Development, Reliability, and Initial Validation of the Fear of Institutional Betrayal Questionnaire.

Residency training (RT) represents the transition from undergraduate medical education to independent clinical practice and plays a fundamental role in preparing competent obstetricians. Compared with many other medical specialties, obstetrics presents distinctive educational challenges because clinicians must frequently manage unpredictable emergencies involving both maternal and fetal wellbeing. Obstetric residents are therefore expected to integrate theoretical knowledge with rapid clinical reasoning, timely decision-making, technical proficiency, and effective multidisciplinary teamwork in high-pressure situations. These characteristics make obstetrics one of the most demanding specialties for competency-based medical education. The complexity of obstetric practice has increased worldwide in recent years. Rising maternal age, increasing rates of cesarean delivery, growing numbers of pregnancies complicated by chronic medical conditions, and advances in reproductive medicine have contributed to a higher proportion of high-risk pregnancies. These changes have increased the complexity of obstetric decision-making and reinforced the need for educational strategies that better prepare residents for real-world clinical practice. Although the specific drivers vary across healthcare systems, improving the quality of obstetrics residency education has become an international priority. Lecture-Based Learning (LBL) remains the predominant teaching approach in many residency programs and continues to play an important role in establishing foundational medical knowledge. Its structured format enables efficient delivery of core concepts and standardized educational content. However, when used as the primary teaching strategy, LBL provides limited opportunities for learners to actively apply knowledge in authentic clinical situations. This limitation is particularly relevant in obstetrics, where successful clinical performance depends not only on knowledge acquisition but also on clinical reasoning, emergency response, communication, and collaborative decision-making. Consequently, there is increasing interest in educational approaches that complement traditional lectures by promoting active learning and clinical application.