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

Background. It is well documented that residents have limited knowledge about 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 were assigned to an intervention or control group; both groups participated in pre-and post-intervention Objective Structured Clinical Examinations (OSCEs) and completed written questionnaires. The intervention consisted of a 4.5 hour interactive workshop with didactic presentations and opportunities to work with a lactation consultant and standardized patients trained to role-play selected breastfeeding problems. Results. There were no baseline differences in knowledge or performance scores on the OSCEs between the intervention and control groups. OSCE scores after intervention were significantly better in the intervention group for the content areas assessing position and latch and the evaluation of sore nipples (P < 0.001 and P = 0.05, respectively). There was a trend towards improvement in assessment of the problem of low milk supply (P = 0.31). All residents in the intervention group correctly diagnosed the cause of both the sore 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 more 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 breastfeeding.