Postgraduate medical education in obstetrics and gynecology in Switzerland in comparison to Germany and Austria: the results of an international survey.

Abstract

Background: There is frequent academic exchange between Switzerland, Germany and Austria, facilitated by the common language. Additionally, the postgraduate training curricula in obstetrics and gynecology show some similarities. We aimed to compare self-perceived level of ability, availability of simulation training and teaching and feedback culture among residents in obstetrics and gynecology in Switzerland, Germany, and Austria. The focus was on Switzerland to gain a better understanding of strengths and room for improvement.

Methods: With a cross-sectional design, a web-based survey with 30 questions was distributed to obstetrics and gynecology residents in the three countries in August and September 2020. The primary outcome was the self-perception of skills in between-country comparisons of mid-training trainees, i.e., omitting trainees in their first year as well as very advanced trainees and specialists. The secondary outcomes were reported teaching, simulation training and feedback culture. German and Austrian responses were calculated together and compared with the Swiss replies.

Results: A total of 422 participants took part in the survey, 27.5% (n = 116) of whom were from Switzerland, corresponding to a questionnaire response rate of approximately 19%. 48% of Swiss trainees were in training years 2-5. 57% of Swiss participants felt confident in obstetric procedures and 69% in gynecological procedures, compared to 52% and 68% of non-Swiss participants (p = 0.005 and p = 0.176, respectively). Swiss participants felt significantly more confident in performing gynecological than obstetric procedures (p = 0.015). A total of 63% of the Swiss participants had obstetric simulation training, and 28% had gynecological simulation training compared to 37% and 17% in Germany and Austria, respectively (p < 0.001 and p = 0.007). 56% of Swiss participants reported "sufficient structured teaching", 43% reported a "good teaching culture", 47% of Swiss participants stated that they received regular feedback.

Conclusions: The majority of trainees in Switzerland feel confident in a range of procedures and interventions. Simulation training is relatively widespread, although in particular surgical simulation training should be expanded. Clinical teaching and feedback culture should be strengthened. "Teach the teacher" courses should be encouraged to promote a sustainable feedback culture.