70-item structured questionnaire consisting of demographic information and 5-point Likert scale questions relating to O&G was administered to final year medical students in the Republic of Ireland. Data were analysed with descriptive statistics, logistic regression, and odds ratios as appropriate. RESULTS Of 195 medical students approached, 134 completed the questionnaire, a response rate of 68.7%. The majority were female (55.2%, n = 74) and 76.1% of respondents (n = 102) were Direct Entry Medicine students, with the remainder Graduate Entry Medicine students. 30.8% (n = 41) of students who responded scored 6 or more on a 10-point Likert scale when asked about their likelihood of considering a career in O&G. Students' clerkship experience factored heavily into their perception of the specialty and was more likely to be positive if they experienced direct consultant engagement and the opportunity for hands-on experience. Lifestyle factors, litigation and media were found to be deterrents to considering the specialty after graduation. CONCLUSIONS This study demonstrates the importance of good clerkship experience in fostering an interest amongst undergraduates in O&G. Educators and those working within the specialty should showcase the strengths of the specialty during undergraduate education, and work on ameliorating deterrents to ultimately provide a structured approach to improving recruitment into O&G.
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Affiliation(s)
- Caoimhe Ní hÉalaithe
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Aoife Howard
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Paul Corcoran
- National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland
| | | | - Mary Horgan
- Royal College of Physicians of Ireland, Dublin, Ireland
| | - Deirdre Bennett
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
| | - Keelin O'Donoghue
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
- Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
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Lin PL, Huang JP, Fujii T, Cho EH, Huang MC. A survey of specialty choice among obstetrics and gynecology residents in Japan, Korea, and Taiwan. J Obstet Gynaecol Res 2022; 48:1968-1977. [PMID: 35474372 DOI: 10.1111/jog.15274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/17/2022] [Indexed: 11/29/2022]
Abstract
AIM The percentage of medicine graduates opting for residency in obstetrics and gynecology (OB/GYN) has been decreasing in developed countries, including in Taiwan, Japan, and Korea. This multicountry study surveyed the OB/GYN residents affiliated with the Taiwan Association of Obstetrics and Gynecology (TAOG), the Japanese Society of Obstetrics and Gynecology (JSOG), and the Korean Society of Obstetrics and Gynecology (KSOG) to evaluate the factors affecting the choice of pursing OB/GYN. METHODS A 17-item questionnaire surveying the factors influencing the choice of pursuing a major medical specialty was translated into Japanese, Korean, and Chinese and administered to postgraduate OB/GYN residents between July 1, 2020, and August 31, 2020. Data on the participants' sex, age, and level of residency were collected. Responses were compared between countries and sexes. RESULTS Residents of all three countries chose OB/GYN based on personal interest, and a sense of accomplishment in saving people's life. Other positive factors include improved quality of life; higher salaries; and more opportunity for new techniques, research, and promotion. The negative factors included medical litigations, longer work hours, and unsafe working environments. Korean residents had lower ratings in several items, including "support from family," "safety of working environment," and "effectiveness of the alternative dispute resolution system," which, unlike Japan and Taiwan, is not a no-fault compensation system for childbirth accidents. CONCLUSIONS The study findings can guide strategy making, such as decreasing workload and yet maintain training quality, to increase the number of medical students pursuing OB/GYN residency.
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Affiliation(s)
- Ping-Lun Lin
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tatsuya Fujii
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eun H Cho
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Ewha Womans University, Seoul, South Korea
| | - Ming-Chao Huang
- Department of Obstetrics and Gynecology, HsinChu MacKay Memorial Hospital, HsinChu, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
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Ladha FA, Pettinato AM, Perrin AE. Medical student residency preferences and motivational factors: a longitudinal, single-institution perspective. BMC MEDICAL EDUCATION 2022; 22:187. [PMID: 35300656 PMCID: PMC8929265 DOI: 10.1186/s12909-022-03244-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 03/07/2022] [Indexed: 05/02/2023]
Abstract
BACKGROUND A high proportion of medical school graduates pursue specialties different from those declared at matriculation. While these choices influence the career paths, satisfaction, and potential regret students will experience, they also impact the supply and demand ratio of the shorthanded physician workforce across many specialties. In this study, we investigate how the choice of medical specialty and the factors motivating those choices change between the beginning and end of medical school training. METHODS A questionnaire was administered annually from 2017 to 2020 to a cohort of medical students at the University of Connecticut to determine longitudinal preferences regarding residency choice, motivational factors influencing residency choice, future career path, and demographic information. RESULTS The questionnaire respondent totals were as follows: n = 76 (Year 1), n = 54 (Year 2), n = 31 (Year 3), and n = 65 (Year 4). Amongst newly matriculated students, 25.0% were interested in primary care, which increased ~ 1.4-fold to 35.4% in the final year of medical school. In contrast, 38.2% of matriculated students expressed interest in surgical specialties, which decreased ~ 2.5-fold to 15.4% in the final year. Specialty choices in the final year that exhibited the largest absolute change from matriculation were orthopedic surgery (- 9.9%), family medicine (+ 8.1%), radiology (+ 7.9%), general surgery (- 7.2%), and anesthesiology (+ 6.2%). Newly matriculated students interested in primary care demonstrated no differences in their ranking of motivational factors compared to students interested in surgery, but many of these factors significantly deviated between the two career paths in the final year. Specifically, students interested in surgical specialties were more motivated by the rewards of salary and prestige compared to primary care students, who more highly ranked match confidence and family/location factors. CONCLUSIONS We identified how residency choices change from the beginning to the end of medical school, how certain motivational factors change with time, how these results diverge between primary care and surgery specialty choice, and propose a new theory based on risk-reward balance regarding residency choice. Our study promotes awareness of student preferences and may help guide school curricula in developing more student-tailored training approaches. This could foster positive long-term changes regarding career satisfaction and the physician workforce.
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Affiliation(s)
- Feria A Ladha
- University of Connecticut School of Medicine, Farmington, CT, USA.
| | | | - Adam E Perrin
- Department of Family Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
- Family Medicine Center at Asylum Hill, Hartford, CT, USA
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Harrold IM, Bean SM, Williams NC. Emerging From the Basement: The Visible Pathologist. Arch Pathol Lab Med 2020; 143:917-918. [PMID: 31339753 DOI: 10.5858/arpa.2019-0020-ed] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ian M Harrold
- From the Department of Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey (Drs Harrold and Williams); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Bean)
| | - Sarah M Bean
- From the Department of Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey (Drs Harrold and Williams); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Bean)
| | - Nicole C Williams
- From the Department of Pathology, Penn State Health Milton S. Hershey Medical Center, Hershey (Drs Harrold and Williams); and the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Bean)
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Al Salehi A, Al Dughaishi T, Rizvi G, Gowri V. Obstetrics and Gynaecology as a Future Career for Medical Graduates in Oman: Factors that attract and discourage graduates. Sultan Qaboos Univ Med J 2019; 19:e58-e62. [PMID: 31198597 PMCID: PMC6544066 DOI: 10.18295/squmj.2019.19.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/24/2018] [Accepted: 11/08/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives Obstetrics and gynaecology (OBGYN) is a major speciality in the medical field that is often demanding yet rewarding; however, OBGYN receives the least number of applicants in Oman. This study aimed to determine the factors that influence graduates in choosing OBGYN as their speciality. Methods This cross-sectional questionnaire-based study was conducted from February to March 2017 at Sultan Qaboos University Hospital, Royal Hospital, Khoula Hospital and Al Nahdha Hospital, Muscat, Oman. The questionnaire was distributed to 150 Omani medical graduates (interns and post-intern doctors). Results A total of 145 Omani graduates took part in the study (response rate: 96.7%) and the participants' average age was 26 years. Family medicine ranked as the first choice followed by paediatrics and emergency medicine. OBGYN was the first choice for eight female graduates. The top factors attracting male graduates to the OBGYN speciality were its surgical opportunities (80.6%), intellectual content (77.4%), faculty interactions and the opportunity to care for a healthy population (54.8% each); however, the top factors attracting females were the intellectual content (88.6%), patients' desire for female physicians (85.1%), the opportunity to care for a healthy population (76.3%) and cultural expectations (69.5%). The most discouraging factors for male graduates were cultural expectations (100%), the patients' desire for a female physician (93.5%) and the level of stress (71%), while the discouraging factors for female graduates were the level of stress (82.5%), time demands (78.1%), night duties and the length of the residency (71.9% each). Conclusion Most of the factors that discourage female graduates from choosing OBGYN are to some extent modifiable. These changes should be considered to encourage the selection of OBGYN as a career by medical students.
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Affiliation(s)
- Asma Al Salehi
- Obstetrics and Gynaecology Programme, Oman Medical Speciality Board, Muscat, Oman
| | - Tamima Al Dughaishi
- Department of Obstetrics and Gynaecology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Gauhar Rizvi
- Department of Family Medicine & Public Health, Sultan Qaboos University, Muscat, Oman
| | - Vaidyanathan Gowri
- Department of Obstetrics and Gynaecology, Sultan Qaboos University, Muscat, Oman
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Fehlmann A, Abbiati M, Dällenbach P, Savoldelli LG. Motives influencing students' preferences for obstetrics and gynaecology speciality: A cross-sectional multi-site Swiss study. Eur J Obstet Gynecol Reprod Biol 2019; 237:157-163. [PMID: 31051419 DOI: 10.1016/j.ejogrb.2019.04.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/14/2019] [Accepted: 04/21/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Knowing and understanding the reasons why medical students choose postgraduate medical specialities are essential to help influence the workforce for a balanced national healthcare system. The objective of this study was to determine motivating factors for choosing a speciality career in general and, more specifically, for the choice of obstetrics and gynaecology (OBGYN) over surgery or general practice. STUDY DESIGN This study was based on prospectively collected data from a large research multi-site cross-sectional study. We sent a survey to medical students in the sixth year, which contained questions about demographics, choice of speciality and motives for choosing. We grouped the specialities into families of specialities and motives into motivating factors clustered by principal component analysis. We used a multivariate analysis of variance (MANOVA) test to identify differences between motivating factors in speciality categories and gender. We performed logistic regression analyse to compare the choice of OBGYN to choices of surgery and general practice as well as undecided. RESULTS A total of 1749 students responded with an average return rate of 56%. Our study revealed four motivating factors: "experiential", "relational", "occupational" and "scientific". Logistic regression analysis showed that the choice of OBGYN was particularly influenced by "experiential factor" (OR 1.5; 95%CI [1.2; 1.9]) and by gender (OR 4.5; 95%CI [2.2; 9.2]). When we compared the motivational profile of OBGYN to other speciality categories, OBGYN appeared to stand between surgery and general practice for the "experiential" and "relational" factors, more like surgery for the "occupational factor" and more like general practice for the "scientific factor". CONCLUSION This study highlighted the importance of "experiential factor" and gender for choosing OBGYN as a career. OBGYN seemed to stand between surgery and general practice from a Swiss students' point of view. These findings provide useful information for targeted interventions to promote OBGYN at the undergraduate level. Such interventions could include providing more hands-on experiences, improving integration of male students and encouraging student involvement in patient care.
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Affiliation(s)
- Aurore Fehlmann
- Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Milena Abbiati
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Patrick Dällenbach
- Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - L Georges Savoldelli
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Médecine, University of Geneva, Geneva, Switzerland
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Brooks EG, Paus AM, Corliss RF, Ranheim EA. Enhancing preclinical year pathology exposure: the Angevine approach. Hum Pathol 2016; 53:58-62. [PMID: 27016489 DOI: 10.1016/j.humpath.2016.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/22/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022]
Abstract
Less than 2% of graduating US medical seniors select pathology residencies. One major obstacle to attracting prospective residents is the relative "invisibility" of pathology; medical students lacking positive preclinical exposure to pathology are unlikely to later select pathology clerkships or residencies. The Angevine Fellowship is a 10-week competitive pathology internship medical students may apply for the summer following their first year of preclinical training at our institution. We sought to determine whether it was an effective pathology recruitment tool and how it compared with the postsophomore pathology fellowship (PSF). Angevine fellow and PSF data from 2000 to 2014 were retrospectively analyzed. Specialty choices of former fellows already matched into residency programs were tabulated. Data regarding annual percentage of graduating seniors at our institution who matched into pathology during the years former fellow cohorts matched were also examined. Our results showed that of the former Angevine fellow cohorts already matched into residency programs, 40% (8/20) matched in pathology and 20% (4/20) at our own institution. Angevine fellows comprised a disproportionately high number of the graduating seniors matching in pathology at our medical school (26.7%). PSFs comprised 6.67%. Although we have endowment funding for 2 Angevine fellows annually, the level of interest among applicants has increased to the point that our department has consistently contributed funding for 1-2 additional fellowship spots since 2011. We conclude that the Angevine Fellowship offers an effective alternative to the postsophomore fellowship. It has proven successful at our institution and could be implemented at others to potentially improve pathology recruitment trends nationwide.
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Affiliation(s)
- Erin G Brooks
- University of Wisconsin Hospital and Clinics, Department of Pathology and Laboratory Medicine, Madison, WI 53705.
| | - Amanda M Paus
- University of Wisconsin Hospital and Clinics, Graduate Medical Education Office, Madison, WI 53705
| | - Robert F Corliss
- University of Wisconsin Hospital and Clinics, Department of Pathology and Laboratory Medicine, Madison, WI 53705
| | - Erik A Ranheim
- University of Wisconsin Hospital and Clinics, Department of Pathology and Laboratory Medicine, Madison, WI 53705
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Samadi S, Gholizadeh N, Shoar N, Shoar S. Attitudes of Obstetricians toward Cesarean Delivery in Challenging Cases. J Obstet Gynaecol India 2013; 63:301-5. [PMID: 24431663 DOI: 10.1007/s13224-013-0401-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 03/27/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To assess the behavior and preferred delivery method among Iranian obstetricians in challenging cases. METHOD Using the revised Jackson personality inventory questionnaire, the attitudes of obstetricians toward cesarean delivery were assessed in challenging childbirth cases. The study was conducted at the Mashhad University of Medical Sciences in Mashhad, Iran. RESULT Seventy-five obstetricians answered each item reflecting varying levels of preference and risk attitudes. However, a significant number of respondents avoided the risk of requesting a cesarean because of legislation and legal issues. CONCLUSION Iranian obstetricians prefer low-risk behavior for managing ambiguous delivery cases. Fear of legislation and medicolegal issues appear to be of great importance in this cohort primarily comprising female physicians.
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Affiliation(s)
- Sareh Samadi
- Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Naeimeh Gholizadeh
- Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasrin Shoar
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Saeed Shoar
- Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences (TUMS), No. 54, Boostan e Qods (Shilat) Dormitory, Shahed Alley, Qods Street, Keshavarz Boulevard, Tehran, Iran
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Hung T, Jarvis-Selinger S, Ford JC. Residency choices by graduating medical students: why not pathology? Hum Pathol 2011; 42:802-7. [PMID: 21292295 DOI: 10.1016/j.humpath.2010.10.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 10/12/2010] [Accepted: 10/13/2010] [Indexed: 11/30/2022]
Abstract
Pathology is an unpopular residency choice for medical students worldwide. In some countries, this has contributed to a crisis in pathologist human resources that has affected the quality of clinical laboratories. Several previous studies have used information from junior medical students and from residents to suggest ways of improving pathology recruitment. There are, however, no published studies of pathology residency choice that focus on the senior medical students who must be recruited. This study uses focus groups of senior medical students to explore both general and pathology-specific influences on residency choice. Several general influences are identified, including students' expectations for their future clinical practices, their own clinical rotation experiences, influences from other people including mentors, and their choice to reject certain fields. Several specific antipathology influences are also revealed, including negative stereotypes about pathologists, a perceived incompatibility of personality between most medical students (extroverted) and pathologists (introverted), and perceptions of pathologists as being in some ways nonmedical. The most important antipathology influence was that, from the students' perspective, pathology was utterly invisible in clinical practice. Most students did not consider and then reject a pathology residency: instead, pathology was completely ignored. Given the importance of clerkship electives in influencing medical student career choice, promoting clerkship experiences in pathology may improve recruitment. However, departments of pathology must first make pathology visible to students and teach them how pathologists contribute to clinical care.
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Affiliation(s)
- Tawny Hung
- Department of Pathology, University of British Columbia, Vancouver, Canada V6H 3N1
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Obstetricians’ Perception of Medico-legal Problems in Al Madinah Al Munawarah Kingdom of Saudi Arabia. J Taibah Univ Med Sci 2010. [DOI: 10.1016/s1658-3612(10)70135-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Fuglenes D, Øian P, Kristiansen IS. Obstetricians' choice of cesarean delivery in ambiguous cases: is it influenced by risk attitude or fear of complaints and litigation? Am J Obstet Gynecol 2009; 200:48.e1-8. [PMID: 18973870 DOI: 10.1016/j.ajog.2008.07.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 04/23/2008] [Accepted: 07/08/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to test the hypothesis that obstetricians' choice of delivery method is influenced by their risk attitude and perceived risk of complaints and malpractice litigation. STUDY DESIGN The choice of delivery method in ambiguous cases was studied in a nationwide survey of Norwegian obstetricians (n = 716; response rate, 71%) using clinical scenarios. The risk attitude was measured by 6 items from the Jackson Personality Inventory-Revised. RESULTS The proportion of obstetricians consenting to the cesarean request varied both within and across the scenarios. The perceived risk of complaints and malpractice litigation was a clear determinant of obstetricians' choice of cesarean in all of the clinical scenarios, whereas no impact was observed for risk attitude. CONCLUSION Obstetricians' judgments about cesarean request in ambiguous clinical cases vary considerably. Perceived risk of complaints and litigation is associated with compliance with the requested cesarean.
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