{"paper_id":"06bcbd8b-b37a-454c-8f20-bd2f4237fa4d","body_text":"The Labor & Delivery Clerkship Experience for Students: Optimizing Learning in a Complex Clinical Environment | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Labor & Delivery Clerkship Experience for Students: Optimizing Learning in a Complex Clinical Environment Molly Zeme, Jeannette Lager This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9203856/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background: The Ob/Gyn clerkship, particularly labor & delivery (L&D), can pose unique challenges for medical students. Although studies have characterized the Ob/Gyn clerkship as unique yet challenging, much of the literature around preparing students for the clerkship utilizes materials geared towards medicine and surgery rotations. Though helpful at times, borrowing these materials neglects the nuances within Ob/Gyn, such as the prevalence of sensitive exams, gender-affirming care, and the elevated importance of utilizing a trauma-informed approach. Improving the clerkship experience for students, including with more clearly defined roles, will not only enhance student learning but also allow them to reduce the workload on other team members. Methods: The study included UCSF third and fourth-year medical students who completed their Ob/Gyn Clerkships and focuses on the L&D learning environment. We reached participants via email. The survey contained multiple-choice and free-response questions. We also conducted interviews with third and fourth year students. Results: There were 32 survey respondents, 50% of which were third-year students and 50% fourth-year students. On a scale of 1-5, with 5 being the best, students rated their L&D experience overall as 3.53, the clarity of their role on L&D as 2.75, and their ability to contribute meaningfully to their L&D team as 2.71. The average daily downtime they endorsed spending on L&D was 4.37 hours. In addition, students expressed a desire for more clarity on the L&D workflow and their roles. They also expressed disappointment in having decreased hands-on opportunities and guidance from residents compared to other rotations. Conclusions: Students’ uncertainty around how to contribute and discrepancies between their expectations and experiences demonstrate the need for better orientation to L&D. To address this, we added two resources for students: the L&D Workflow, which outlines the daily schedule and different team members’ roles, and a Tips Sheet, which provides students with clear expectations for L&D. We hope these resources better prepare students for the unique and exciting experience of L&D and help them maximize their time on service. Background Studies have shown that the Ob/Gyn clerkship, particularly labor & delivery (L&D), can pose unique challenges for medical students. One contributing factor is residents’ availability to teach students, as residents make up a significant component of students’ learning on their clinical rotations 1 . Despite residents’ vital role in student learning, they are often characterized as less effective teachers within the Ob/Gyn clerkship, largely due to their clinical workload 1 , 2 . This workload can particularly constrain Ob/Gyn residents on L&D, as studies have demonstrated their significant time pressures due to clinical duties 1 , 2 . The sensitivity of exams and experiences patients may have in the field contributes to these challenges as well, especially regarding students’ abilities to find appropriate roles. Patients decline student participation in exams at higher rates within Ob/Gyn, often due to preference for female-identifying students but also due to requests for no student presence 3 , 4 . Another reason for decreased student participation is that pregnant patients may understandably want control over their birthing experience, and their preferences may not include students 5 . Although studies have characterized the Ob/Gyn clerkship as unique yet challenging, much of the literature around preparing students for the clerkship utilizes materials geared towards medicine and surgery rotations 5 . Though helpful at times, borrowing these materials neglects the nuances within Ob/Gyn, such as the prevalence of sensitive exams and gender-affirming care and the elevated importance of situational awareness and a trauma-informed approach 5 . Despite the literature dedicated to obstacles students and residents may face around learning and teaching in Ob/Gyn, there is a gap in studies looking at ways to improve the clerkship experience. This is essential knowledge for institutions to have, as it will maximize student learning and enable the team to function more smoothly. Moreover, students understanding the ways in which they can best contribute to their teams will not only improve their learning but also allow them to reduce the workload on other team members. This project aims to examine the medical student experience on labor & delivery and determine how students can be better oriented to their roles. Methods Study Design: This is a qualitative study using a phenomenological approach. This approach seeks to identify and describe aspects of the Ob/Gyn clerkship through the subjective lived experiences of participants through their viewpoints shared in surveys and interviews. 6 Questions were designed to be open-ended to promote new perspectives and capture authentic experiences. More specifically, we employed an interpretive phenomenological approach, which allows the researcher to take on an active role in the interpretation of data. 7 This is appropriate for this study as the primary researcher is a medical student who completed the Ob/Gyn clerkship and is therefore not free of bias. Through this approach, we reflect upon participants’ experiences while simultaneously reflecting upon personal experiences of the researchers. 7 These dual reflections allow for a nuanced analysis which uses various pieces of data to create an understanding of the overall phenomena of the Ob/Gyn clerkship experience. 7 Participants and Setting: The study was limited to a large urban academic medical center across multiple sites, including a safety-net community hospital and a quaternary-level specialty care center. The study included UCSF third and fourth-year medical students who completed their Ob/Gyn clerkship, which is six weeks long. The study focuses on the L&D learning environment. Sampling and Recruitment Strategy We reached participants primarily via email. We sent out emails over the listservs for the third- year and fourth-year medical school classes. For incentivization, students were entered into a raffle to win a $ 30 gift card of their choosing upon completion of the survey. Students were also made aware that their survey responses would be anonymized and no personal information from them would be collected, in order for students to feel comfortable expressing any viewpoints. This information was communicated to students in the outreach emails as well as within the survey itself. Informed consent to participate was obtained from all of the participants in the study. Data Collection: We used surveys and interviews to assess students’ experiences. The survey sent to students contained a combination of multiple-choice and free-response questions. The survey also had a place for students to express their willingness to participate in interviews about their experiences. Following the survey portion of the data collection, we conducted phone interviews with three third-year medical students and three fourth-year medical students. Both the surveys and interviews asked participants questions about their level of confusion about their role, what information, instructions, or resources would have helped their experiences, their ability to contribute to the team, and any negative experiences they had. Results There were 32 survey respondents, 50% of which were third-year students and 50% fourth-year students. Below are the quantitative findings from the survey data. Questions utilized a scale of 1–5 for students to choose from, with 5 being the best. Question Average How would you rate your L&D experience overall? 3.53 How clear was your role as a student on L&D? 2.75 How much did you feel you were able to meaningfully contribute to your L&D team? 2.71 How much of your day on L&D did you spend on down time? 4.37 hours (assuming a full day for students = 10 hours) In the free response section of surveys and during interviews, students discussed how having more clarity on the L&D workflow and students’ roles would have helped their experiences, as well as a list of tasks students could do to contribute. One student explained, “Because of the nature of L&D the role of students feels more limited than other rotations. A list of things that medical students can do to help or to make the most out of their time would be nice.” Students also recognized how the complex and sensitive nature of L&D contributed to some of this confusion. “I wasn't sure what I could contribute or what was appropriate to contribute,” a student stated, “It also didn't feel like a place for me to contribute either especially since the patients need to rest.” Other students expressed disappointment in not being able to do as many clinical tasks compared to other rotations. Multiple students explained how they were surprised when residents did not offer for them to help with clinical tasks they did regularly on other rotations, such as leading discussions with patients, giving presentations, and writing notes. Students also felt that there was not a defined point person on L&D for them to go to, similar to the senior or chief resident on their medicine and surgery teams. Lastly, another common theme that emerged in the survey and interviews was students’ experience of decreased teaching from residents when compared to other clerkships. Discussion Overall, students endorsed feeling a significant level of confusion about their roles and decreased ability to contribute to the team while on L&D. Students expressed a clear desire for more guidance on the service, especially relating to the workflow of L&D and their roles. Moreover, there appeared to be a discrepancy between student expectations going into the clerkship and their experiences. Students held initial expectations that L&D would not differ significantly from other services. Therefore, students entered the service expecting a clearly defined role, including assigned patients to follow each day and specific residents to collaborate with on their patients. However, they instead were faced with a more unpredictable service, less structured roles, and sometimes less hands-on experience and dedicated teaching from residents. It is no news that L&D is a fast-paced and often unpredictable service- it’s hard to be certain when someone will deliver, if someone might need urgent interventions, or if someone might decline student participation. Though this is standard for Ob/Gyn providers, students are likely to be unaware of this prior to their clerkship. Their uncertainty around how to contribute and what is appropriate, and discrepancies between their expectations and experiences, demonstrate the need for better orientation and expectation setting for L&D. To address these needs, we added additional information and resources to students’ Ob/Gyn clerkship preparation. Students received a detailed L&D workflow, which outlined the schedule for the day, providers’ roles, what students should be doing and the respective point people for those tasks, as well as suggestions for learning opportunities during downtime (see Exhibit A). Students also received a clerkship tips sheet (see Exhibit B). The tips sheet provides students with clear expectations for L&D and how it will differ from past experiences, explaining how the unpredictable, fast-paced, and sensitive nature of the service can make it challenging for team members to provide structured roles to students and one-on-one teaching. The tips sheet also guides students to additional resources for support, including the workflow document, as well as provides suggestions for topics to review prior to L&D to help them maximize their time on service. Conclusion L&D is a uniquely challenging clerkship experience for students. Students endorsed feeling confused about their roles and how to contribute. In order to improve students’ and providers’ experiences during the clerkship, we created additional resources to clarify the L&D workflow and expectations. Our hope is that these resources will better prepare students for the unique and exciting experience of L&D and help them maximize their time on service. In the future, projects should investigate how these new resources improved students’ experiences. Declarations Ethics approval: Ethical approval was sought from the University of California, San Francisco Institutional Review Board (IRB #: 24-42312). This study was deemed exempt. All procedures were conducted in accordance with and adhered to the Declaration of Helsinki. Consent to participate: Informed consent to participate was obtained from all of the participants in the study. Consent for publication: Not Applicable. Funding: This study was partially funded by the UCSF School of Medicine Deep Explore Project Grant. Author Contribution MZ and JL created the study design. JL supervised the project. MZ completed data collection and data analysis and interpretation. MZ drafted the manuscript. JL and MZ critically revised and approved the final manuscript. Acknowledgement The authors are grateful for students’ time in providing feedback on their experiences and to Ob/Gyn clerkship administration for their support of implementing changes. Data Availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. References Carroll MR, Kilpatrick CC, Johnson G, Sukhavasi N, Ratan BM. Utilizing structured worksheets to strengthen resident teaching on the OB/GYN clerkship. Med Sci Educ. 2021;31(4):1379–84. Reddy ST, Zegarek MH, Fromme HB, Ryan MS, Schumann SA, Harris IB. Barriers and facilitators to effective feedback: a qualitative analysis of data from multispecialty resident focus groups. J Grad Med Educ. 2015;7(2):214–9. Jiang X, Altomare C, Egan JF, Tocco DB, Schnatz PF. The ObGyn clerkship: are students denied the opportunity to provide patient care and what is the role of gender? Conn Med. 2012;76(4):231–6. Buck K, Littleton H. Impact of educational messages on patient acceptance of male medical students in OB-GYN encounters. J Psychosom Obstet Gynaecol. 2016;37(3):84–90. Hopkins-Kotb N, Sylla H, Krotinger A, Pelletier A, Bartz DA, Johnson NR. A student-informed guide for success on the OB/GYN clerkship. J Med Educ Curric Dev. 2025;12:23821205241299584. Stenfors-Hayes T, Hult H, Dahlgren MA. A phenomenographic approach to research in medical education. Med Educ. 2013;47(3):261–70. Neubauer BE, Witkop CT, Varpio L. How phenomenology can help us learn from the experiences of others. Perspect Med Educ. 2019;8(2):90–7. Additional Declarations No competing interests reported. Supplementary Files ExhibitA.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 22 Apr, 2026 Reviewers invited by journal 22 Apr, 2026 Editor assigned by journal 01 Apr, 2026 Editor invited by journal 27 Mar, 2026 Submission checks completed at journal 26 Mar, 2026 First submitted to journal 26 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-9203856\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":631825987,\"identity\":\"b5c2e231-c55a-47c6-a806-6b29385fd192\",\"order_by\":0,\"name\":\"Molly Zeme\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0UlEQVRIiWNgGAWjYFAC5sYDUAaIlgPiBEJaGBugWthASo1J0sJjQJwW3fbGhsM8DHVyuu093yR+/DFg4GfPMcCrxezMQZAWNmOzM2e3Sfa2GTBI9rwhoOVGIkgLT+K2G7nbpBkb/jAY3CBkC0SLRP22+2+eSTMAHWZPpBaDBLMbPGzSDGwGDAYSRPjl4ByDBMNtZ9KMLYF+4ZE486wAv5bjzQcfvKmokzc7fvjhDWCIyfG3J2/AqwUEmHiQXMJDUDkIMP4gStkoGAWjYBSMWAAAqf9Iebl9PkEAAAAASUVORK5CYII=\",\"orcid\":\"\",\"institution\":\"University of California, San Francisco\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Molly\",\"middleName\":\"\",\"lastName\":\"Zeme\",\"suffix\":\"\"},{\"id\":631825988,\"identity\":\"001dc969-a1b1-44b2-b427-d6e3d7c2e3f0\",\"order_by\":1,\"name\":\"Jeannette Lager\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University of California, San Francisco\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jeannette\",\"middleName\":\"\",\"lastName\":\"Lager\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-03-23 18:53:13\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-9203856/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-9203856/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":108491794,\"identity\":\"70fab9f5-45e0-4f65-86c2-a2b92374e89e\",\"added_by\":\"auto\",\"created_at\":\"2026-05-05 09:55:35\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":155907,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9203856/v1/134121c2-2d4d-480e-94f7-b10d6744af5f.pdf\"},{\"id\":108241630,\"identity\":\"e5619b59-5f46-4719-aff8-f3fcf1bdd23b\",\"added_by\":\"auto\",\"created_at\":\"2026-04-30 20:56:43\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":1124597,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"ExhibitA.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9203856/v1/257794630d1e409b92be65fa.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"The Labor \\u0026 Delivery Clerkship Experience for Students: Optimizing Learning in a Complex Clinical Environment\",\"fulltext\":[{\"header\":\"Background\",\"content\":\"\\u003cp\\u003eStudies have shown that the Ob/Gyn clerkship, particularly labor \\u0026amp; delivery (L\\u0026amp;D), can pose unique challenges for medical students. One contributing factor is residents\\u0026rsquo; availability to teach students, as residents make up a significant component of students\\u0026rsquo; learning on their clinical rotations\\u003csup\\u003e\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e\\u003c/sup\\u003e. Despite residents\\u0026rsquo; vital role in student learning, they are often characterized as less\\u003c/p\\u003e \\u003cp\\u003eeffective teachers within the Ob/Gyn clerkship, largely due to their clinical workload\\u003csup\\u003e\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e\\u003c/sup\\u003e. This\\u003c/p\\u003e \\u003cp\\u003eworkload can particularly constrain Ob/Gyn residents on L\\u0026amp;D, as studies have demonstrated\\u003c/p\\u003e \\u003cp\\u003etheir significant time pressures due to clinical duties\\u003csup\\u003e\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eThe sensitivity of exams and experiences patients may have in the field contributes to these challenges as well, especially regarding students\\u0026rsquo; abilities to find appropriate roles. Patients decline student participation in exams at higher rates within Ob/Gyn, often due to preference for female-identifying students but also due to requests for no student presence\\u003csup\\u003e\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e\\u003c/sup\\u003e. Another reason for decreased student participation is that pregnant patients may understandably want control over their birthing experience, and their preferences may not include students\\u003csup\\u003e\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eAlthough studies have characterized the Ob/Gyn clerkship as unique yet challenging, much of\\u003c/p\\u003e \\u003cp\\u003ethe literature around preparing students for the clerkship utilizes materials geared towards\\u003c/p\\u003e \\u003cp\\u003emedicine and surgery rotations\\u003csup\\u003e\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e\\u003c/sup\\u003e. Though helpful at times, borrowing these materials neglects the\\u003c/p\\u003e \\u003cp\\u003enuances within Ob/Gyn, such as the prevalence of sensitive exams and gender-affirming care and\\u003c/p\\u003e \\u003cp\\u003ethe elevated importance of situational awareness and a trauma-informed approach\\u003csup\\u003e\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eDespite the literature dedicated to obstacles students and residents may face around learning and\\u003c/p\\u003e \\u003cp\\u003eteaching in Ob/Gyn, there is a gap in studies looking at ways to improve the clerkship\\u003c/p\\u003e \\u003cp\\u003eexperience. This is essential knowledge for institutions to have, as it will maximize student\\u003c/p\\u003e \\u003cp\\u003elearning and enable the team to function more smoothly. Moreover, students understanding the\\u003c/p\\u003e \\u003cp\\u003eways in which they can best contribute to their teams will not only improve their learning but\\u003c/p\\u003e \\u003cp\\u003ealso allow them to reduce the workload on other team members. This project aims to examine\\u003c/p\\u003e \\u003cp\\u003ethe medical student experience on labor \\u0026amp; delivery and determine how students can be better\\u003c/p\\u003e \\u003cp\\u003eoriented to their roles.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStudy Design:\\u003c/h2\\u003e \\u003cp\\u003eThis is a qualitative study using a phenomenological approach. This approach seeks to identify\\u003c/p\\u003e \\u003cp\\u003eand describe aspects of the Ob/Gyn clerkship through the subjective lived experiences of\\u003c/p\\u003e \\u003cp\\u003eparticipants through their viewpoints shared in surveys and interviews.\\u003csup\\u003e\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e\\u003c/sup\\u003e Questions were designed\\u003c/p\\u003e \\u003cp\\u003eto be open-ended to promote new perspectives and capture authentic experiences. More\\u003c/p\\u003e \\u003cp\\u003especifically, we employed an interpretive phenomenological approach, which allows the\\u003c/p\\u003e \\u003cp\\u003eresearcher to take on an active role in the interpretation of data.\\u003csup\\u003e\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u003c/sup\\u003e This is appropriate for this study\\u003c/p\\u003e \\u003cp\\u003eas the primary researcher is a medical student who completed the Ob/Gyn clerkship and is\\u003c/p\\u003e \\u003cp\\u003etherefore not free of bias. Through this approach, we reflect upon participants\\u0026rsquo; experiences while\\u003c/p\\u003e \\u003cp\\u003esimultaneously reflecting upon personal experiences of the researchers.\\u003csup\\u003e\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u003c/sup\\u003e These dual reflections\\u003c/p\\u003e \\u003cp\\u003eallow for a nuanced analysis which uses various pieces of data to create an understanding of the\\u003c/p\\u003e \\u003cp\\u003eoverall phenomena of the Ob/Gyn clerkship experience.\\u003csup\\u003e\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eParticipants and Setting:\\u003c/h3\\u003e\\n\\u003cp\\u003eThe study was limited to a large urban academic medical center across multiple sites, including a\\u003c/p\\u003e \\u003cp\\u003esafety-net community hospital and a quaternary-level specialty care center. The study included\\u003c/p\\u003e \\u003cp\\u003eUCSF third and fourth-year medical students who completed their Ob/Gyn clerkship, which is\\u003c/p\\u003e \\u003cp\\u003esix weeks long. The study focuses on the L\\u0026amp;D learning environment.\\u003c/p\\u003e\\n\\u003ch3\\u003eSampling and Recruitment Strategy\\u003c/h3\\u003e\\n\\u003cp\\u003e We reached participants primarily via email. We sent out emails over the listservs for the third-\\u003c/p\\u003e \\u003cp\\u003eyear and fourth-year medical school classes. For incentivization, students were entered into a\\u003c/p\\u003e \\u003cp\\u003eraffle to win a \\u003cspan\\u003e$\\u003c/span\\u003e30 gift card of their choosing upon completion of the survey. Students were also made aware that their survey responses would be anonymized and no personal information from\\u003c/p\\u003e \\u003cp\\u003ethem would be collected, in order for students to feel comfortable expressing any viewpoints. This information was communicated to students in the outreach emails as well as within the survey itself. Informed consent to participate was obtained from all of the participants in the study.\\u003c/p\\u003e\\n\\u003ch3\\u003eData Collection:\\u003c/h3\\u003e\\n\\u003cp\\u003eWe used surveys and interviews to assess students\\u0026rsquo; experiences. The survey sent to students\\u003c/p\\u003e \\u003cp\\u003econtained a combination of multiple-choice and free-response questions. The survey also had a\\u003c/p\\u003e \\u003cp\\u003eplace for students to express their willingness to participate in interviews about their experiences.\\u003c/p\\u003e \\u003cp\\u003eFollowing the survey portion of the data collection, we conducted phone interviews with three\\u003c/p\\u003e \\u003cp\\u003ethird-year medical students and three fourth-year medical students. Both the surveys and\\u003c/p\\u003e \\u003cp\\u003e interviews asked participants questions about their level of confusion about their role, what\\u003c/p\\u003e \\u003cp\\u003einformation, instructions, or resources would have helped their experiences, their ability to\\u003c/p\\u003e \\u003cp\\u003econtribute to the team, and any negative experiences they had.\\u003c/p\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eThere were 32 survey respondents, 50% of which were third-year students and 50% fourth-year\\u003c/p\\u003e \\u003cp\\u003estudents. Below are the quantitative findings from the survey data. Questions utilized a scale of\\u003c/p\\u003e \\u003cp\\u003e1\\u0026ndash;5 for students to choose from, with 5 being the best.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"No\\\" id=\\\"Taba\\\" border=\\\"1\\\"\\u003e \\u003ccolgroup cols=\\\"2\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eQuestion\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eAverage\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHow would you rate your L\\u0026amp;D experience overall?\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3.53\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHow clear was your role as a student on L\\u0026amp;D?\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2.75\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHow much did you feel you were able to meaningfully contribute to your L\\u0026amp;D team?\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2.71\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHow much of your day on L\\u0026amp;D did you spend on down time?\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4.37 hours (assuming a full\\u003c/p\\u003e \\u003cp\\u003eday for students\\u0026thinsp;=\\u0026thinsp;10 hours)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eIn the free response section of surveys and during interviews, students discussed how having\\u003c/p\\u003e \\u003cp\\u003emore clarity on the L\\u0026amp;D workflow and students\\u0026rsquo; roles would have helped their experiences, as\\u003c/p\\u003e \\u003cp\\u003ewell as a list of tasks students could do to contribute. One student explained, \\u0026ldquo;Because of the\\u003c/p\\u003e \\u003cp\\u003enature of L\\u0026amp;D the role of students feels more limited than other rotations. A list of things that\\u003c/p\\u003e \\u003cp\\u003emedical students can do to help or to make the most out of their time would be nice.\\u0026rdquo; Students\\u003c/p\\u003e \\u003cp\\u003ealso recognized how the complex and sensitive nature of L\\u0026amp;D contributed to some of this\\u003c/p\\u003e \\u003cp\\u003econfusion. \\u0026ldquo;I wasn't sure what I could contribute or what was appropriate to contribute,\\u0026rdquo; a\\u003c/p\\u003e \\u003cp\\u003estudent stated, \\u0026ldquo;It also didn't feel like a place for me to contribute either especially since the\\u003c/p\\u003e \\u003cp\\u003epatients need to rest.\\u0026rdquo; Other students expressed disappointment in not being able to do as many\\u003c/p\\u003e \\u003cp\\u003eclinical tasks compared to other rotations. Multiple students explained how they were surprised\\u003c/p\\u003e \\u003cp\\u003ewhen residents did not offer for them to help with clinical tasks they did regularly on other\\u003c/p\\u003e \\u003cp\\u003erotations, such as leading discussions with patients, giving presentations, and writing notes.\\u003c/p\\u003e \\u003cp\\u003eStudents also felt that there was not a defined point person on L\\u0026amp;D for them to go to, similar to\\u003c/p\\u003e \\u003cp\\u003ethe senior or chief resident on their medicine and surgery teams. Lastly, another common theme\\u003c/p\\u003e \\u003cp\\u003ethat emerged in the survey and interviews was students\\u0026rsquo; experience of decreased teaching from\\u003c/p\\u003e \\u003cp\\u003eresidents when compared to other clerkships.\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eOverall, students endorsed feeling a significant level of confusion about their roles and decreased\\u003c/p\\u003e \\u003cp\\u003eability to contribute to the team while on L\\u0026amp;D. Students expressed a clear desire for more\\u003c/p\\u003e \\u003cp\\u003eguidance on the service, especially relating to the workflow of L\\u0026amp;D and their roles. Moreover,\\u003c/p\\u003e \\u003cp\\u003ethere appeared to be a discrepancy between student expectations going into the clerkship and\\u003c/p\\u003e \\u003cp\\u003etheir experiences. Students held initial expectations that L\\u0026amp;D would not differ significantly from\\u003c/p\\u003e \\u003cp\\u003eother services. Therefore, students entered the service expecting a clearly defined role, including\\u003c/p\\u003e \\u003cp\\u003eassigned patients to follow each day and specific residents to collaborate with on their patients.\\u003c/p\\u003e \\u003cp\\u003eHowever, they instead were faced with a more unpredictable service, less structured roles, and\\u003c/p\\u003e \\u003cp\\u003esometimes less hands-on experience and dedicated teaching from residents.\\u003c/p\\u003e \\u003cp\\u003eIt is no news that L\\u0026amp;D is a fast-paced and often unpredictable service- it\\u0026rsquo;s hard to be certain\\u003c/p\\u003e \\u003cp\\u003ewhen someone will deliver, if someone might need urgent interventions, or if someone might\\u003c/p\\u003e \\u003cp\\u003edecline student participation. Though this is standard for Ob/Gyn providers, students are likely to\\u003c/p\\u003e \\u003cp\\u003ebe unaware of this prior to their clerkship. Their uncertainty around how to contribute and what\\u003c/p\\u003e \\u003cp\\u003eis appropriate, and discrepancies between their expectations and experiences, demonstrate the\\u003c/p\\u003e \\u003cp\\u003eneed for better orientation and expectation setting for L\\u0026amp;D.\\u003c/p\\u003e \\u003cp\\u003eTo address these needs, we added additional information and resources to students\\u0026rsquo; Ob/Gyn\\u003c/p\\u003e \\u003cp\\u003eclerkship preparation. Students received a detailed L\\u0026amp;D workflow, which outlined the schedule\\u003c/p\\u003e \\u003cp\\u003efor the day, providers\\u0026rsquo; roles, what students should be doing and the respective point people for\\u003c/p\\u003e \\u003cp\\u003ethose tasks, as well as suggestions for learning opportunities during downtime (see Exhibit A).\\u003c/p\\u003e \\u003cp\\u003eStudents also received a clerkship tips sheet (see Exhibit B). The tips sheet provides students\\u003c/p\\u003e \\u003cp\\u003ewith clear expectations for L\\u0026amp;D and how it will differ from past experiences, explaining how the\\u003c/p\\u003e \\u003cp\\u003eunpredictable, fast-paced, and sensitive nature of the service can make it challenging for team\\u003c/p\\u003e \\u003cp\\u003emembers to provide structured roles to students and one-on-one teaching. The tips sheet also\\u003c/p\\u003e \\u003cp\\u003eguides students to additional resources for support, including the workflow document, as well as\\u003c/p\\u003e \\u003cp\\u003eprovides suggestions for topics to review prior to L\\u0026amp;D to help them maximize their time on\\u003c/p\\u003e \\u003cp\\u003eservice.\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eL\\u0026amp;D is a uniquely challenging clerkship experience for students. Students endorsed feeling\\u003c/p\\u003e \\u003cp\\u003econfused about their roles and how to contribute. In order to improve students\\u0026rsquo; and providers\\u0026rsquo;\\u003c/p\\u003e \\u003cp\\u003eexperiences during the clerkship, we created additional resources to clarify the L\\u0026amp;D workflow\\u003c/p\\u003e \\u003cp\\u003eand expectations. Our hope is that these resources will better prepare students for the unique and\\u003c/p\\u003e \\u003cp\\u003eexciting experience of L\\u0026amp;D and help them maximize their time on service. In the future, projects\\u003c/p\\u003e \\u003cp\\u003eshould investigate how these new resources improved students\\u0026rsquo; experiences.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e \\u003cstrong\\u003eEthics approval:\\u003c/strong\\u003e \\u003cp\\u003e Ethical approval was sought from the University of California, San Francisco Institutional Review Board (IRB #: 24-42312). This study was deemed exempt. All procedures were conducted in accordance with and adhered to the Declaration of Helsinki.\\u003c/p\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cstrong\\u003eConsent to participate:\\u003c/strong\\u003e \\u003cp\\u003eInformed consent to participate was obtained from all of the participants in the study.\\u003c/p\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cstrong\\u003eConsent for publication:\\u003c/strong\\u003e \\u003cp\\u003eNot Applicable.\\u003c/p\\u003e \\u003c/p\\u003e\\u003ch2\\u003eFunding:\\u003c/h2\\u003e \\u003cp\\u003eThis study was partially funded by the UCSF School of Medicine Deep Explore Project Grant.\\u003c/p\\u003e\\u003ch2\\u003eAuthor Contribution\\u003c/h2\\u003e\\u003cp\\u003eMZ and JL created the study design. JL supervised the project. MZ completed data collection and data analysis and interpretation. MZ drafted the manuscript. JL and MZ critically revised and approved the final manuscript.\\u003c/p\\u003e\\u003ch2\\u003eAcknowledgement\\u003c/h2\\u003e\\u003cp\\u003eThe authors are grateful for students\\u0026rsquo; time in providing feedback on their experiences and to Ob/Gyn clerkship administration for their support of implementing changes.\\u003c/p\\u003e\\u003ch2\\u003eData Availability\\u003c/h2\\u003e\\u003cp\\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eCarroll MR, Kilpatrick CC, Johnson G, Sukhavasi N, Ratan BM. Utilizing structured worksheets to strengthen resident teaching on the OB/GYN clerkship. Med Sci Educ. 2021;31(4):1379\\u0026ndash;84.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eReddy ST, Zegarek MH, Fromme HB, Ryan MS, Schumann SA, Harris IB. Barriers and facilitators to effective feedback: a qualitative analysis of data from multispecialty resident focus groups. J Grad Med Educ. 2015;7(2):214\\u0026ndash;9.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJiang X, Altomare C, Egan JF, Tocco DB, Schnatz PF. The ObGyn clerkship: are students denied the opportunity to provide patient care and what is the role of gender? Conn Med. 2012;76(4):231\\u0026ndash;6.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBuck K, Littleton H. Impact of educational messages on patient acceptance of male medical students in OB-GYN encounters. J Psychosom Obstet Gynaecol. 2016;37(3):84\\u0026ndash;90.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHopkins-Kotb N, Sylla H, Krotinger A, Pelletier A, Bartz DA, Johnson NR. A student-informed guide for success on the OB/GYN clerkship. J Med Educ Curric Dev. 2025;12:23821205241299584.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eStenfors-Hayes T, Hult H, Dahlgren MA. A phenomenographic approach to research in medical education. Med Educ. 2013;47(3):261\\u0026ndash;70.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eNeubauer BE, Witkop CT, Varpio L. How phenomenology can help us learn from the experiences of others. Perspect Med Educ. 2019;8(2):90\\u0026ndash;7.\\u003c/span\\u003e\\u003c/li\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-medical-education\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"meed\",\"sideBox\":\"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/meed/default.aspx\",\"title\":\"BMC Medical Education\",\"twitterHandle\":\"BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-9203856/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-9203856/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003eBackground:\\u003c/p\\u003e\\n\\u003cp\\u003eThe Ob/Gyn clerkship, particularly labor \\u0026amp; delivery (L\\u0026amp;D), can pose unique challenges for\\u003c/p\\u003e\\n\\u003cp\\u003emedical students. Although studies have characterized the Ob/Gyn clerkship as unique yet challenging, much of the literature around preparing students for the clerkship utilizes\\u003c/p\\u003e\\n\\u003cp\\u003ematerials geared towards medicine and surgery rotations. Though helpful at times, borrowing\\u003c/p\\u003e\\n\\u003cp\\u003ethese materials neglects the nuances within Ob/Gyn, such as the prevalence of sensitive exams,\\u003c/p\\u003e\\n\\u003cp\\u003egender-affirming care, and the elevated importance of utilizing a trauma-informed approach.\\u003c/p\\u003e\\n\\u003cp\\u003eImproving the clerkship experience for students, including with more clearly defined roles, will\\u003c/p\\u003e\\n\\u003cp\\u003enot only enhance student learning but also allow them to reduce the workload on other team\\u003c/p\\u003e\\n\\u003cp\\u003emembers.\\u003c/p\\u003e\\n\\u003cp\\u003eMethods:\\u003c/p\\u003e\\n\\u003cp\\u003eThe study included UCSF third and fourth-year medical students who completed their Ob/Gyn Clerkships and focuses on the L\\u0026amp;D learning environment. We reached participants via email. The survey contained multiple-choice and free-response questions. We also conducted interviews with third and fourth year students.\\u003c/p\\u003e\\n\\u003cp\\u003eResults:\\u003c/p\\u003e\\n\\u003cp\\u003eThere were 32 survey respondents, 50% of which were third-year students and 50% fourth-year\\u003c/p\\u003e\\n\\u003cp\\u003estudents. On a scale of 1-5, with 5 being the best, students rated their L\\u0026amp;D experience overall as 3.53, the clarity of their role on L\\u0026amp;D as 2.75, and their ability to contribute meaningfully to their L\\u0026amp;D team as 2.71. The average daily downtime they endorsed spending on L\\u0026amp;D was 4.37 hours. In addition, students expressed a desire for more clarity on the L\\u0026amp;D workflow and their roles. They also expressed disappointment in having decreased hands-on opportunities and guidance from residents compared to other rotations.\\u003c/p\\u003e\\n\\u003cp\\u003eConclusions:\\u003c/p\\u003e\\n\\u003cp\\u003eStudents’ uncertainty around how to contribute and discrepancies between their expectations and experiences demonstrate the need for better orientation to L\\u0026amp;D. To address this, we added two resources for students: the L\\u0026amp;D Workflow, which outlines the daily schedule and different team members’ roles, and a Tips Sheet, which provides students with clear expectations for L\\u0026amp;D. We hope these resources better prepare students for the unique and exciting experience of L\\u0026amp;D and help them maximize their time on service.\\u003c/p\\u003e\",\"manuscriptTitle\":\"The Labor \\u0026amp; Delivery Clerkship Experience for Students: Optimizing Learning in a Complex Clinical Environment\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-04-30 20:56:39\",\"doi\":\"10.21203/rs.3.rs-9203856/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"reviewerAgreed\",\"content\":\"58423775279112829603699579462812301028\",\"date\":\"2026-04-22T18:43:16+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-04-22T18:38:10+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-04-01T05:57:19+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvited\",\"content\":\"\",\"date\":\"2026-03-27T18:14:45+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-03-26T17:09:14+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"BMC Medical Education\",\"date\":\"2026-03-26T17:05:05+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-medical-education\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"meed\",\"sideBox\":\"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/meed/default.aspx\",\"title\":\"BMC Medical Education\",\"twitterHandle\":\"BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"04ade02c-57a0-41bf-9128-85684936bad3\",\"owner\":[],\"postedDate\":\"April 30th, 2026\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"under-review\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-04-30T20:56:39+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-04-30 20:56:39\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-9203856\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-9203856\",\"identity\":\"rs-9203856\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}