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Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum 3.0

Gibson, Marie Eve S; Alaniz, Veronica I; Coble, Chanelle; Dumont, Tania; Howell, Jennifer O; Karjane, Nicole W; Lawson, Ashli A; Nur, Marcella; Parks, Melissa; Teelin, Karen L; Thieu, Hong-Thao; Romano, Mary
Exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology, family medicine, and pediatrics, as well as fellowship programs in adolescent medicine. Nevertheless, these programs are responsible for training residents and fellows and providing opportunities within their programs to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG education by creating and systematically updating the Short Curriculum. This curriculum outlines specific learning objectives that are central to PAG education and lists essential resources for learners' reference. This updated curriculum replaces the previous 2018 publication with added content, resources, and updated references.
PMID: 33810968
ISSN: 1873-4332
CID: 4851222


Famiglietti, H S; Phillips, D; Howell, H; Goonan, M; Coble, C; Zabar, S
Background: The transition from medical student to intern presents a major patient safety concern. Our institution implemented an immersive First Night OnCall (FNOC) simulation to support transitioning trainees and cultivate a culture of safety.
Objective(s): Engage pediatric interns in a pediatric focused FNOC simulation to ensure readiness to recognize and address common safety issues in practice.
Method(s): Interns were asked to recognize patient safety hazards in a simulated patient room and participate in case based safety discussions. Interns then participated in GOSCEs (Group Observed Standardized Clinical Encounters). GOSCEs tasked trainees to obtain informed consent, evaluate a decompensating patient, recognize a mislabeled culture bottle, and give an effective patient handoff. Faculty debriefed all activities. Learners completed pre and post program assessments and a program evaluation.
Result(s): Twenty incoming interns completed FNOC. Only 11% reported any prior formal training in patient safety. Interns recognized 46% of the environmental patient safety hazards. Out of the 5 GOSCE groups, 3 called a rapid response team, 3 noted the label error for the culture bottle, and 3 obtained complete informed consent. After FNOC, 92% of interns reported increased comfort (4 or 5 on 1-5 scale) in speaking to a supervisor, escalating a situation, and reporting a medical error. All interns agreed that the case based safety discussions and the patient safety room increased readiness for internship. Almost all of the interns (85%) agreed or strongly agreed that FNOC was an effective way to learn patient safety, a good approach to improve readiness, fun, and engaging.
Conclusion(s): Incoming interns are not consistently able to demonstrate common safety practices. Engaging, immersive, simulation based experiences like FNOC may reduce this variability, while simultaneously instilling aspirational institutional norms, promoting a culture of safety, and providing a framework for effective on-boarding strategies for new trainees.
ISSN: 1876-2867
CID: 4021172


Chieco, D; Chen, X; Thabit, C; Kariuki, E; Goonan, M; Coble-Sadaphal, C; Famiglietti, H; Howell, H; Poitevien, P
Background: Resident didactics often occur during noon conferences. In 2017, the New York University School of Medicine Pediatric Residency Program transitioned from daily noon conferences to a weekly 3-hour Academic Half Day (AHD). While internal medicine residency programs have shown an association between AHD and higher in-training exam (ITE) scores1, the impact of AHD on pediatric resident ITE scores or satisfaction with preparation for the General Pediatric Board Exam is not well studied.
Objective(s): To investigate the impact of AHD on resident ITE scores and satisfaction with board preparation.
Method(s): We compared PGY2 raw ITE scores between the 2018 and 2019 graduating resident classes using a 2-sample t-test. We performed the same comparison for the PGY3 raw ITE scores. For the year between exams, the Class of 2018 received noon conferences, while the Class of 2019 received AHD. To assess resident satisfaction with board preparation, residents completed a survey prior to starting AHD and after 1 year. Satisfaction was reported on a Likert scale. Responses were categorized as "agree", "neutral", or "disagree" and analyzed with a chi-square test.
Result(s): There was no significant difference between the mean PGY2 ITE scores for the Class of 2018 (63.8 +/- 7.2) and 2019 (63.3 +/- 7.2) (p=0.8). The Class of 2019 had a significantly higher PGY3 ITE score (73.8 +/- 5.2) than the Class of 2018 (67.7 +/- 7.4) (p=0.01). When rating the statement "the current curriculum prepares me to take the boards", the percent of residents responding "agree" was 18% pre-AHD and 73% 1-year post-AHD. The association between initiation of AHD and satisfaction with exam preparation was statistically significant (X2=23.1, p<0.001).
Conclusion(s): The transition to an AHD had a positive impact on ITE scores and resident satisfaction with board preparation.
ISSN: 1876-2867
CID: 4021182

Case of a Girl with Vaginal Discharge Who Has Sex with Girls

Chapter by: Coble, Chanelle; Futterman, Donna
in: Adolescent gynecology : a clinical casebook by Talib, Hina J
[S.l.] : Springer International, 2018
pp. 127-136
ISBN: 9783319669779
CID: 2793662

Description of Sexual Orientation and Sexual Behaviors among High School Girls in New York City

Coble, Chanelle A; Silver, Ellen J; Chhabra, Rosy
STUDY OBJECTIVE: Examination of the association of sexual orientation to the sexual practices and health behaviors of high school girls in New York City (NYC). DESIGN, SETTING, AND PARTICIPANTS: Data were drawn from the 2013 Youth Risk Behavior Surveillance System survey of public high school students in grades 9-12 in NYC. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Independent variables included sexual orientation and gender of sexual partners. Dependent variables include sexual/health risk behaviors. We used t tests to compare mean ages and chi2 tests to compare distributions according to sexual orientation, gender of sexual partners, and differences in risk behaviors. RESULTS: The survey was completed by 4643 girls; mean age, 15.5 years; (1103 + 1842)/4254 (69%) black or Latina; 1101/4000 (27.5%) sexually active; 3574/4412 (81%) heterosexual; and (92 + 526)/4412 (14%) sexual minorities; 24.1% were heterosexual, 52.1% lesbian, and 49.4% were bisexual girls and were sexually active; 247 were classified as women who have sex with women (WSW) or WSW and men (WSWM). Of the sexually active girls, (65 + 182)/1081 (23%) were WSW/WSWM. The WSW/WSWM reported earlier sexual debut, more sexual partners, higher pregnancy rate, use of alcohol at last sex, history of intimate partner violence, and less likelihood of having an HIV test. CONCLUSION: Almost one in four of sexually active high school girls in NYC can be classified as WSW, who are vulnerable to increased sexual and health risk-taking behaviors leading to adverse health outcomes. The discordance between sexual behavior and sexual orientation emphasizes the importance of the provider sharing protective strategies in the sexual health counseling session for their patients who engage in sex with female partners regardless of sexual orientation.
PMID: 28279826
ISSN: 1873-4332
CID: 2613842

Polycystic Ovary Syndrome: An Under-recognized Cause of Abnormal Uterine Bleeding in Adolescents Admitted to a Children's Hospital

Maslyanskaya, Sofya; Talib, Hina J; Northridge, Jennifer L; Jacobs, Amanda M; Coble, Chanelle; Coupey, Susan M
STUDY OBJECTIVE: To evaluate whether ovulatory dysfunction due to polycystic ovary syndrome (PCOS) is a common underlying etiology of abnormal uterine bleeding (AUB) in adolescents who require hospitalization and to explore etiology, treatment, and complications of AUB with severe anemia in adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We identified female patients aged 8-20 years admitted to a children's hospital for treatment of AUB from January 2000 to December 2014. Our hospital protocol advises hormonal testing for PCOS and other disorders before treatment for AUB. We reviewed medical records and recorded laboratory evaluations, treatments, and final underlying diagnoses as well as recurrences of AUB and readmissions in the subsequent year. RESULTS: Of the 125 subjects, the mean age was 16.5 +/- 2.9 years; mean hemoglobin level was 7.0 +/- 1.8 g/dL; 54% were overweight/obese; and 41% sexually active. PCOS accounted for 33% of admissions; hypothalamic pituitary ovarian axis immaturity 31%; endometritis 13%; bleeding disorders 10%. Girls with PCOS were more likely to be overweight/obese (74% vs 46%; P < .01) and girls with hypothalamic pituitary ovarian axis immaturity had lower hemoglobin levels (6.4 g/dL vs 7.4 g/dL; P < .05), than girls with all other etiologies of AUB. Treating physicians failed to diagnose endometritis as the etiology for AUB in 4 of 8 girls with positive tests for sexually transmitted infection and no other etiology. CONCLUSION: PCOS was the most common underlying etiology in adolescents hospitalized with AUB. Screening for hyperandrogenemia is important for early diagnosis of PCOS to allow ongoing management and prevention of comorbidities. Endometritis was frequently underestimated as an etiology for AUB.
PMID: 27903446
ISSN: 1873-4332
CID: 2524542

Etiology and Management of Abnormal Uterine Bleeding in Adolescents Admitted to a Children’s Hospital Over a Nine -Year Period, 2005-2013 [Meeting Abstract]

Maslyanskaya, Sofya; Talib, Hina J; Jacobs, Amanda M; Coble-Sadaphal, Chanelle; Northridge, Jennifer; COupey, Susan M
ISSN: 1873-4332
CID: 2793652

Cardiovascular fibrosis, hydrocephalus, ophthalmoplegia, and visceral involvement in an American child with Gaucher disease [Letter]

Stone, D L; Tayebi, N; Coble, C; Ginns, E I; Sidransky, E
PMID: 11073549
ISSN: 1468-6244
CID: 2793642