Evaluation of a group prenatal care-based curriculum in a family medicine residency.

BACKGROUND There is a growing trend within family medicine residency training programs to implement group prenatal care programs. While the clinical benefits of group prenatal care have been well documented, there have been no published studies to date evaluating the educational impact of using group prenatal care in residency training programs. METHODS A retrospective cohort study of both patient care performance and outcome measures over a 4-year time span in a pre- and post-intervention design in a single family medicine training program was used. RESULTS A total of 184 women were cared for by residents educated under the old curriculum, and 195 women were cared for under the new curriculum. Patients cared for by residents under the new curriculum had significantly fewer cesarean sections compared to patients cared for under the old curriculum (17.53% versus 26.92%) and also trended toward having a lower rate of preterm births (4.15% versus 8.33%) that reached significance when controlled for parity and insurance status. CONCLUSIONS The ultimate measure of how well we train our residents is how well they care for their patients. Our evaluation of teaching residents maternity care through group prenatal visits and the IMPLICIT quality improvement initiative found that we improved not only several processes of care outcomes but most importantly the key maternity care outcomes of cesarean section and preterm birth rates.