Download LEARNING OBJECTIVES for Obstetrics and Gynecology CLINICAL

LEARNING OBJECTIVES for Obstetrics and Gynecology
CLINICAL SCIENCE
Approach to the Patient
1. The student will become comfortable with a gynecologic evaluation and assessment.
2. Demonstrate a comprehensive women's medical interview including menstrual history, obstetrical
history, gynecologic history, contraceptive history, sexual history, family history and social history
and be able to present this in written and oral form.
3. Demonstrate interpersonal skills that build trust by addressing contextual factors (i.e. Culture,
ethnicity, language, literacy, socioeconomic class, spirituality/religion, age, sexual orientation,
disability).
4. Recognize the value of routine health surveillance as part of health promotion and disease
prevention.
5. Demonstrate the ability to perform an accurate pelvic and breast exam in a sensitive manner and
communicate the relevant findings using accurate & concise medical terminology in written & oral
reports.
6. Demonstrate knowledge of general pelvic anatomy- organs, vasculature, nerves, and lymph system.
7. Properly obtain specimens to detect sexually transmitted infections [cultures & wet prep].
8. Demonstrates the ability to educate patients regarding self breast examination.
9. Can list age appropriate screening procedures (mammograms, pap tests, bone density, STIs).
10. Can counsel patients on immunizations (in pregnant and non-pregnant state).
Normal Obstetrics
1. Demonstrate knowledge of the physiologic adaptions to pregnancy; allowing them to better
understand the impact of pregnancy in health and disease
2. Understand the process of normal labor and delivery allowing for optimal care and timely
recognition of abnormal events.
3. Understand and appropriately assign gravity and parity for a given patient.
4. Perform basic prenatal exam: including but not limited to assessing fundal height & FHT's.
5. Understand timing of prenatal laboratory and standard ultrasound evaluation.
6. Recognize how certain medical conditions affect pregnancy.
7. Counsel patients regarding substance abuse during pregnancy.
8. Can diagnose pregnancy.
9. Can assess gestational age by Nagel's rule, wheel and computer based applications.
10. Distinguish at risk pregnancy.
11. Perform fetal auscultation.
12. Interpret electronic fetal monitoring.
13. Describe basic management of fetal heart rate deceleration.
14. List the signs and symptoms of labor.
15. Describe the 3 stages of labor and recognize common abnormalities.
16. Describe and demonstrate the steps of a vaginal delivery.
17. State the evaluation of common puerperal complications.
18. Describe the components of normal postpartum care.
19. List the reasons why breastfeeding should be encouraged.
20. Summarize the physical findings and diagnostic methods to confirm rupture of membranes.
Abnormal Obstetrics
1. The student should value that medical and surgical conditions may alter the course of pregnancy
and pregnancy may have an impact on the management of these conditions.
2. Develop a differential diagnosis for bleeding and abdominal pain in the first trimester.
3. Identify risk factors for an ectopic pregnancy.
4. Be able to evaluate a patient suspected of having an ectopic pregnancy.
5. Discuss the impact the following medical conditions may have on pregnancy: anemia, diabetes, UTI,
herpes, rubella, group B strep, hepatitis, HIV, cytomegalovirus, toxoplasmosis, varicella, parvovirus,
cardiac disease, asthma, surgical abdomen.
6. Define hypertension in pregnancy.
7. Enumerate the symptoms of preeclampsia and eclampsia.
8. Summarize the physical findings of preeclampsia and eclampsia.
9. List the causes of 3rd trimester bleeding.
10. Differentiate the signs and symptoms of 3rd trimester bleeding.
11. Describe the initial management plan for shock secondary to acute blood loss.
12. Site the risk factors for preterm labor.
13. Counsel the patient regarding the signs and symptoms of preterm labor.
14. Formulate a differential diagnosis of postpartum hemorrhage.
15. Describe the immediate management of the patients with postpartum hemorrhage.
16. Site the risk factors for PPROM and know how to diagnose.
17. Describe basic initial management for PTL, PPROM and PRE-E.
18. Identify risk factors and diagnose postpartum blues, depression and psychosis.
Gynecology
1. Understand the medical and personal issues involved in decisions regarding contraceptive methods
and they should feel comfortable presenting these options to their patients.
2. Understand the basic epidemiology, diagnosis and management of sexually transmitted infections.
3. Understand the basic approach to evaluating the common symptoms associated with the breast.
4. Evaluation and management of gynecologic problems frequently requires performing diagnostic and
therapeutic surgical procedures. Understand the risks and benefits associated with such
procedures.
5. Counsel patients regarding the benefits and risks of each form of contraception.
6. Explain surgical and non-surgical methods of pregnancy termination.
7. Provide non-directive counseling to patients surrounding pregnancy options.
8. Diagnose and manage and patient with vaginitis.
9. Interpret a wet mount microscopic examination.
10. Describe dermatologic disorders of the vulva.
11. Differentiate the signs and symptoms; list the physical exam findings and describe the management
of the following sexually transmitted infections: gonorrhea, chlamydia, herpes, HIV, pelvic
inflammatory disease.
12. Identify the long-term sequelae of pelvic inflammatory disease.
13. List the symptoms of endometriosis and physical exam findings.
14. Define chronic pelvic pain and describe clinical manifestations.
15. Discuss the diagnostic approach to women with a breast mass, nipple discharge or br pain.
16. List the physical exam findings that may suggest the following: mastitis, br cancer, fibrocystic
changes, intraductal papilloma, fibroma.
17. Be able to demonstrate basic knot tying & suturing skills.
Reproductive Endocrinology and Infertility
1. Understand a systematic approach to evaluation, diagnosis and treatment of abnormal uterine
bleeding.
2. Understand the physical and emotional changes caused by menopause.
3. Define amenorrhea and oligomenorrhea and their etiologies.
4. Define abnormal uterine bleeding.
5. Describe the etiologies of abnormal uterine bleeding.
6. Discuss the evaluation methods of abnormal uterine bleeding.
7. Define primary and secondary dysmenorrhea.
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Identify etiologies of dysmenorrhea.
Describe the evaluation and management of dysmenorrhea.
Describe the appropriate management of menopausal/perimenopausal symptoms.
Define infertility.
Describe causes of male and female infertility.
Describe basic work up of infertility couple.
Neoplasia
1. Understand the basics of the diagnosis and management of precancerous and cancerous lesions of
the female genital tract.
2. Describe the risk factors for vulvar neoplasms.
3. Identify the risk factors for cervical neoplasia and cancer.
4. Describe the management of patients with an abnormal pap smear.
5. Describe symptoms and physical findings in patients with uterine fibroids.
6. List the risk factors for endometrial cancer.
7. Describe the symptoms and physical findings of a patient with endometrial cancer.
8. Outline the appropriate management of the patient with postmenopausal bleeding.
9. Outline the approach to a patient with an adnexal mass.
10. Compare the characteristics of functional cysts, benign ovarian neoplasms and ovarian malignancy.
11. Describe the symptoms and physical findings of a patient with an ovarian malignancy.
12. List risk factors for ovarian cancer.
Urogynecology/Female Pelvic Medicine and Reconstructive Surgery
1. Explain the anatomic structures of pelvic support and how the pelvis is built for support.
2. Describe the causes of pelvic organ prolapse, how common it is, and what is its natural history.
3. Define and describe the different kinds of pelvic organ prolapse
4. Discuss first line treatment for pelvic organ prolapse
5. Define and classify the different types of urinary incontinence.
6. Discuss first line treatment options for urinary incontinence
7. Understand the definition of basic urinary complaints such as interstitial cystitis, overactive
bladder as well as urinary tract infection, as well as first line evaluation and management
8. Be able to interpret basic urinalysis and urine culture
9. Be proficient catheterizing a female patient
Human Sexuality
1. Provide a preliminary assessment of patients with sexual concerns.
2. Categorize common patterns of female sexual dysfunction.
Violence Against Women
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Recognize individuals of sexual assault often have significant physical and emotional sequelae.
Cite the prevalence and incidence of violence against women.
Assess the involvement of any patient in domestic violence situations.
Counsel patients for short-term safety.
BASIC SCIENCE
Normal Obstetrics
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Discuss maternal physiologic changes in pregnancy.
Describe the physiologic functions of the placenta.
Report nutritional needs of pregnant women.
List the normal physiologic and anatomic changes of the breast during pregnancy and lactation.
Identify commonly used medications which are appropriate/inappropriate to use while
breastfeeding
Abnormal Obstetrics
1. Discuss the use of immunoglobulin prophylaxis to prevent isoimmunization.
2. Discuss the etiology of monozygotic, dizygotic and multizygotic gestation.
Gynecology
1. Describe the physiologic basis of contraception (OCPs, emergency contraception, patch, vaginal ring,
depo provera, implanon, IUD, and sterilization).
2. Describe the effectiveness of each form of contraception.
Reproductive Endocrinology and Infertility
1. Illustrate the normal menstrual cycle.
RESEARCH
1. Students will utilize evidence based resources in answering clinical questions, when applicable.
INTERPROFESSIONALISM
1. The student should consider themselves part of the healthcare team and should have opportunities
to cooperatively interact with other members of the team.
2. Establishes rapport with patients.
3. Works cooperatively with members of the healthcare team.