College of Medicine MD Curriculum

Centering Pregnancy Program: A Longitudinal Obstetric Care Elective

TITLE: Centering Pregnancy Program: A Longitudinal Obstetric Care Elective 

COURSE NUMBER: SOMN 749

DEPARTMENT: OB GYN 

DURATION: 2-part elective course, including spring M1 and fall M2 students.  Must complete spring M1 in order to register for fall M2.  Students are strongly encouraged to complete both courses for best experience.  

DIRECTOR: Lauren Regueyra, MD; lauren.regueyra@promedica.org

SEMESTER AVAILABLE: Fall, Spring

NUMBER OF STUDENTS: 10 maximum 

LOCATION: Center for Health Services - ProMedica Women’s Services, 2150 West Central Drive, Toledo, Ohio 43606 

FACULTY:  Lauren Regueyra, MD 

GENERAL DESCRIPTION:

This longitudinal elective in obstetrics aims to increase the knowledge base of medical students interested in obstetrics during their preclinical years by actively participating within the Centering Pregnancy Program.  With this innovative model of prenatal care, women are placed into a Centering group which consists of groups of eight to twelve women with similar estimated delivery dates. Each Centering group meets for ten two hour prenatal and postnatal visits. At each session patients participate in one hour of group education beside their peers. During the second hour, patients meet with a provider to receive individualized prenatal care. This time also allows patients to form connections with other expecting mothers, sharing a similar experience and bond. This new, nontraditional approach integrates the three vital components of obstetric care: education, risk assessment, and support. By pairing a student with a Centering group, the student will have invaluable exposure to both the medical and social aspects of pregnancy. Students in the elective will learn about routine prenatal and postpartum care, antepartum labor management, and common pregnancy complications. Additionally, students will have the opportunity to observe how socioeconomic status and healthcare systems affect women throughout their pregnancies.  

Students will have the opportunity to participate in the Centering group sessions offered during non-instructional or self-directed learning time, typically on Monday, Wednesday, and Friday afternoons or evenings. The time commitment of this elective will increase as the frequency of prenatal care visits increase later in pregnancy. Centering groups meet on the same day of the week and time for two hours per session. Students will be expected to arrive one hour prior to the start of the session to prepare for the session with the provider. There are ten total sessions over the course of nine months. Students will be permitted to miss a maximum of two sessions, as inconsistent attendance negatively affects the group dynamic and patient experience. The initial time commitment will be approximately three hours per month increasing to a maximum of nine hours per month. Additionally, students will periodically meet with an elective coordinator and peers in the elective to discuss foundational science topics in obstetrics. 

GOALS:

The overarching goal of this elective is to provide students with an opportunity to understand the importance of health systems science and how it is critical for providing obstetrical care. Participation in this elective will allow students to develop the knowledge, skills and attitudes necessary to appreciate the complex relationship of biological, psychological, and social systems that impact obstetrical care. Furthermore, through this elective students will experience and actively participate in patient centered, longitudinal care. Students will follow pregnancies from the initial prenatal visits to postpartum follow up, an opportunity that is not provided during the third year OB GYN clerkship due to time constraints. 

COURSE and EDUCATIONAL PROGRAM OBJECTIVES

  1. Implement skills learned in Principles of Clinical Medicine to obtain patient history and current patient concerns regarding their pregnancy at each prenatal visit. (EPOs: MK-1, MK-4, PC-1, PC-8, PB-3, IPC-1, SBP-5)
  2. Demonstrate routine obstetric physical exam skills including interpreting maternal vital signs, measuring fetal heart tones, and fundal heights at each prenatal visit. (EPOs: MK-1, MK-4, PC-1, PC-8, PB-3, IPC-1, SBP-5)
  3. Describe and explain normal maternal and fetal physiology and articulate how they are impacted by social factors. (EPOs: MK-1, MK-4, PC-6, PB-3, SBP-2, SBP-5, SBP-6)
  4. Demonstrate interpersonal and communication skills that build trust with the obstetric patient by addressing relevant factors including culture, ethnicity, language/ literacy, socioeconomic class, spirituality/ religion, age, sexual orientation and disability. (EPOs: MK-3, PB-3, IPC-1, SBP-2, SBP-5, SBP-6)
  5. Describe standard of care guidelines based on trimester and implement this knowledge in the management of patients throughout their pregnancy. (EPOs: PC-6, PC-8, IPC-1, SBP-5, MK-6)
  6. Recognize common stressors and concerns faced in pregnancy and how to address them as a provider. (EPOs: MK-3, PB-3, IPC-1, SBP-2, SBP-5, SBP-6)
  7. Describe the essential components of an outpatient antepartum clinical note and demonstrate proficiency by writing one antepartum note. (EPOs: PC-1, PB-3, IPC-1, SBP-5)
  8. Establish rapport with patients and work cooperatively with patients, their social supports and other members of the health care team.  (EPOs: PC-4, PC-9, PB-1, PB-3, IPC-1, SBP-5)

METHODS OF TEACHING: Independent study, presentations, clinical observation, facilitated discussion, preceptor mentoring

METHODS OF EVALUATION AND STUDENT FEEDBACK

  • Attendance and Participation: Missing more than two sessions will result in failure to earn elective credit. Providers will report attendance to elective coordinators. 
  • Student Presentations: Students will choose one topic in the following categories: obstetric infectious disease, physiology, pathophysiology. Students create a brief presentation to share with peers in the elective.
  • End of elective debriefing in the form of a survey to continually improve elective quality for future students. 

QUALITY ASSURANCE: Students will provide feedback throughout and at the end of the elective to ensure educational development. Providers will also provide formative feedback to students to improve their patient interaction, medical knowledge, and physical exam skills. 

PREREQUISITES: M1 or M2 student in good academic standing. If student interest in the elective exceeds availability, students will be asked to write a maximum of 500 words expressing why they are interested in the field of OB GYN or taking the elective. Applications will be blinded and reviewed by elective faculty and coordinators. 

ECC Approved
July 2023

Last Updated: 7/15/24