Forceps delivery volumes in teaching and Nonteaching hospitals: Are volumes sufficient for physicians to acquire and maintain competence?

Kathy L. Kyser, Xin Lu, Donna Santillan, Mark Santillan, Aaron Caughey, Mark C. Wilson, Peter Cram

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

PURPOSE: The decline in the use of forceps in operative deliveries over the last two decades raises questions about teaching hospitals' ability to provide trainees with adequate experience in the use of forceps. The authors examined (1) the number of operative deliveries performed in teaching and nonteaching hospitals, and (2) whether teaching hospitals performed a sufficient number of forceps deliveries for physicians to acquire and maintain competence. METHOD: The authors used State Inpatient Data from nine states to identify all women hospitalized for childbirth in 2008. They divided hospitals into three categories: major teaching, minor teaching, and nonteaching. They calculated delivery volumes (total operative, cesarean, vacuum, forceps, two or more methods) for each hospital and compared data across hospital categories. RESULTS: The sample included 1,344,305 childbirths in 835 hospitals. The mean cesarean volumes for major teaching, minor teaching, and nonteaching hospitals were 969.8, 757.8, and 406.9. The mean vacuum volumes were 301.0, 304.2, and 190.4, and the mean forceps volumes were 25.2, 15.3, and 8.9. In 2008, 31 hospitals (3.7% of all hospitals) performed no vacuum extractions, and 320 (38.3%) performed no forceps deliveries. In 2008, 13 (23%) major teaching and 44 (44%) minor teaching hospitals performed five or fewer forceps deliveries. CONCLUSIONS: Low forceps delivery volumes may preclude many trainees from acquiring adequate experience and proficiency. These findings highlighted broader challenges, faced by many specialties, in ensuring that trainees and practicing physicians acquire and maintain competence in infrequently performed, highly technical procedures.

Original languageEnglish (US)
Pages (from-to)71-76
Number of pages6
JournalAcademic Medicine
Volume89
Issue number1
DOIs
StatePublished - Jan 2014

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Surgical Instruments
Teaching Hospitals
Mental Competency
physician
Physicians
Teaching
Vacuum
trainee
Parturition
Aptitude
Inpatients
experience
ability

ASJC Scopus subject areas

  • Medicine(all)
  • Education

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Forceps delivery volumes in teaching and Nonteaching hospitals : Are volumes sufficient for physicians to acquire and maintain competence? / Kyser, Kathy L.; Lu, Xin; Santillan, Donna; Santillan, Mark; Caughey, Aaron; Wilson, Mark C.; Cram, Peter.

In: Academic Medicine, Vol. 89, No. 1, 01.2014, p. 71-76.

Research output: Contribution to journalArticle

Kyser, Kathy L. ; Lu, Xin ; Santillan, Donna ; Santillan, Mark ; Caughey, Aaron ; Wilson, Mark C. ; Cram, Peter. / Forceps delivery volumes in teaching and Nonteaching hospitals : Are volumes sufficient for physicians to acquire and maintain competence?. In: Academic Medicine. 2014 ; Vol. 89, No. 1. pp. 71-76.
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