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A List of the Best Dissertation Topics in Obstetrics and Gynecology

Before students can graduate, they may have to create a dissertation on gynecology and obstetrics. In addition to requiring a significant amount of research, this research paper will necessitate hours of time spent writing and proofreading. To get started on the essay, students need to pick a topic. The best topics are completely original and contain an interesting subject. If the student truly cares about their topic, they will find it easier to research and write the paper. For some dissertation ideas, read through the following list.

Topic Ideas for Obstetrics and Gynecology

• Effectiveness of Cloposcopic Cervical Screenings
• Do Patients With frequent Miscarriages Have Higher Anticardiolip Antibodies?
• Acute Liver Failure During Pregnancy: Different Prognostic Techniques and Medical Treatments
• Prevalence of Thyroid Disorders in Obstetrics Patients
• Comparison of the Efficacy of Different Techniques for Estimating Fetal Weight Throughout Pregnancy
• Techniques for Managing Hypertension During Pregnancy
• Dealing With Insulin Resistance Among Women Who Have Polycystic Ovarian Syndrome
• How Does Vitamin D Supplementation During Pregnancy Change the Outcomes for Mother and Child?
• Gestational Diabetes and Medical Interventions
• Hepatitis-B in Pregnant Women and Their Neonatal Outcome: Do Vaccines Effectively Reduce Transmission?
• Gestational Weight Gain's Effect on Delivery and Neonatal Health
• Are Lowered Blood Platelet Counts an Indication of Hypertension Among Pregnant Women?
• Study of Human Chimeras and Their Pregnancy Outcomes
• Techniques for Treating Malignant Ovarian Tumors During Pregnancy
• Dynsfunctional Uterine Bleeding: The Efficacy of an Ultrasound Diagnosis
• What Enzymes Are Linked to Gestational Diabetes?
• Can Ultrasounds be Used as a Pelvimetric Tool?
• The Efficacy of Hormone Therapy in Early Menopause
• Comparative Study for Different Preventive Methods for Postpartum Hemorrhage
• Neonatal Outcome of Third Trimester Confinement Versus Non-Confinement
• High Risk Pregnancies and the Implications of Color Doppler
• Will an Amnio-Infusion Reduce Fetal Distress in Cases of Thick Meconoium Amniotic Fluid?
• What are the Predictors for Pregnancy-Induced Hypertension?
• Uterine Bleeding: Is Bleeding Due to Histopathological Differences in the Endometrium?
• Physical Activity Levels and Perinatal Mortality Rates
• Comparative Study of Cesarean Sections in the United States and the United Kingdom
• The Implications of Different Volumes of Amniotic Fluid in Predicting Perinatal Outcomes
• Does the Consumption of Sugar-Sweetened Beverages in Childhood Change the Age of Menarchy?
• Study of Maternal Health Services Available in Rural Peru
• Boosting Fertility Rates in Women With Polycystic Ovarian Syndrome
• Comparison of Neonatal and Maternal Outcomes for Hospital Deliveries Versus Midwifery Deliveries
• Comparison of Side Effects of Different Contraceptive Methods
• Management of Ovarian Cancer in HNPCC Carrier Families

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PRENATAL OBSTETRICS

Congenital anomaly risk with methadone or buprenorphine exposure (April 2024)

Data regarding the teratogenic risk of medications for opioid use disorder (MOUD) are limited. In a population-based study comparing over 9500 pregnancies exposed to buprenorphine in the first trimester with nearly 3900 methadone-exposed pregnancies, buprenorphine use was associated with a lower overall risk of congenital anomalies (5 versus 6 percent) [ 1 ]. Although the analysis adjusted for multiple potential confounding factors, unmeasured confounders may explain some of the observed associations. We base the choice of buprenorphine versus methadone for MOUD on other factors ( table 1 ). (See "Opioid use disorder: Pharmacotherapy with methadone and buprenorphine during pregnancy", section on 'Risk of structural anomalies' .)

Maternal sepsis risk with membrane rupture before 23 weeks of gestation (April 2024)

Chorioamnionitis can be a cause or a consequence of preterm prelabor rupture of membranes (PPROM), especially before 24 weeks of gestation. Development of maternal sepsis is a major concern in these pregnancies. In a prospective study of 364 patients with PPROM between 16 weeks 0 days and 22 weeks 6 days, maternal sepsis developed in 10 percent of patients with singleton pregnancies who chose to undergo pregnancy termination soon after diagnosis of PPROM and in 13 percent of those who initially chose to continue the pregnancy [ 2 ]. Two patients died. These findings underscore the importance of close maternal monitoring, early diagnosis of chorioamnionitis, timely fetal extraction, and appropriate antibiotic treatment in patients with PPROM. (See "Prelabor rupture of membranes before and at the limit of viability", section on 'Maternal sepsis and death' .)

Perinatal depression and mortality (March 2024)

Perinatal depression is associated with an increased risk of death. An analysis of a national register from Sweden compared outcomes among individuals with and without a diagnosis of depression during pregnancy or postpartum, matched by age and year of delivery [ 3 ]. After controlling for potential confounding factors, all-cause mortality was greater in those with perinatal depression over 18 years of follow-up; the increased risk was largely driven by suicide. These results confirm previous data on the risks of perinatal depression and support our practice of screening for depression during pregnancy and postpartum. Services to ensure follow-up for diagnosis and treatment should accompany screening efforts. (See "Unipolar major depression during pregnancy: Epidemiology, clinical features, assessment, and diagnosis", section on 'All cause' .)

Noninsulin antidiabetic medications and pregnancy (February 2024)

Noninsulin antidiabetic medications such as glucagon-like peptide 1 (GLP-1) agonists, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, and dipeptidyl peptidase 4 (DPP-4) inhibitors are commonly used in nonpregnant individuals but avoided in pregnancy because of lack of safety data in humans and harms observed in animal studies. However, in a multinational population-based cohort study including nearly 2000 individuals with preconception/first trimester exposure to these medications, the frequency of congenital anomalies was not increased compared with insulin [ 4 ]. A limitation of the study is that it did not adjust for potential differences in A1C, diabetes severity, or diabetes duration, which could obscure true effects on risk for congenital anomalies. We continue to avoid use of GLP-1 agonists, SGLT-2 inhibitors, and DPP-4 inhibitors in females planning to conceive and in pregnancy. (See "Pregestational (preexisting) diabetes: Preconception counseling, evaluation, and management", section on 'Patients on preconception noninsulin antihyperglycemic agents' .)

Updates to the United States perinatal HIV clinical guidelines (February 2024)

The United States Department of Health and Human Services has released updates to the perinatal HIV clinical guidelines [ 5 ]. Ritonavir-boosted darunavir is now a preferred agent only for treatment-naïve pregnant individuals who have used cabotegravir-based pre-exposure prophylaxis, because of the concern for integrase inhibitor-resistant mutations; for other pregnant individuals, it is now an alternative rather than preferred agent. Additionally, bictegravir, which was previously not recommended for initial therapy in pregnant individuals, is now an alternative agent based on new pharmacokinetic data that support its use during pregnancy. Our approach to treating HIV during pregnancy is consistent with these updated guidelines. (See "Antiretroviral selection and management in pregnant individuals with HIV in resource-rich settings", section on 'Selecting the third drug' .)

Combined use of metformin and insulin for treating diabetes in pregnancy (February 2024)

In patients with type 2 diabetes, insulin is the mainstay for managing hyperglycemia in pregnancy. The addition of metformin improves maternal glucose control and reduces the chances of a large for gestational age newborn, but a prior randomized trial reported an increased risk for birth of a small for gestational age (SGA) infant. A recent randomized trial comparing use of insulin alone with insulin plus metformin in nearly 800 adult pregnant patients with either preexisting type 2 diabetes or diabetes diagnosed in early pregnancy confirmed the previously reported benefits but found that both treatment groups had low and similar rates of SGA [ 6 ]. The discordancy in SGA risk needs to be explored further, as metformin cotreatment would be undesirable if this risk is real. (See "Pregestational (preexisting) diabetes mellitus: Antenatal glycemic control", section on 'Metformin' .)

Fetoplacental GDF15 linked to nausea and vomiting of pregnancy (February 2024)

Almost all pregnant people experience nausea with or without vomiting in early pregnancy; however, the pathogenesis of the disorder has been unclear. Previous studies have shown that GDF15 is expressed in a wide variety of cells, with the highest expression in placental trophoblast, and that its protein (GDF15) appears to regulate appetite. A recent study confirmed the fetoplacental unit as a major source of GDF15 and also found that higher GDF15 levels correlated with more severe nausea and vomiting of pregnancy [ 7 ]. In the future, drugs targeting the production or action of GDF15 are a potential novel pathway for treating nausea and vomiting of pregnancy, if safety and efficacy are established. (See "Nausea and vomiting of pregnancy: Clinical findings and evaluation", section on 'Pathogenesis' .)

Use of cerebroplacental ratio at term does not reduce perinatal mortality (February 2024)

Cerebral blood flow may increase in chronically hypoxemic fetuses to compensate for the decrease in available oxygen and can be assessed by the cerebroplacental ratio (CPR; middle cerebral artery pulsatility index divided by the umbilical artery pulsatility index). However, increasing evidence indicates that use of the CPR does not reduce perinatal mortality in low-risk pregnancies. In a randomized trial comparing fetal growth assessment plus revealed versus concealed CPR in over 11,000 low-risk pregnancies at term, knowledge of CPR combined with a recommendation for delivery if the CPR was <5th percentile did not reduce perinatal mortality compared with usual care (concealed group) [ 8 ]. We do not perform umbilical artery Doppler surveillance, including the CPR, in low-risk pregnancies. (See "Doppler ultrasound of the umbilical artery for fetal surveillance in singleton pregnancies", section on 'Low-risk and unselected pregnancies' .)

Low- versus high-dose calcium supplements and risk of preeclampsia (January 2024)

In populations with low baseline dietary calcium intake, the World Health Organization recommends 1500 to 2000 mg/day calcium supplementation for pregnant individuals to reduce their risk of developing preeclampsia. However, a recent randomized trial that evaluated low (500 mg) versus high (1500 mg) calcium supplementation in over 20,000 nulliparous pregnant people residing in two countries with low dietary calcium intake found low and similar rates of preeclampsia in both groups [ 9 ]. These findings suggest that a 500 mg supplement is sufficient for preeclampsia prophylaxis in these populations. For pregnant adults in the United States, we prescribe 1000 mg/day calcium supplementation, which is the recommended daily allowance to support maternal calcium demands without bone resorption. (See "Preeclampsia: Prevention", section on 'Calcium supplementation' .)

Respectful maternity care (January 2024)

Respectful maternity care is variably defined but broadly involves both absence of disrespectful conduct and promotion of respectful conduct toward pregnant individuals. A systematic review found that validated tools to measure respectful maternity care were available, but the optimal tool was unclear and high quality studies were lacking on the effectiveness of respectful maternity care for improving any maternal or infant health outcome [ 10 ]. Respectful maternal care is a basic human right, but how to best implement and monitor it and assess outcomes requires further study. (See "Prenatal care: Initial assessment", section on 'Effectiveness' .)

Outcome of a multifaceted intervention in patients with a prior cesarean birth (January 2024)

Patients with a pregnancy after a previous cesarean birth must choose between a trial of labor (TOLAC) and a planned repeat cesarean. The optimal care of such patients is unclear. In a multicenter, cluster-randomized trial including over 20,000 patients with one prior cesarean birth, a multifaceted intervention (patient decision support, use of a calculator to assess chances of a vaginal birth after cesarean [VBAC], sonographic measurement of myometrial thickness, clinician training in best intrapartum practices during TOLAC) reduced perinatal and major maternal morbidity composite outcomes compared with usual care [ 11 ]. VBAC and uterine rupture rates were similar for both groups. Further study is needed to identify the most useful component(s) of the intervention for reducing morbidity. (See "Choosing the route of delivery after cesarean birth", section on 'Person-centered decision-making model' .)

Serial amnioinfusions for bilateral renal agenesis (January 2024)

Bilateral renal agenesis (BRA) is incompatible with extrauterine life because prolonged oligohydramnios results in pulmonary hypoplasia, leading to postnatal respiratory failure. A prospective study (RAFT) assessed use of serial amnioinfusions to treat 18 cases of BRA diagnosed at <26 weeks of gestation [ 12 ]. Of the 17 live births, 14 survived ≥14 days and had placement of dialysis access, but only 6 survived to hospital discharge. Of the 4 children alive at 9 to 24 months of age, 3 had experienced a stroke and none had undergone transplant. These findings show that serial amnioinfusions for BRA mitigates pulmonary hypoplasia and increases short-term survival and access to dialysis; however, long-term outcome remains poor with no survival to transplantation. Serial amnioinfusions remain investigational and should be offered only as institutional review board-approved research. (See "Renal agenesis: Prenatal diagnosis", section on 'Investigative role of therapeutic amnioinfusion' .)

Prenatal genetic testing for monogenic diabetes due to glucokinase deficiency (December 2023)

In pregnant individuals with monogenic diabetes due to glucokinase (GCK) deficiency, management depends on the fetal genotype. If the fetus inherits the maternal GCK variant, maternal hyperglycemia will not cause fetal hyperinsulinemia and excessive growth, and maternal hyperglycemia does not require treatment. However, if the fetus does not inherit the pathogenic variant, maternal insulin therapy is indicated to prevent excessive fetal growth. Fetal ultrasound has been used to predict fetal genotype but has limited diagnostic utility. In a cohort of 38 pregnant individuals with GCK deficiency, fetal genetic testing using cell-free DNA in maternal blood had higher sensitivity (100 versus 53 percent) and specificity (96 versus 61 percent) for prenatal diagnosis of GCK deficiency compared with ultrasound measurement of fetal abdominal circumference [ 13 ]. When available, noninvasive prenatal genotyping should be used to guide management of GCK deficiency during pregnancy. (See "Classification of diabetes mellitus and genetic diabetic syndromes", section on 'Glucokinase' .)

Early metformin treatment of gestational diabetes mellitus (November 2023)

Usual initial gestational diabetes mellitus (GDM) care (ie, medical nutritional therapy, exercise) may result in a few weeks of hyperglycemia before a need for pharmacotherapy is established. In a randomized trial evaluating whether initiating metformin at the time of GDM diagnosis regardless of glycemic control improves clinical outcomes compared with usual care, the metformin group had a lower rate of insulin initiation and favorable trends in mean fasting glucose, gestational weight gain, and excessive fetal growth, but more births <2500 grams [ 14 ]. Rates of preeclampsia, neonatal intensive care unit admission, and neonatal hypoglycemia were similar for both groups. Given these mixed results, we recommend not initiating metformin at the time of GDM diagnosis except in a research setting. (See "Gestational diabetes mellitus: Glucose management and maternal prognosis", section on 'Does early metformin initiation improve glycemic control and reduce need for insulin?' .)

Automated insulin delivery in pregnant patients with type 1 diabetes (October 2023)

Hybrid closed-loop insulin therapy is associated with improved glucose control in nonpregnant adults and in children, but little information is available in pregnant people. In the first randomized trial in this population, hybrid closed-loop insulin delivery beginning at 11 weeks gestation improved glycemic control compared with standard insulin therapy in 124 patients with type 1 diabetes, without increasing their risk of severe hypoglycemia [ 15 ]. The system allowed customization of glycemic targets appropriate to pregnancy, in contrast to other commercially available systems in the United States. Additional study is needed to confirm these findings, evaluate the effects on obstetric and neonatal outcomes, and identify optimal candidates. (See "Pregestational (preexisting) diabetes mellitus: Antenatal glycemic control", section on 'Continuous subcutaneous insulin infusion (insulin pump)' .)

Respiratory syncytial virus vaccination in pregnancy (April 2023, Modified October 2023)

Respiratory syncytial virus (RSV) is a major cause of morbidity and mortality in infants. In October 2023, the United States Centers for Disease Control and Prevention, along with guidelines from other expert groups, endorsed RSV vaccination of pregnant individuals to reduce severe RSV infections in their infants [ 16-19 ]. Nirsevimab , a monoclonal antibody that can be given to infants postnatally to reduce the risk of severe RSV, has also been recently approved and endorsed by expert guidance panels. In settings where nirsevimab is not available, we suggest vaccination of pregnant individuals between 32 0/6 and 36 6/7 weeks of gestation in September through January (in the northern hemisphere) with inactivated nonadjuvanted recombinant RSV vaccine (RSVPreF; Abrysvo). In settings where both maternal vaccination and nirsevimab are available, the optimal preventive strategy remains uncertain, and, in most cases, it will not be possible to use both. For such patients, both options should be discussed and shared decision-making undertaken. (See "Immunizations during pregnancy", section on 'Choosing the optimal strategy' .)

INTRAPARTUM AND POSTPARTUM OBSTETRICS

Updates on congenital fibrinogen disorders (April 2024)

Congenital fibrinogen disorders are rare and remain underdiagnosed. New publications address the clinical manifestations of these disorders and provide obstetric guidance:

● A new report from the Rare Bleeding Disorders database described 123 patients with afibrinogenemia, hypofibrinogenemia, and dysfibrinogenemia and characterized bleeding and thrombotic manifestations [ 20 ]. (See "Disorders of fibrinogen", section on 'Clinical manifestations' .)

● New guidelines from the International Society on Thrombosis and Hemostasis (ISTH) provide target fibrinogen levels and advice for managing postpartum bleeding and thromboprophylaxis in individuals with congenital fibrin disorders [ 21 ]. (See "Disorders of fibrinogen", section on 'Conception and pregnancy' .)

A high index of suspicion for these disorders and multidisciplinary management are required.

Intrauterine postpartum hemorrhage control devices for managing postpartum hemorrhage (February 2024)

Intrauterine balloon tamponade and vacuum-induced uterine compression are the most common devices used for intrauterine postpartum hemorrhage (PPH) control in patients with atony, but it is unclear which device is superior as few comparative studies have been performed. In a retrospective study including nearly 380 patients with PPH, quantitative blood loss after placement, rate of blood transfusion, and discharge hematocrit were similar for both devices [ 22 ]. Based on these and other data, in the setting of ongoing uterine bleeding, rapid use of one of these devices is likely to be more important than the choice of device when both devices are available. (See "Postpartum hemorrhage: Use of an intrauterine hemorrhage-control device", section on 'Choice of method' .)

Labor epidural analgesia and risk of emergency delivery (December 2023)

It is well established that contemporary neuraxial labor analgesia does not increase the overall risk of cesarean or instrument-assisted vaginal delivery. However, a new retrospective database study of over 600,000 deliveries in the Netherlands reported that epidural labor analgesia was associated with an increased risk of emergency delivery (cesarean or instrument-assisted vaginal) compared with alternative analgesia (13 versus 7 percent) [ 23 ]. Because of potential confounders and lack of detail on epidural and obstetric management, we consider these data insufficient to avoid neuraxial analgesia or change the practice of early labor epidural placement to reduce the potential need for general anesthesia in patients at high risk for cesarean delivery. (See "Adverse effects of neuraxial analgesia and anesthesia for obstetrics", section on 'Effects on the progress and outcome of labor' .)

Delayed cord clamping in preterm births (December 2023)

Increasing evidence supports delaying cord clamping in preterm births. In an individual participant data meta-analysis of randomized trials of delayed versus immediate cord clamping at births <37 weeks (over 3200 infants), delaying cord clamping for >30 seconds reduced infant death before discharge (6 versus 8 percent) [ 24 ]. In a companion network meta-analysis evaluating the optimal duration of delay, a long delay (≥120 seconds) significantly reduced death before discharge compared with immediate clamping; reductions also occurred with delays of 15 to <120 seconds but were not statistically significant [ 25 ]. For preterm births that do not require resuscitation, we recommend delayed rather than immediate cord clamping. We delay cord clamping for at least 30 to 60 seconds as approximately 75 percent of blood available for placenta-to-fetus transfusion is transfused in the first minute after birth. (See "Labor and delivery: Management of the normal third stage after vaginal birth", section on 'Preterm infants' .)

Vacuum-induced intrauterine tamponade for postpartum hemorrhage (November 2023)

Intrauterine tamponade (with a balloon, packing, or vacuum) may be used to manage patients with postpartum hemorrhage (PPH) resulting from uterine atony that is not controlled by uterotonic medications and uterine massage. However, outcome data regarding vacuum-induced tamponade are limited. A study of data from a postmarketing registry of over 500 patients with PPH and isolated atony treated with vacuum-induced tamponade reported that the device controlled bleeding without treatment escalation or bleeding recurrence in 88 percent following cesarean birth and 96 percent following vaginal birth, typically within five minutes [ 26 ]. These data are consistent with previously published outcomes. Given its efficacy and ease of use, vacuum-induced tamponade is an important option for managing PPH in centers where this device is available. (See "Postpartum hemorrhage: Use of an intrauterine hemorrhage-control device", section on 'Vacuum-induced tamponade' .)

Risk of pregnancy-associated venous and arterial thrombosis in sickle cell disease (November 2023)

Sickle cell disease (SCD) and pregnancy both confer an increased risk of venous thromboembolism (VTE), but the magnitude of the risk is unclear. In a new administrative claims data study involving >6000 people with SCD and >17,000 age- and race-matched controls who were followed for one year postpartum, the risk of VTE was 11.3 percent in the patients with SCD, versus 1.2 percent in controls [ 27 ]. Arterial thromboembolism was also increased (5.2 percent, versus 0.6 percent in controls). This study emphasizes the value of postpartum VTE prophylaxis in people with SCD and the need for vigilance in evaluating suggestive symptoms. (See "Sickle cell disease: Obstetric considerations", section on 'Maternal risks' .)

Racial disparities in anemia during pregnancy (October 2023)

A new study has found that racial disparities in anemia during pregnancy persist and may be increasing. This analysis involved nearly four million births in the state of California from 2011 to 2020 [ 28 ]. Antepartum anemia was most common in Black individuals (22 percent), followed by Pacific Islanders (18 percent), Native American and Alaska Native peoples (14 percent), multiracial individuals (14 percent), Hispanic individuals (13 percent), Asian individuals (11 percent), and White individuals (10 percent). Antepartum anemia is associated with an increase in severe maternal morbidity. The reasons for disparities are multifactorial. (See "Anemia in pregnancy", section on 'Racial disparities' .)

Intrapartum magnesium sulfate before preterm birth and cerebral palsy (October 2023)

Magnesium sulfate is typically administered to pregnant women with impending preterm birth <32 weeks of gestation to decrease the incidence and severity of cerebral palsy in offspring. However, the recent MAGENTA trial comparing the effects of magnesium sulfate versus placebo administered before impending preterm birth between 30 and 34 weeks of gestation found that it did not prevent cerebral palsy among surviving infants [ 29 ]. These findings do not change our current practice because the trial used a single 4 g bolus of magnesium sulfate alone, whereas we also provide an ongoing 1 g/hour infusion until delivery and do not use the medication after 32 weeks; the trial was likely underpowered to find a significant difference. (See "Neuroprotective effects of in utero exposure to magnesium sulfate", section on 'Lower and upper gestational age' .)

OFFICE GYNECOLOGY

Infertility and autism spectrum disorder (December 2023)

Patients with infertility often ask about the impact of the disorder and its treatment on risk of autism spectrum disorder (ASD) in offspring. In a large population-based cohort study comparing ASD risk among children whose parents had subfertility (an infertility consultation without treatment), infertility treatment, or neither (unassisted conception), children in the subfertility and infertility treatment groups had a small increased risk of ASD compared with unassisted conception but the absolute risk was low (2.5 to 2.7 per 1000 person-years versus 1.9 per 1000 person-years with unassisted conception) [ 30 ]. The increased risk was similar in the subfertile and infertility treatment groups, suggesting that infertility treatment was not a major risk factor. Obstetrical and neonatal factors (eg, preterm birth) appeared to mediate a sizeable proportion of the increased risk for ASD. (See "Assisted reproductive technology: Infant and child outcomes", section on 'Confounders' .)

Macular changes related to pentosan polysulfate sodium (November 2023)

Macular eye disease has been reported in patients who have taken pentosan polysulfate sodium (PPS), which is used for the treatment of interstitial cystitis. In a prospective cohort study of 26 eyes with PPS maculopathy and >3000 g cumulative PPS exposure, progression of macular changes continued 13 to 30 months after drug cessation [ 31 ]. Median visual acuity decreased slightly; most patients reported progression of symptoms, including difficulty in low-light environments and blurry vision. These results indicate that PPS maculopathy progresses despite drug discontinuation, underscoring the importance of regular screening for maculopathy in patients with current or prior PPS exposure. (See "Interstitial cystitis/bladder pain syndrome: Management", section on 'Pentosan polysulfate sodium as alternative' .)

Vaginal laser therapy not effective for genitourinary syndrome of menopause (November 2023)

Laser devices, including the fractional microablative CO 2 laser, have been marketed for treatment of patients with genitourinary syndrome of menopause (GSM), but data regarding their safety and efficacy are limited. In a randomized trial including nearly 50 postmenopausal patients with GSM, treatment with CO 2 laser did not improve symptom severity compared with sham therapy [ 32 ]. Change in vaginal histology, which is a common surrogate determinant of treatment success, was similar in both groups at six months postprocedure. In addition, histologic features associated with a hypoestrogenic state correlated poorly with the severity of vaginal symptoms. Although the trial had limitations, these findings are consistent with other data and support our practice of not using laser treatment for patients with GSM. (See "Genitourinary syndrome of menopause (vulvovaginal atrophy): Treatment", section on 'Laser or radiofrequency devices' .)

Use of vaginal estrogen in breast cancer patients taking aromatase inhibitors (October 2023)

Use of vaginal estrogen to manage symptoms of genitourinary syndrome of menopause (GSM) may be harmful in patients with breast cancer on aromatase inhibitors (AIs). In a subgroup analysis of a claims-based analysis, vaginal estrogen therapy was associated with a higher rate of breast cancer recurrence in patients taking versus not taking an AI [ 33 ]. Time to recurrence in the AI group was approximately 140 days. While this study had many limitations, these data support our general practice of avoiding vaginal estrogen for the management of GSM in most patients with breast cancer taking AIs. (See "Genitourinary syndrome of menopause (vulvovaginal atrophy): Treatment", section on 'Patients with breast cancer' .)

GYNECOLOGIC SURGERY

Risk of unplanned hysterectomy at time of myomectomy (February 2024)

Myomectomy is an option for patients with bothersome fibroid symptoms (eg, bleeding, bulk); however, data are limited regarding the risk of unplanned hysterectomy at the time of myomectomy. In a retrospective study of the American College of Surgeons' National Surgical Quality Improvement Program database from 2010 to 2021 including over 13,000 patients undergoing myomectomy, the risk of unplanned hysterectomy was higher in those undergoing laparoscopic myomectomy compared with an open abdominal or hysteroscopic approach (7.1, 3.2, and 1.9 percent respectively) [ 34 ]. While much lower risks have been reported (<0.4 percent), and expert surgeons at high-volume centers may have fewer conversions to hysterectomy, this study highlights the importance of discussing the risk of unplanned hysterectomy during the informed consent process. (See "Uterine fibroids (leiomyomas): Laparoscopic myomectomy and other laparoscopic treatments", section on 'Unplanned hysterectomy' and "Uterine fibroids (leiomyomas): Open abdominal myomectomy procedure", section on 'Unplanned hysterectomy' and "Uterine fibroids (leiomyomas): Hysteroscopic myomectomy", section on 'Unplanned hysterectomy' .)

Risk of subsequent hysterectomy after endometrial ablation (January 2024)

Endometrial ablation is an alternative to hysterectomy in selected premenopausal patients with heavy menstrual bleeding. Most ablations are performed using a non-resectoscopic technique; however, the long-term efficacy of this approach is unclear. In a meta-analysis of 53 studies including over 48,000 patients managed with non-resectoscopic endometrial ablation (NREA), the rates of subsequent hysterectomy were 4 percent at 12 months, 8 to 12 percent at 18 to 60 months, and 21 percent at 120 months [ 35 ]. Hysterectomy rates were similar for the different NREA devices (eg, thermal balloon, microwave, radiofrequency). These findings are useful for counseling patients about the long-term risk for hysterectomy after NREA. (See "Endometrial ablation: Non-resectoscopic techniques", section on 'Efficacy' .)

Pregnancy and childbirth after urinary incontinence surgery (January 2024)

Patients with stress urinary incontinence (SUI) have historically been advised to delay midurethral sling (MUS) surgery until after childbearing because of concerns for worsening SUI symptoms following delivery. In a meta-analysis of patients with MUS surgery who were followed for a mean of nearly 10 years, similar low SUI recurrence and reoperation rates were reported for the 381 patients with and the 860 patients without subsequent childbirth [ 36 ]. Birth route did not affect the findings. Although the total number of recurrences and reoperations was small, this study adds to the body of evidence suggesting that subsequent childbirth does not worsen SUI outcomes for patients who have undergone MUS. (See "Surgical management of stress urinary incontinence in females: Retropubic midurethral slings", section on 'Subsequent pregnancy' .)

GYNECOLOGIC ONCOLOGY

Types of hysterectomy in patients with stage IB1 cervical cancer (March 2024)

Patients with stage IB1 cervical cancer (ie, >5 mm depth of stromal invasion and ≤2 cm in greatest dimension) are typically treated with radical hysterectomy; however, less extensive surgery is being evaluated. In a randomized trial including over 640 patients with stage IB1 cervical cancer, radical hysterectomy and simple hysterectomy plus lymph node assessment resulted in similar rates of recurrence at three years (2.2 and 2.5 percent, respectively) [ 37 ]. Although the study has limitations, including a short follow-up period, simple hysterectomy with lymph node assessment may be an acceptable alternative to radical hysterectomy in patients with IB1 cervical cancer. (See "Management of early-stage cervical cancer", section on 'Type of surgery' .)

Increasing incidence of cervical and uterine corpus cancer in the United States (February 2024)

In January 2024, the American Cancer Society published their annual report of cancer statistics in the United States [ 38 ]. Notable trends in regard to gynecologic cancers include a 1.7 percent increase in the annual incidence of cervical cancer from 2012 to 2019 in individuals aged 30 to 44 years, after decades of decline. Cancer of the uterine corpus (all ages) continued to increase by approximately 1 percent annually and was the only cancer in the report in which survival decreased. These and other data emphasize the continued importance of both early detection and prevention (eg, for cervical cancer: human papillomavirus vaccination and screening for precursor lesions; for endometrial cancer: achieving and maintaining a normal body mass index). (See "Invasive cervical cancer: Epidemiology, risk factors, clinical manifestations, and diagnosis", section on 'Incidence and mortality' and "Endometrial carcinoma: Epidemiology, risk factors, and prevention", section on 'Epidemiology' and "Endometrial carcinoma: Clinical features, diagnosis, prognosis, and screening", section on 'Prognosis' .)

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Nursing research in obstetrics and gynaecology

• PMID: 6926006
• DOI: 10.1016/0020-7489(82)90003-7
• Infant, Newborn
• Labor, Obstetric
• Midwifery* / trends
• Obstetric Nursing* / trends
• Preoperative Care

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• v.2022; 2022

This article has been retracted.

Analysis of obstetric clinical nursing integrating situational teaching simulation, shanshan xiao.

The Affiliated Hospital of Medical School, Ningbo University, Ningbo 315020, China

Xiaoxiao Zhao

Hongyan tang, yuanping wang, associated data.

The labeled dataset used to support the findings of this study are available from the corresponding author upon request.

This paper applies the situational teaching mode to obstetric clinical nursing. When explaining the nursing operation skills, according to the pre written script, design some common clinical nurse-patient conflicts and carry out situational simulation performances, so as to inspire students to think about how to effectively communicate with patients and their families and establish a harmonious nurse-patient relationship. At the same time, this paper also urges students to improve their initiative of autonomous learning and actively participate in the whole process of learning, rather than passively accept knowledge. Finally, the teaching methods of combining obstetric clinical nursing teaching with experimental teaching were compared to explore the effectiveness of situational teaching simulation teaching mode. Through the experimental comparative analysis, it can be seen that the obstetric clinical nursing teaching model based on situational teaching simulation has a certain effect and has a good guiding significance for the practical teaching of obstetric clinical nursing.

1. Introduction

Scenario-based teaching refers to a teaching method in which teachers create a realistic teaching situation with the support of relevant technical conditions according to the requirements of teaching objectives, so that students can play roles in an environment close to the real situation, and learn relevant knowledge and skills from it. The nursing teaching of obstetrics and gynecology in secondary vocational education is a practical course. Students need to master proficient operating skills and be familiar with various practical problems during the study period, so that they can be handy in the future nursing work in obstetrics and gynecology, deal with various problems calmly, and improve patients' satisfaction with nursing. Therefore, the teaching of obstetrics and gynecology should actively introduce the situational teaching method to fully demonstrate the dominant position of students.

At present, with the wide application of information technology, the nursing teaching of secondary vocational obstetrics and gynecology has made new progress. Teachers use the support of multimedia technology in the classroom, which can make the teaching content richer and more vivid, which is convenient for students to extensively study practical cases, and then guide their own professional skills training. However, the nursing work of obstetrics and gynecology contains many contents, even very trivial. In the treatment of gynecological diseases and maternal care, students need to have strong practical ability to provide effective nursing and help to patients. Therefore, the nursing course of obstetrics and gynecology has the characteristics of large amount of knowledge and abstract content, and the existing teaching work still has certain shortcomings.

The purpose of scenario teaching is to stimulate students' enthusiasm and initiative. Therefore, after selecting and creating scenarios, teachers should further set up specific tasks and problems to give students the opportunity to learn independently. Teachers can divide the students in the class into several groups and then introduce problems that need to be considered and dealt with in various situations and then discussed by the group members. The members of the group have both division of labor and cooperation, and they jointly apply the relevant knowledge points of obstetrics and gynecology nursing, break through difficulties, and propose solutions, so as to realize the integration of theory and practice. For example, after collecting and examining the medical history of obstetrics and gynecology patients, how to formulate nursing measures according to different cases and the issues that should be paid attention to in the nursing work after natural childbirth, etc. can be used as topics for students to think about. Moreover, students draw and practice through simulation, and finally, the group representatives make a summary and share the results in the class. Through the analysis of different case scenarios, the team members communicated nursing plans, which not only realized mutual learning but also facilitated familiarity with more practical scenarios.

In order to improve the clinical nursing effect of obstetrics, this paper applies situational teaching to the clinical nursing research teaching of obstetrics, improves the teaching effect of obstetrics nursing, and promotes the nursing effect of hospital obstetrics.

2. Related Work

The situational teaching method dilutes the traditional teacher's “preaching” color, gives students more classroom practice, stimulates students' interest in learning, and creates a good classroom learning atmosphere. The situational teaching method changes students' passive acceptance state, encourages students to actively participate in teaching activities, and promotes abstraction. The specific theoretical knowledge can effectively make up for the shortcomings of traditional “cramming” teaching and optimize the teaching effect of obstetrics and gynecology nursing. In the simulation situation, students play a certain role in it, actively participate in practical activities, think and explain according to learning theory, and give students more opportunities to express and think [ 1 ]. Actively participating in classroom learning activities is conducive to improving the enthusiasm of classroom teaching, improving the openness of teaching, and enabling students to better grasp the knowledge of obstetrics and gynecology nursing [ 2 ].

In the process of situational teaching, the use of situational interaction can promote teachers and students to communicate on an equal footing. At the same time, teachers can also guide students to express their personal opinions, so that students can analyze and solve problems, put forward personal opinions, and improve students' innovative ability. The situational teaching mode breaks the traditional teaching mode, combines theory with practice, cultivates students' autonomous learning ability, urges students to deeply understand relevant theories, realizes entertaining, pays more attention to the cultivation of patients' true feelings, and improves the communication skills between nurses and patients [ 3 ]. Actual situational teaching can provide students with more opportunities for practical exercise and encourage students to combine the professional knowledge of obstetrics and gynecology nursing and related knowledge and use the simulation environment to encourage students to realize empathy and train their professional quality and thinking. Moral quality, psychological quality, and body speed, promote self-education and, at the same time, promote better development of students, realize division of labor and mutual learning through situational demonstrations, cultivate students' spirit of unity and cooperation, improve students' work ability, and lay a good foundation for students' future development. [ 4 ]. Therefore, the situational teaching mode is an open teaching mode, which is conducive to cultivating students' various abilities and meeting the requirements of cultivating high-quality applied talents [ 5 ].

During the situational teaching, students analyze and discuss nursing error cases, so that students can realize that once mistakes occur in the work, nursing errors may occur and then cultivate students to enrich medical theoretical knowledge and serious and responsible attitude, cultivate students' prudent and independent spirit, and avoid occurrences as much as possible. With the popularization and development of hospital nursing systemization, the teaching focus has shifted to realize the integration of nursing teaching [ 6 ]. In the process of obstetrics and gynecology nursing training, doctors and nurses can be combined with clinical teaching, and theoretical learning and practice can be combined, which can promote strengths and avoid weaknesses, transform medical knowledge and nursing theory into practice, and promote students to better observe and analyze conditions, shorten the distance between theory and practice as much as possible, consolidate classroom knowledge, better understand and master nursing procedures and really apply them to practice, improve students' nursing level, and lay a good foundation for students' clinical practice and practical work [ 7 ].

During scenario teaching, teachers can guide students to analyze specific scenarios with the help of basic theories and then be able to identify problems, analyze problems, and choose the best solution. The combination of basic theory and specific practice can cultivate students' ability to integrate theory with practice, realize application of what they have learned, and cultivate students' clinical practice. It can change the current disconnection between knowledge and action and improve students' problem analysis ability and problem solving ability [ 8 ]. The situational teaching mode changes the traditional single teaching method, respects the dominant position of students in the classroom, realizes the bilateral interaction between teachers and students, and improves the teaching quality of obstetrics and gynecology nursing. It can optimize the effect of classroom teaching, promote bilateral interaction between teachers and students, and gradually cultivate students' clinical thinking. The situational teaching mode is more vivid, intuitive, and vivid, which enables students to carry out practical exercises more concretely and deeply, gives students a better emotional experience, cultivates students' active learning attitude, and improves the teaching effect of obstetrics and gynecology nursing [ 9 ]. In the traditional teaching process, teachers pay more attention to the diagnosis and treatment of obstetrics and gynecology diseases of students, but they do not pay enough attention to cultivating students' comprehensive quality and overall nursing concept, which prevents students from effectively grasping the overall nursing effect [ 10 ]. From the current point of view, the overall nursing application in the teaching of obstetrics and gynecology nursing is not very ideal and thus cannot meet the requirements of clinical nursing and health care. Reforming teaching methods is conducive to cultivating more practical talents, improving students' business ability and professional ability, and improving the overall quality of nursing [ 11 ]. As a teaching practice and a feasible and effective teaching method, the situational teaching mode breaks through the traditional teaching mode, makes up for the shortcomings of pure knowledge imparting, promotes emotional resonance between teachers and students, and then stimulates students' interest in learning and improves the teaching of obstetrics and gynecology nursing. It can cultivate more practical and high-quality nursing talents [ 12 ].

3. Research Method

3.1. test preparation.

We randomly select the students into groups and divided them into the experimental group and the control group. There is no significant difference in the medical education background of the two groups of students, and they were comparable. The theoretical and experimental teaching of the two groups of students is all completed by the researchers themselves, and the teaching syllabus, teaching plan, number of hours, teaching objectives, and teaching progress are all the same. In the teaching of the experimental group, some experimental courses are selected to be taught by the PBL-scenario simulation teaching method, and the teaching of the control group is taught by the traditional teaching method.

The PBL teaching method adopts a problem-based teaching method, and the design and compilation of medical records is the core of the whole teaching. The design and compilation of medical records should be based on the undergraduate syllabus and teaching objectives, covering the teaching content of the taught courses, with prominent key points and difficulties, and students should be able to find enough relevant materials and reference books or learning websites for autonomous learning. The medical records are sufficiently representative, inspiring, and exploratory. The design of medical records should be clear in diagnosis and moderate in difficulty and in line with the cognitive characteristics and level of students in school and can be grasped and understood by students. When compiling PBL medical records, the teacher designs and compiles the cases according to the selected nursing operation techniques [ 13 ]. After forming the preliminary cases, the teachers of the teaching and research department will design and discuss in detail whether the various manifestations of the cases and the auxiliary examination conditions are true and complete when the teaching and research room meetings are held. Finally, in order to make the cases more standardized, systematic, and more in line with the actual clinical situation, after the preparation of the medical records, the cases are handed over to the teachers of the obstetrics and gynecology department of the internship hospital for discussion and revision in the department, and the final SC is formed. After the writing of SC is completed, it is rewritten according to the experimental content, and it is divided into student version and teacher version. In the case of the student version, there is a brief introduction of the medical history and a small number of physical examination results, which only serve to introduce the case and inspire students to think. The teacher's version of the case contains comprehensive medical history, physical examination, and laboratory test results, which are used for teachers to guide students' thinking.

For students, PBL situational simulation teaching is a brand-new teaching mode. Before this study, all students had never been exposed to this teaching method. Before teaching, students should give a brief introduction to the PBL scenario simulation teaching method. At the same time, it is necessary to do a good job of mobilizing students' thoughts, so that students have the necessary understanding of this teaching method and sufficient psychological preparation to accept a new teaching method. In addition, it is necessary to inform students that PBL teaching is a teaching method of “teacher-led, student-based, and case-based.” The five-stage teaching process is applied in PBL teaching, namely, teachers raise questions, and students establish hypotheses, collect data, demonstrate hypotheses, and summarize [ 14 ]. In PBL teaching, only by thinking independently and independently can we acquire knowledge and solve problems. A situational teaching method means that in the process of teaching, teachers purposefully design or introduce realistic clinical scenarios, so that students can be immersed in the situation, arouse students' emotional experience, stimulate students to think actively, and finally inspire students to understand knowledge, analyze problems, deal with emergencies, and communicate and coordinate. Moreover, situational teaching emphasizes placing learning in a real situation, so that students can have real experience and solve real problems.

After the SC preparation is completed, according to the characteristics of the case and the development process of the disease, a scenario simulation script is prepared. First of all, according to the needs of the development of the plot, the characters to appear are generally composed of 1 nurse, 1 patient, and 1.2 family members of the patient. Secondly, it is necessary to discuss the writing of the script with the nurse-patient communication teacher, set the nurse-patient conflict in the experiment, and write the script. For example, in scene 1, because of lack of medical knowledge, a woman with episiotomy who refused to perform genital scrubbing operation had some language conflicts with the nurse and refused to continue treatment. In scenario 2, there is a lack of breastfeeding knowledge, and there is difficulty in breastfeeding, and the mother and family members who are ready to choose supplementary feeding. In scene 3, the patient is faced with arrears and withdrawal of medication, the family members are waiting in the corridor for the patient to undergo vaginal lavage treatment, and the anxious family members speak rudely to the nursing staff and other common conflicts. Finally, after the playbook is finalized, teachers guide students to memorize and recite lines and guide and correct students' performances [ 15 ]. In order to avoid the students' performances being too exaggerated, false, and the traces of the performances too heavy, it is necessary to make all the students' attention focus on the performance itself, so as to avoid ignoring the solution of the problem and fail to achieve the purpose of promoting students' critical thinking. At the same time, the test site needs to be prepared according to the experimental requirements. The test site is set up in the classroom of the nursing department, and the simulated hospital bed is set up in the classroom.

As a new open teaching method, PBL-scenario simulation teaching method has higher requirements on teachers' own professional quality, classroom regulation ability, teaching skills, language communication ability, and so on. This teaching method not only requires teachers to be proficient and thorough in the content of this major and the course but also requires teachers to master a lot of knowledge of related disciplines and have the ability to ask and solve problems, the ability to use knowledge flexibly, more rigorous logical thinking, and good organizational skills and to be able to mobilize students' enthusiasm, achieve entertaining, and control the rhythm of the classroom [ 16 ]. Therefore, when teaching PBL-scenario simulation teaching method, teachers need to learn and read a large number of PBL and situational simulation teaching materials and be proficient in the PBL-scenario simulation teaching method. Before teaching, teachers should prepare lessons carefully, write medical records, and be familiar with the contents of cases and related knowledge of anatomy, physiology, and pathology. At the same time, it is also necessary to have rich clinical experience and communication skills and to be able to cope with the occurrence of emergencies, all of which put forward very high requirements for teachers.

3.2. Implementation of Scenario Simulation Teaching

In the first stage (20 minutes after the theory class), the problem is raised, and the division of labor is arranged. This stage is not completed in the experimental class, but in 20 minutes after the theoretical class, 3-5 days before the first experimental class, the teacher distributes the SC to the students, finds a student to read the SC aloud in the class, and guides the students to familiarize themselves with the case, so as to ensure that there are no questions that the students cannot understand in the case. After that, we need to select the leader of the group discussion and arrange for the leader to lead the students to have an after-class discussion and ask interesting learning questions. At the same time, it is necessary to decompose, classify, and arrange the problems raised to ensure that each student in the group has a problem that needs to be solved. Finally, the reference books and websites that students use to solve problems are given to ensure that students can get enough help and expand their learning space and time. In the second stage (the first experimental class), there are class discussion and problem-solving stage. This stage is completed in the experimental classroom, and the patient and the patient's family will tell the medical history process according to the lines written in advance. After listening to the narration of the medical history, the group members will discuss and share the materials they have collected with the group members and use the brainstorming method. After that, students need to be encouraged to put forward as many assumptions and questions as possible and then question these assumptions and questions one by one. At the same time, there needs to be an in-group discussion, the secretary records the feedback information, and then the students discuss further to solve the problem. After a large amount of data collection, information aggregation, and layer-by-layer analysis and after removing the false and keeping the truth, a summary is made, the most appropriate treatment method is found, and the students are guided to analyze the nursing operation skills most needed by the patients and lead to the experimental teaching content of the next class. At the same time, the teacher assigns the teaching tasks of the next experimental class to the students, shows the conflict script to the students, guides the students to discuss after class, and analyzes the method to resolve the conflict. In phase 3 (second lab session), questions left over from the previous session are discussed to ensure there are no more unresolved issues. After that, the teacher taught nursing operation techniques. During the process of the teacher's narration and teaching, the students who played the patient and their family members performed according to the script written in advance, forming a conflict between nurses and patients. At this time, it is necessary to guide students to use the knowledge of nurse-patient communication that they have learned to analyze and resolve the conflict between nurses and patients and form a summary after class discussion. Finally, it is necessary to guide students to practice experimental operation techniques in groups and require students to master the experimental operation steps. Before getting out of class, the teacher assigns homework and asks each student to organize the knowledge gained from self-learning into documents, send them to the public mailbox to report and exchange, and solve problems together through the sharing of information and experience. At the same time, the teacher summarizes the key points and difficulties of the teaching and gives feedback and evaluation of the teaching activities to give positive encouragement to students, affirm students' spirit of exploration and active learning performance, and give objective evaluations at the same time.

In the first experimental class, it is necessary to teach the experiment according to the requirements of the experimental outline, follow the experimental operation guidance steps, and tell the students about the experimental purpose, operation materials, experimental steps, and experimental precautions. At the same time, it is necessary to play the recorded experimental operation video and teach it and then guide the students to practice in groups and the teacher to patrol. In the second experimental class, it is necessary to point out the common mistakes and deficiencies of the students in the first experimental class and guide the students to practice in groups, and the teachers will inspect and help the students to correct the problems in time. Before the end of the experimental class, the teacher summarizes the steps that students are prone to make mistakes in operation and gives emphasis and guidance [ 17 ].

3.3. Data Collection

After the two experiments are completed, a questionnaire was distributed to investigate the teaching effect of the two experimental teaching methods. In order to ensure the effectiveness and fairness of the assessment, the distribution and recovery of the questionnaires are independently completed by the researchers themselves.

After the data was collected and sorted, SPSS13.0 software was used for statistical analysis and processing. In general, descriptive statistical analysis and chi-square test are used for analysis. For students' theoretical test scores, experimental assessment scores, experimental teaching method teaching effect investigation, critical thinking ability measurement, and medical students' communication skills and attitude measurement, normality analysis of the data is carried out first. The data are normally distributed and are further tested by a t -test.

The scores of nurse-patient communication and experimental operation skills all showed a normal distribution. The data are then subjected to descriptive statistics and independent samples t -test, and the results show that the students in the experimental group have higher test scores than the control group, and the difference is statistically significant. The test results are shown in Tables ​ Tables1 1 ​ 1 – 3 . The corresponding statistical chart is shown in Figures ​ Figures1 1 ​ 1 – 3 .

Comparison of total test scores.

Comparison of nurse-patient communication scores.

Comparison of experimental operation skills scores.

After the test results come out, the scores are input into SPSS13.0, and a single-sample normality analysis is carried out, which shows that the test scores are normally distributed. Then descriptive statistics and independent samples t -test are performed, and the analysis results show that there is no statistically significant difference in theoretical scores between the experimental group and the control group, as shown in Table 4 below. The corresponding statistical chart is shown in Figure 4 .

Comparison of the theoretical test scores of the two groups of students.

The comparison of critical thinking is shown in Tables ​ Tables5 5 ​ 5 ​ ​ ​ ​ – 11 . The corresponding statistical chart is shown in Figures ​ Figures5 5 ​ 5 ​ ​ ​ ​ – 11 . Descriptive statistics and independent samples t -test are performed on the scores of the students in the two groups. The results show that the total score of the CTDI-CV scale of the students in the experimental group is higher than that in the control group, and the difference is statistically significant.

Comparison of the ability to find the truth.

Comparison of open minds.

Comparison of analytical capabilities.

Comparison of systematic capabilities.

Comparison of self-confidence in critical thinking.

Comparison of intellectual curiosity.

Comparison of cognitive maturity.

5. Analysis and Discussion

After reforming the traditional experimental course teaching, this research has preliminarily constructed the PBL-scenario simulation combined teaching method and applied it in the teaching of the experimental course of obstetrics and gynecology nursing. This teaching method combines PBL teaching with situational simulation teaching method. In the experiment, the teacher first gave the students SC and guides the students to study in groups, discuss, look up materials, analyze cases, and analyze layer by layer. In addition, teachers make students find the most appropriate treatment method and select patients who need nursing operation skills most. In the explanation of nursing operation techniques, according to the prewritten script, a situational simulation performance is performed, and some common clinical nurse-patient conflicts are designed to inspire students to think about how to communicate effectively with patients and their families and establish a harmonious nurse-patient relationship. Moreover, every link in the teaching process reflects the principle of “students as the main body, teachers as the main body, and cases as the main line.” It urges students to improve the initiative of self-learning and actively participate in the whole process of learning, instead of passively accepting knowledge.

Obstetrics and Gynecology Nursing, as the main clinical course of nursing, is offered in the sixth semester, which is the last semester for students to study at the school. At this point, students have learned all the basic medical courses and most of the clinical medical courses, laid a good medical foundation and self-learning ability, and formed a preliminary medical analysis ability. This enables PBL-scenario-simulation combined teaching to be opened and welcomed by students.

Acknowledgments

This work was supported by the Affiliated Hospital of Medical School, Ningbo University.

Data Availability

Conflicts of interest.

The authors declare no competing interests.

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