Improving residents' breastfeeding assessment skills: a problem-based workshop

Background. It is well documented that residents have limited knowledge abo ut common breastfeeding problems. Objectives. The purpose of this study was to assess whether a problem-based , interactive breastfeeding workshop would improve resident skill level. Methods. Two groups of second- and third-year family medicine residents wer e assigned to an intervention or control group; both groups participated in pre-and post-intervention Objective Structured Clinical Examinations (OSCE s) and completed written questionnaires. The intervention consisted of a 4. 5 hour interactive workshop with didactic presentations and opportunities t o work with a lactation consultant and standardized patients trained to rol e-play selected breastfeeding problems. Results. There were no baseline differences in knowledge or performance sco res on the OSCEs between the intervention and control groups. OSCE scores a fter intervention were significantly better in the intervention group for t he content areas assessing position and latch and the evaluation of sore ni pples (P < 0.001 and P= 0.05, respectively). There was a trend towards impr ovement in assessment of the problem of low milk supply (P= 0.31). All resi dents in the intervention group correctly diagnosed the cause of both the s ore nipples and low milk supply at the follow-up OSCE, with P values of < 0 .001 and 0.068, respectively. The intervention group felt significantly mor e confident in their breastfeeding problem-solving (P < 0.001). Conclusions. An interactive, problem-based workshop to teach residents the basics of breastfeeding problem solving can be implemented in residency and improve clinical diagnostic skills and residents' comfort with breastfeedi ng.