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CHICAGO MEDICAL SCHOOL Obstetrics and Gynecology MOBG700 SYLLABUS 2016-2017 ACADEMIC YEAR Clerkship Director Richard Trester, MD [email protected] Clerkship Coordinator Sandra Guzeldere Office: (773)257-5098 Cell: (847) 477-9285 CLERKSHIP DESCRIPTION The service is a 6 week core clerkship in Obstetrics and Gynecology. Obstetrics 55%- Gynecology 36% Uro-gynecology 3% Gynecologic Oncology 3% Reproductive Endocrinology Infertility 3% The program is divided into clinic and in-patient services. The clinic service includes both hospital outpatient and office based clinic. The in-patient service includes labor & delivery, obstetrics and gynecologic surgery and nurse midwife services. Students are on a rotating schedule and assigned to a team under the direction the resident chief and or attending. CLERKSHIP OBJECTIVES LINKED TO CMS COMPETENCIES AND OBJECTIVES (see next page)

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CHICAGO MEDICAL SCHOOL

Obstetrics and Gynecology MOBG700

SYLLABUS

2016-2017 ACADEMIC YEAR

Clerkship Director

Richard Trester, MD [email protected]

Clerkship Coordinator

Sandra Guzeldere Office: (773)257-5098 Cell: (847) 477-9285

CLERKSHIP DESCRIPTION

The service is a 6 week core clerkship in Obstetrics and Gynecology. Obstetrics 55%- Gynecology 36% Uro-gynecology 3% Gynecologic Oncology 3% Reproductive Endocrinology Infertility 3%

The program is divided into clinic and in-patient services. The clinic service includes both hospital outpatient and office based clinic. The in-patient service includes labor & delivery, obstetrics and gynecologic surgery and nurse midwife services. Students are on a rotating schedule and assigned to a team under the direction the resident chief and or attending.

CLERKSHIP OBJECTIVES LINKED TO CMS COMPETENCIES AND OBJECTIVES

(see next page)

Page 1

Obstetrics & Gynecology Clerkship Competency Map 2016-2017

I. Medical and Scientific Knowledge: Demonstrate knowledge about established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences and apply this knowledge in caring for ill and healthy patients of all ages. Specifically, the student must demonstrate:

CMS Objective

Course Objective(s)

Learning Activity/ Content

Assessment Method(s)

1.1 Describe the normal structure and function of the body.

Describe the normal structure and function of the body as it relates to the following content domains in obstetric and gynecologic cases/ management:

- General Obstetrics, General Gynecology, Gynecologic Surgery, Endocrinology, Oncology, Uro-Gynecology, Post Menopause.

Identify anatomic landmarks used in ultrasound during the first and second trimester.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Required lecture topics/ presentations attended during clerkship.

Each student will spend one half-day working with the ultrasound simulator. Teaching will focus on principles of ultrasound, image orientation, and first ultrasound. At the end of the session, students will be able to:

1. Identify the uterus, pregnancy, ovaries, endometrium, and cervix.

2. Identify the following 8-week pathologies:

a. Bicornuate Uterus b. Blighted Ovum c. Twins Dichorionic-Diamniotic d. Fetal Demise

Performance on NBME Obstetrics & Gynecology Shelf Examination.

Performance on USMLE Step 2CK/ CS as appropriate to obstetrics and gynecology domains.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Completion of all required minimum encounters.

Documented attendance at all required lectures.

Direct observation/ evaluation by faculty during ultrasound simulation activity.

Page 2

e. Subchorionic Hematoma

f. Molar Pregnancy g. Twins Monochorionic-Diamniotic

3. Acquire an M-mode tracing of the fetal heart.

1.2 Distinguish the causes and underlying mechanisms of disease.

Distinguish the causes and underlying mechanisms of disease as it relates to the following content domains in obstetric and gynecologic cases/management:

- General Obstetrics, General Gynecology, Gynecologic Surgery, Endocrinology, Oncology, Uro-Gynecology, Post Menopause.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Required lecture topics/ presentations attended during clerkship.

uWISE Questions

Performance on NBME Obstetrics & Gynecology Shelf Examination.

Performance on USMLE Step 2CK/ CS as appropriate to obstetrics and gynecology domains.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Documentation student logged into the uWise system.

Completion of all required minimum encounters.

Documented attendance at all required lectures.

1.3 Identify the epidemiology of common illnesses.

N/A

N/A

N/A

Page 3

1.4 Describe the principles and methods of diagnostic decision-making (to include clinical, laboratory, pathologic and imaging studies).

Describe the principles and methods of diagnostic decision-making in obstetric and gynecologic cases (to include clinical, laboratory, pathologic and imaging studies).

- General Obstetrics, General Gynecology, Gynecologic Surgery, Endocrinology, Oncology, Uro-Gynecology, Post Menopause.

Understand the advantage of transvaginal compared to trans-abdominal ultrasound.

Describe the role of ultrasound in the work up of first trimester pregnancy complications.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Required lecture topics/ presentations attended during clerkship.

uWise Questions

Each student will spend one half-day working with the ultrasound simulator. Teaching will focus on principles of ultrasound, image orientation, and first ultrasound. At the end of the session, students will be able to:

1. Identify the uterus, pregnancy, ovaries, endometrium, and cervix.

2. Identify the following 8-week pathologies:

a. Bicornuate Uterus b. Blighted Ovum c. Twins Dichorionic-Diamniotic d. Fetal Demise e. Subchorionic Hematoma f. Molar Pregnancy g. Twins Monochorionic-Diamniotic

3. Acquire an M-mode tracing of the fetal heart.

Performance on NBME Obstetrics & Gynecology Shelf Examination.

Performance on USMLE Step 2CK/ CS as appropriate to obstetrics and gynecology domains.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Documentation student logged into the uWise system.

Completion of all required minimum encounters.

Documented attendance at all required lectures.

Direct observation/ evaluation by faculty during ultrasound simulation activity.

Page 4

1.5 Describe the principles of therapeutic decision- making.

Describe the principles of therapeutic decision making in

- General Obstetrics, General Gynecology, Gynecologic Surgery, Endocrinology, Oncology, Uro-Gynecology, Post Menopause.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Required lecture topics/ presentations attended during clerkship.

uWise Questions

Performance on NBME Obstetrics & Gynecology Shelf Examination.

Performance on USMLE Step 2CK/ CS as appropriate to obstetrics and gynecology domains.

Direct observation/ evaluation by faculty

Page 5

II. Patient Care and Prevention: Demonstrate patient centered care that is compassionate, appropriate and effective for the

promotion of health, quality of life, prevention of illness, treatment of disease, and the end of life. Specifically, students must:

CMS Objective

Course Objective(s)

Learning Activity/ Content

Assessment Method(s)

2.1 Identify factors that place individuals at risk for disease or injury and use strategies to prevent or slow the disease process.

Identify factors that place individuals at risk for disease or injury and use strategies to prevent or slow the disease process.

- General Obstetrics, General Gynecology, Gynecologic Surgery, Endocrinology, Oncology, Uro-Gynecology, Post Menopause.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

uWise Questions

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Completion of all required minimum encounters.

Documentation student logged into uWise system.

2.2 Perform reliable (comprehensive and problem focused) history and physical examinations.

Participate in the performance of a reliable history and physical exam for obstetrics and gynecology patients with conditions applicable to:

- General Obstetrics, General Gynecology, Gynecologic Surgery, Endocrinology, Oncology, Uro-Gynecology, Post Menopause.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Submit history and physical for faculty review.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Completion of all required minimum encounters.

Faculty reviews history and physical and gives feedback.

2.3 Order and appropriately interpret the results of commonly used diagnostic procedures.

Order and appropriately interpret the results of commonly used diagnostic procedures in obstetrics and gynecology rotations.

Identify pathologies seen in early pregnancy.

Participation in procedures as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Page 6

uWise Questions

Each student will spend one half-day working with the ultrasound simulator. Teaching will focus on principles of ultrasound, image orientation, and first ultrasound. At the end of the session, students will be able to:

1. Identify the uterus, pregnancy, ovaries, endometrium, and cervix.

2. Identify the following 8-week pathologies:

a. Bicornuate Uterus b. Blighted Ovum c. Twins Dichorionic-Diamniotic d. Fetal Demise e. Subchorionic Hematoma f. Molar Pregnancy g. Twins Monochorionic-Diamniotic

3. Acquire an M-mode tracing of the fetal heart.

Completion of the procedure log.

Documentation student logged into uWise system.

Direct observation/ evaluation by faculty during ultrasound simulation activity.

2.4 Perform routine technical procedures.

Perform routine obstetric and gynecologic technical procedures.

- Cervical Cytology Screen/ Pap Test, Colposcopy, Breast Exam, Pelvic Exam, Vaginal Delivery, Cesarean Section

Use ultrasound to estimate the accuracy of pregnancy dating.

Participation in procedures as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Simulation Lab: labor and delivery procedures.

Each student will spend one half-day working with the ultrasound simulator. Teaching will focus on

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Completion of the procedure log.

Documented attendance at

Page 7

principles of ultrasound, image

orientation, and first ultrasound. At the end of the session, students will be able to:

1. Identify the uterus, pregnancy, ovaries, endometrium, and cervix.

2. Identify the following 8-week pathologies:

a. Bicornuate Uterus b. Blighted Ovum c. Twins Dichorionic-Diamniotic d. Fetal Demise e. Subchorionic Hematoma f. Molar Pregnancy g. Twins Monochorionic-Diamniotic

3. Acquire an M-mode tracing of the fetal heart.

the simulation lab.

Direct observation/ evaluation by faculty during ultrasound simulation activity.

2.5 Construct appropriate diagnostic and therapeutic strategies for patients with common acute and chronic conditions.

Construct appropriate diagnostic and therapeutic strategies for patients with common acute and chronic conditions:

- General Obstetrics, General Gynecology, Gynecologic Surgery, Endocrinology, Oncology, Uro-Gynecology, Post Menopause.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Submit history and physical for faculty review.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Completion of all required minimum encounters.

Faculty reviews history and physical and gives feedback

2.6 Provide effective education to patients and their families.

N/A

N/A

N/A

Page 8

III. Professionalism and self-awareness: Demonstrate a commitment to professional services, adherence to ethical principles, and awareness of one’s own interests and vulnerabilities. Specifically, students must:

CMS Objective

Course Objective(s)

Learning Activity/ Content

Assessment Method(s)

3.1 Apply the theories and principles that govern ethical decision-making in medicine.

Apply the theories and principles that govern ethical decision-making in obstetrics and gynecology care.

Recognize and address ethical issues that arise during patient encounters.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Discussion of cases with faculty on the appropriate role of a medical student, resident, attending physician, as well as other members of the healthcare team.

Required lecture topics/ presentations attended during clerkship.

Clinical Ethics assignment

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Completion of all required minimum encounters.

Documented attendance at ethics lecture.

Review of clinical ethics assignment by faculty mid- clerkship

3.2 Demonstrate respect, dignity, compassion and integrity when engaging patients, their families, peers, the university community and other healthcare providers.

Demonstrate respect, dignity, compassion and integrity when engaging patients, their families, peers, the university community and other healthcare providers in the context of Obstetrics and Gynecology.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Discussion with faculty on the appropriate role of a medical student, resident, attending physician, as well as other members of the healthcare team

Follows clerkship policies and requirements

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Completion of all required minimum encounters and logs them in one45.

Documented attendance at ethics lecture.

Page 9

Required lecture topics/

presentations attended during clerkship.

Completes assignments on time, is punctual and has good attendance.

3.3 Recognize how one’s own limitations, personal biases and vulnerabilities may impact patient care and interactions with other healthcare providers.

Recognize one’s own limitations, biases, and vulnerabilities may impact care of the surgical patient and interactions with other providers on the obstetrics and gynecology teams.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Discussion of cases with faculty on the appropriate role of a medical student, resident, attending physician, as well as other members of the healthcare team.

Self-evaluation completed mid clerkship.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Completion of all required minimum encounters.

Review self-evaluation document with faculty.

3.4 Seek and respond appropriately to performance feedback.

Seek and respond appropriately to performance feedback during obstetrics and gynecology rotations.

Complete all mid-term and end of clerkship logging requirements.

Meet with clerkship/site director or designated faculty for mid-clerkship evaluation.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Integration of feedback into practice habits and clinical performance.

Faculty documentation of feedback on self-evaluation form.

Page 10

IV. Practice-Based, Life-Long Learning: Demonstrate the ability to appraise and assimilate scientific evidence to evaluate and

improve patient care practices. Specifically, students must:

CMS Objective

Course Objective(s)

Learning Activity/ Content

Assessment Method(s)

4.1 Search for, evaluate, and apply evidence-based medicine for solving clinical problems.

Search for, evaluate, and apply evidence-based medicine for solving obstetric and gynecologic clinical problems.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Discussion of cases with faculty with particular emphasis on current best practices for managing common obstetric and gynecologic conditions and presentations.

Student gives at least one lecture topic presentation with evidence based references.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Faculty observes presentation and stated evidence based references.

4.2 Apply current technology to access, manage, and use biomedical information in the context of patient care.

Read and present on clinical questions that arise during patient encounters.

Assess evidence based literature and apply it to clinical problems/situations:

- General Obstetrics, General Gynecology, Gynecologic Surgery, Endocrinology, Oncology, Uro-Gynecology, Post Menopause.

- Cervical Cytology Screen/ Pap Test, Colposcopy, Breast Exam, Pelvic Exam, Vaginal Delivery, Cesarean Section.

Student attends lecture on a technology topic.

uWISE Questions

Documented attendance at technology topic lecture.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Performance on NBME Obstetrics & Gynecology Shelf Examination.

Documentation student logged into uWISE system.

Page 11

4.3 Develop the ability to self-assess and demonstrate a willingness to engage in reflective practice.

Develop the ability to self-assess and demonstrate a willingness to engage in reflective practice during obstetric and gynecology rotations.

Complete all mid-term and end of clerkship logging requirements.

Meet with clerkship/site director or designated faculty for mid-clerkship evaluation.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Integration of feedback into practice habits and clinical performance.

Faculty documentation of feedback on self-evaluation form.

4.4 Provide constructive feedback to peers/ colleagues aimed at fostering professional growth and improving patient care.

N/A

N/A

N/A

Page 12

V. Systems-based, Interprofessional Practice: Demonstrate and awareness of and responsiveness to the larger context of health

care and be able to call on system resources and other health care professionals to provide optimal care. Specifically, students must:

CMS Objective

Course Objective(s)

Learning Activity/ Content

Assessment Method(s)

5.1 Identify one’s own role on the healthcare team and how it is complementary to other health professionals in the delivery of patient care.

Identify one’s own role as a physician on the obstetric and gynecologic team and how it relates to other members of the healthcare team.

In small groups, participate in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document, as well as during simulation lab, and discuss one’s own professional role, identity, and the role of other providers specific to the management of obstetric and gynecologic cases.

Direct observation/ evaluation/feedback by faculty for each student completing the required performance evaluation. Case log review and self-reflection form completion which asks the student to identify their own role on the team and discuss a case perspective of another member of the team including the patient and/or family

5.2 Recognize when and how to initiate the assistance of other healthcare providers in the context of patient care.

Recognize when and how to initiate the assistance of other providers in the context of caring for the obstetric/gynecologic patient to provide high quality interprofessional care.

Participation in simulation lab problem solving exercises which include identifying when and how to initiate assistance of other healthcare professionals in the context of OB/GYN patient care.

Direct observation/ evaluation/feedback by faculty for each student completing the required simulation lab exercises.

Page 13

5.3 Describe various healthcare practice types, delivery systems, and identify interprofessional members of these practices and how they work together to meet the needs of the community.

N/A

N/A

N/A

5.4 Identify systematic interprofessional practices that improve patient safety, minimize error, and contribute to continuous quality improvement.

N/A

N/A

N/A

Page 14

VI. Interpersonal Communication Skills: Demonstrate effective understanding, information exchange, and teamwork with

patients, their families, peers and other health professionals. Specifically, students must:

CMS Objective

Course Objective(s)

Learning Activity/ Content

Assessment Method(s)

6.1 Demonstrate the ability to initiate and sustain professional relationships with patients, their families, and other members of the healthcare team.

Interact effectively with obstetric and gynecologic patients and their families.

Interact effectively with other members of the obstetric and gynecology team.

Communicate effectively with office staff, nurses, and other physicians.

Appreciate patient privacy issues and concerns.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Discussion of cases with faculty with particular emphasis on interpersonal relationships between providers, members of the healthcare team, patients and their families.

Direct observation/ evaluation by faculty completing the required evaluation form.

6.2 Use effective listening, questioning, verbal, nonverbal, and writing skills when communicating with patients and their families.

Demonstrate effective communications skills when interacting with obstetric and gynecologic patients and their families.

Communicate effectively with other members of the healthcare team.

Provide educational materials and discuss the appropriate diagnosis and treatment plan with patients and their families.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Discussion of cases with faculty with particular emphasis on interpersonal relationships between providers, patients and their families.

Direct observation/ evaluation by faculty completing the required evaluation form.

6.3 Prepare and organize comprehensive, timely, and legible medical records.

Prepare and organize comprehensive, timely, and legible medical records for obstetric and gynecologic patients.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Submit history and physical for faculty review.

Completion of all required minimum encounters.

Faculty reviews history and physical and gives feedback.

Page 15

6.4 Use effective verbal presentation and written skills when communicating with colleagues, superiors, and other members of the healthcare team.

Use effective verbal presentation and written skills when communicating with colleagues, superiors, and other members of the obstetric and gynecologic teams.

Participation in patient cases as defined by the Obstetrics & Gynecology Required Patient Encounters Document.

Discussion of cases with faculty with particular emphasis on interpersonal relationships between providers, patients and their families.

Student presents history and physical.

Direct observation/ evaluation by faculty completing the required performance evaluation form.

Faculty reviews history and physical and gives feedback.

EVALUATION, EXAMINATION, AND REMEDIATION POLICIES

See D2L for CMS Clerkship Grading Policy See D2L for Clinical Evaluation Standards See D2L for Teacher-Learner Expectations

For successful completion of the clerkship a minimum number of encounters must be met [D2L Required Patient Encounters]. Students are required to have their logs reviewed at the Midterm Evaluation. If there are any anticipated problems completing the log they should be addressed with the Site Director at that time. The log should be completed by the end of week 5 of the rotation. If a student fails to find a particular required encounter – student should refer to the Remediation Requirement [D2L Required Patient Encounters]. Students who fail to meet this requirement by the end of the clerkship will have their clinical evaluation score for professionalism reduced by 1 point.

If a student misses a Combined Lecture, remediation must include a 1 page chapter review on each topic missed. Page reviews should be emailed to the Clerkship Director before the end of week four - [email protected]

CMS Clerkship Remediation Guidelines

Reference the CMS Clerkship Exam Failure Policy document for specific make-up/retake examination guidelines. [Posted in D2L]

Reference the CMS Excused Absence Policy document for examination and other clinical experience remediation guidelines. [Posted in D2L]

In general, Clerkship Directors will determine how the student will make up patient encounters, clinical activities or other clerkship requirements. Clerkship Directors will determine if and when the student will be required to repeat the clerkship. Clerkship Directors will use case-by- case evaluation and coordinate with the Office of Student Affairs & Education.

ATTENDANCE POLICY

See D2L for Excused Absence Policy. Holiday Schedule: You must follow the holiday schedule for your site, not Chicago Medical School's schedule. Weather Emergencies: If the University is closed due to extreme weather, check with your clinical site regarding its status. Unless otherwise directed by your Site Director, you should go to your clinical site. REQUIRED PATIENT ENCOUNTERS AND ALTERNATIVE LEARNING (see next page)

Minimum Required Patient Encounters – 2016-2017 OBSTETRICS & GYNECOLOGY

Type of Patient/

Clinical Condition Clinical Setting

Level of Student Responsibility

Benchmark/Explanation Alternative

Vaginal Delivery I OB,PP,FP

4 at any level

Encounter must include the following 3 elements (element 3 determines the level of student responsibility): 1. Student creates a therapeutic relationship with the patient by any of the following:

History taking/data gathering/chart review Introduction to patient as team member Performs physical examination

2. Student uses clinical reasoning to recognize patient is in the second stage of labor. 3. Student will Observe, Partially Participate or Fully Participate in the following elements of Vaginal Delivery. Observed = Observation Only Partial Participation = Participation in at least 4 of the following elements: Full Participation = Participation in 6 of the following elements:

Student assists to position patient for delivery. Student gowns and gloves. Student assists with the delivery of the infant.

delivery of head delivery of body suction of the mouth and nose

Student assists physician to clamp and cut umbilical cord Student assists physician to collect cord blood samples. Student assists physician with the delivery of the placenta. Student assists physician with the repair of lacerations or episiotomy. Student assists with cleaning and restoring patient to a resting state. Student assists with delivery note.

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Vaginal Delivery has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Vaginal Delivery OR (b) Arrange for simulation of a Vaginal

Delivery under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Cesarean Section I OB PP,FP

2 at any level.

Encounter must include the following 2 elements (element 2 determines the level of student responsibility):

1. Student creates a therapeutic relationship with the

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter

Minimum Required Patient Encounters – 2016-2017 OBSTETRICS & GYNECOLOGY

patient by any of the following:

History taking/data gathering/chart review Introduction to patient as team member Performs physical examination

2. Student participates in the following elements of Cesarean Section:

Observed = Student observes greater than 50% of procedure. Partial Participation = Student scrubs/gowns/gloves and assists with at least 50% procedure. Full Participation = Student scrubs/gowns/gloves and assists with greater than 50% of the procedure.

for Cesarean Section has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Cesarean Section OR (b) Arrange for simulation of a Cesarean

Section under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Obstetrics – General I, O FP 6 at FP

1. Student creates a therapeutic relationship with the patient and performs the following under the guidance of a resident or attending:

History taking/data gathering/chart review Performs physical examination Develops clinical assessment Develops therapeutic plan

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Obstetrics – General has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in an Obstetrics – General case OR

(b) Arrange for simulation of Obstetrics – General case under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Breast Exam I, O OB,PP,FP

2 at PP or FP

Encounter must include the following 2 elements (element 2 determines the level of student responsibility): 1. Student creates a therapeutic relationship with the patient by any of the following:

History taking/data gathering/chart review Introduction to patient as team member Performs physical examination

2. Student participates in the following elements of the

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Breast Exam has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following:

Minimum Required Patient Encounters – 2016-2017 OBSTETRICS & GYNECOLOGY

breast exam. Observed = Student observes a breast exam done by someone else. Student performs and is able to describe findings for the following elements of the breast exam: Partial Participation in at least 5 elements. Full Participation in all 6 elements Proper hand hygiene. Positioning patient for exam. Inspect and describe normal vs. abnormal breast anatomy. Inspect and describe normal vs. abnormal breast development. Inspect and identify pathologic conditions of the breast. Manual examination of the breast and identify when present:

Normal breast exam Axillary and supra-clavicular lymphadenopathy. Nipple discharge. Breast engorgement.

(a) Locate patient for student to participate in a Breast Exam OR

(b) Arrange for simulation of a Breast Exam under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Pelvic Exam I, O PP,FP

4 at PP or FP

Encounter must include the following 2 elements (element 2 determines the level of student responsibility): 1. Student creates a therapeutic relationship with the patient by any of the following:

History taking/data gathering/chart review Introduction to patient as team member Performs physical examination

2. Student participates in the following elements of the pelvic exam. Observed = Student observes a pelvic exam done by someone else. Student performs and is able to describe findings for the following elements of the pelvic exam: Partial Participation = Participation in at least 4 of the following elements. Full Participation = Participation in at least 5 or more of the following elements.

• Student demonstrates proper hand hygiene. • Student assists to position patient for exam.

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Pelvic Exam has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Pelvic Exam OR (b) Arrange for simulation of a Pelvic Exam

under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Minimum Required Patient Encounters – 2016-2017 OBSTETRICS & GYNECOLOGY

• Student inspects external genitalia and identifies

anatomic structures. • Student inserts speculum and is able to visualize

the cervix or vaginal cuff. • Student does bimanual exam and reports uterine

size and adnexal findings. • Student checks cervical dilatation and effacement

of laboring patient. • Student is able to identify cervical motion

tenderness when present. • Student is able to identify pathologic conditions

when present. • Student is able to identify normal anatomy and

physical findings. • Student does cultures of cervix or vagina. • Student demonstrates the ability to document

exam.

Gynecology – General I, O FP

6 at FP

1. Student creates a therapeutic relationship with the patient and performs the following under the guidance of a resident or attending:

History taking/data gathering/chart review Performs physical examination Develops clinical assessment Develops therapeutic plan

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Gynecology General has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Gynecology General case OR

(b) Arrange for simulation of a Gynecology General case under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Gynecologic Surgery I, O OB,PP,FP

2 at any level

Encounter must include the following 2 elements (element 2 determines the level of student responsibility):

1. Student creates a therapeutic relationship with the

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter

Minimum Required Patient Encounters – 2016-2017 OBSTETRICS & GYNECOLOGY

patient by any of the following:

History taking/data gathering/chart review Introduction to patient as team member Performs physical examination

2. Student participates in the following elements of Gynecologic Surgery:

Observed = Student observes greater than 50% of procedure. Partial Participation = Student scrubs/gowns/gloves and assists with at least 50% procedure. Full Participation = Student scrubs/gowns/gloves and assists with greater than 50% of the procedure.

for Gynecologic Surgery has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Gynecologic Surgery OR (b) Arrange for simulation of a Gynecologic

Surgery under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Gyn- Endocrine I, O FP

1 at FP

1. Student creates a therapeutic relationship with the patient and performs the following under the guidance of a resident or attending:

History taking/data gathering/chart review Performs physical examination Develops clinical assessment Develops therapeutic plan

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Gyn- Endocrine has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Gyn- Endocrine case (b) Arrange for simulation of a Gyn-

Endocrine case under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Gyn- Oncology I, O PP, FP 1 at PP or FP

Student creates a therapeutic relationship with the patient and performs the following under the guidance of a resident or attending: PP= at least 2 elements FP= at least 3 or more elements

History taking/data gathering/chart review Performs physical examination Develops clinical assessment Develops therapeutic plan

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Gyn- Oncology has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

Minimum Required Patient Encounters – 2016-2017 OBSTETRICS & GYNECOLOGY

Participates or observes Gyn-Oncology Procedure participate in a Gyn- Oncology case

(b) Arrange for simulation of a Gyn- Oncology case under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Uro-Gynecology or Pelvic Floor Disorder

I, O FP

1 at FP

1. Student creates a therapeutic relationship with the patient and performs the following under the guidance of a resident or attending:

History taking/data gathering/chart review Performs physical examination Develops clinical assessment Develops therapeutic plan

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Uro-Gynecology or Pelvic Floor Disorder has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Uro-Gynecology or Pelvic Floor Disorder case

(b) Arrange for simulation of a Uro- Gynecology or Pelvic Floor Disorder case under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Cervical Cytology Screen/ Pap Test

O OB PP,FP 2 at OB,PP or FP.

Encounter must include the following 2 elements (element 2 determines the level of student responsibility): 1. Student creates a therapeutic relationship with the patient by any of the following:

History taking/data gathering/chart review Introduction to patient as team member Performs physical examination

2. Student participates in the following elements of the pap test. Observed = Student observes a pap test done by someone else. Partial Participation = Student identifies cervix and collects

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Cervical Cytology Screen/ Pap Test has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Cervical Cytology Screen/ Pap Test OR

Minimum Required Patient Encounters – 2016-2017 OBSTETRICS & GYNECOLOGY

cervical cytology specimen using a broom brush or spatula.

Full Participation = Student places speculum, identifies cervix, collects cervical cytology specimen using a broom, brush or spatula and then transfers material to specimen cup.

(b) Arrange for simulation of a Cervical Cytology Screen/ Pap Test under direct faculty supervision, where the faculty member will document a post- encounter discussion and that the requirement has been met.

Colposcopy I, O OB,PP,FP

1 at OB, PP or FP

Encounter must include the following 2 elements (element 2 determines the level of student responsibility): 1. Student creates a therapeutic relationship with the patient by any of the following:

History taking/data gathering/chart review Introduction to patient as team member Performs physical examination

2. Student participates in the following elements of colposcopy. Observed = Student observes a colposcopy done by someone else or participating in procedure but not meeting the criteria for PP or FP. Partial Participation =at least 4 elements category A and; at least 1 element category B Full Participation = at least 4 elements category A and: at least 2 elements category B Category A Identify and describe the purpose of the following elements of colposcopy: Colposcope Magnification settings Light filters Biopsy instruments Kevorkian curet Acetic acid Monsel solution Lugols solution Formalin Category B Observe and identify the following elements of colposcopy: The cervix and/ or vagina

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Colposcopy has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Colposcopy OR (b) Arrange for simulation of a Colposcopy

under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Minimum Required Patient Encounters – 2016-2017 OBSTETRICS & GYNECOLOGY

The cervical transformation zone

Squamous columnar junction White epithelium The following vascular patterns when present;

Punctation Mosaic Atypical

Post Menopause I, O FP 1 at FP

1. Student creates a therapeutic relationship with the patient and performs the following under the guidance of a resident or attending:

History taking/data gathering/chart review Performs physical examination Develops clinical assessment Develops therapeutic plan

Student notifies Site Director and/or Clerkship Director at the end of week five of the rotation that the required encounter for Post Menopause has not been met.

Site Director and/or Clerkship Director will determine the course of action from the following: (a) Locate patient for student to

participate in a Post Menopause case OR

(b) Arrange for simulation of a Post Menopause case under direct faculty supervision, where the faculty member will document a post-encounter discussion and that the requirement has been met.

Your 6-week OB/Gyn Clerkship Patient logs should include all of the above requirements and should be documented on one45. Use supplemental Alternative Encounter Documentation Form for all alternative cases.

CLERKSHIP-SPECIFIC PERFORMANCES, PROJECTS, REQUIREMENTS:

1. Complete Ethics Assignment per D2L guidelines 2. Attend both days of Mandatory Combined Lectures (First Wednesday and Third Tuesday) 3. Complete Patient Log as indicated above – Will be reviewed at midterm with site

director. Contact the Site Director and/or Clerkship Director if all required encounters have not been met by the end of week five. An encounter or alternative will be arranged.

4. Complete CMS on-line Clerkship Evaluation at end of rotation -you will have 7 days to complete

5. Complete UWISE questions on line- a great study guide for the NBME 6. Complete Midterm Self Evaluation by the end of the third week. Review with your Site

Director or designated Faculty and return completed and signed evaluation to site coordinators before the end of the 4th week.

7. Do presentations as assigned at each site. One literature reference must be included on the last slide of your power point presentation- enter the reference into your D2L DROPBOX file under Presentation References

8. Adherence to the Attendance Policy

REQUIRED AND RECOMMENDED CLERKSHIP MATERIALS

REQUIRED

• UWISE 547 web-based questions can be found on www.APGO.com RECOMMENDED

• Blueprints • Case Files • UWorld • Beckmanns

OTHER CLERKSHIP INFORMATION

Alternative Encounter Documentation Form

(see next page)

2016-2017 OB/Gyn Mid-Rotation Clerkship Feedback Rosalind Franklin University of Medicine and Science

It is the Medical Student’s Responsibility to complete this prior to meeting with site director Student Name Faculty Name Hospital: Feedback Session Date: I am participating in the hand off Process Yes No I have completed the following # of procedures/diagnosis and have logged them on one45. Obstetrics-General 6 Gynecologic Surgery 2 Gyne-Endocrine 1 Vaginal Delivery 4 Gynecologic General 6 Post-Menopausal 1 Cesarean Section 2 Colposcopy 1 Uro-Gynecology Patient 1 Pelvic Exams 4 Pap Smear 2 Gyne-Oncology Patients 1 Ethics statement review w/ site director Breast Exams 2 ALTERNATIVE H&P- Direct observation Form

I have completed a history and physical under the observation of an attending.

NBME Shelf I have been actively studying for the NBME shelf exam (including suggested reading and UWISE quizzes) To date I have completed ________ UWISE questions.

Student Self-Assessment of Learning - Circle standards that you meet. Competency

with Objectives Partially

Meets Standards

Meets Standards Occasionally Exceeds Standards

Consistently Exceeds Standards

Medical and Scientific Knowledge-

• 1.1 Body structure & function

• 1.2 Disease mechanisms • 1.4 Diagnostic decision-

making 1.5 Describe the principles of therapeutic decision-making

• Does Not M

eet Standard

• Demonstrates incomplete knowledge of basic abdominal and pelvic anatomy

• Identifies patient with OB/Gyn problem but is unable to identify treatment options

• Understands basic abdominal, pelvic, and breast anatomy

• Identifies patient with OB/Gyn problem and identifies treatment options

• Understands basic pelvic/abdominal anatomy and the common diseases/ mechanisms that affect its functions

• Identifies patient with OB/Gyn problem and creates differential diagnosis

• Understands basic pelvic/abdominal anatomy and accurately identifies abnormalities

• Identifies patient with OB/Gyn problem and creates a comprehensive management plan

Patient Care and Prevention- 2.1 Perform reliable history and physical examinations

• 2.2 Perform reliable H&P’s • 2.3 Interpret results • 2.4 Technical procedures • 2.5 Construct appropriate

diagnostic and therapeutic strategies for patients with common acute and chronic conditions.

• Does Not M

eet Standard • Demonstrates

basic skills during procedures but with errors (i.e., pelvic exam)

• Demonstrates basic knowledge of complications in common cases (e.g., pregnancy)

• Demonstrates basic skills during common procedures (pelvic exam, clamp cut umbilical cord)

• Recognizes risk factors and signs of complications in common patient cases

• Demonstrates advanced skills (i.e.surgical assist) during procedures with attending

• Effectively manages common complications (i.e., preterm labor)

• Demonstrates advanced skills during procedures(i.e. suturing and knot tying) and properly interprets test results (e.g., Pap Test)

• Effectively educates patients on common complications and related risk factors

Professionalism and Self-Awareness

• 3.1 Ethical decision-making 3.2 Demonstrate respect, dignity, compassion and integrity, when engaging patients, families, peers and other healthcare providers

• 3.3 Recognize limitations & biases

3.4 Seek & respond to performance feedback

• Does Not M

eet Standard

• Understands the importance of treating others with compassion and respect

• Recognizes ethical principles of a physician but does not use them when making decisions

• Consistently shows integrity and respect to patients and members of healthcare team

• Demonstrates strong knowledge on specific principles that govern decision-making process

• Seeks and responds to feedback on how to improve ability to show integrity and respect to other

• Demonstrates knowledge of ethical principles, namely boundary issues, and applies them to patient care

• Maintains high level of respect and compassion for others, even during conflict

• Balances patient privacy with the ethical and legal requirements of physicians

Practice based, life-long learning

• 4.1 Evidence-based medicine

• 4.2 Apply current technology

4.3 Reflective practice

• Does Not M

eet Standard

• Reviews evidence-based medicine but doesn’t understand its implications in patient care

• Understands the importance of critically analyzing literature

• Uses evidence-based medicine when making decisions in patient care

• Answers patient care questions by identifying the appropriate resources (i.e., texts, databases)

• Reflects on own practices and how it compares with national standards

• Critically reviews literature (e.g., potential biases) and analyzes its implications on patient care

• Implements changes in practice based on national standards to enhance patient care

• Incorporates patient’s values and preferences into evidence-based practice

Interpersonal and Communication Skills

• 6.1 Sustain professional relationships

• 6.2 Effective communication with patients

• 6.3 Organized records 6.4 Effective communication with colleagues

Does Not M

eet Standard

• Communicates with health care team and patients but lacks organization

• Completes patient histories and physical exam notes with inaccuracies

• Effectively communicates with patients and the health care team in routine clinical encounters

• Completes patient histories and physical exam notes without error

• Effectively listens to and questions patients or team members in routine clinical encounters

• Efficiently completes all documentation and effectively communicates during patient hand- offs

• Effectively communicates with health care team and patients, even in stressful situations

• Demonstrates clinical reasoning and synthesis in all documentation

System Based Interprofessional practice +5.1 Identify team roles *5.2 Initiate assistance of others

Pass or Fail • Identifies roles and specialties of each team member and how that affects patient care

• Immediately identifies urgent situations that require assistance • Recognizes the limitations of a team approach and effects on patient care (i.e., miscommunication)

Efficiently employs the assistance of team members during both minor and urgent situations

Student Reflections- Select a clinical situation during this rotation that taught you the most about demonstrating integrity, respect and responsiveness to the needs of the patient above your own

(1) Subjective: Analyze your experience by considering its content, processes and premises.

(2) Objective: Now reconsider the experience from multiple perspectives-include one example from a person from another field, nurse technician, other specialty, etc.

(3) Assessment: Synthesize your thinking and learning

(4) Plan: Make a plan to address your challenges. How will you know if your plan is working?

Faculty Acknowledgement Suggestions for an Improvement Plan

1. 2. 3.

Case Presentation I have been assigned a topic to give my formal presentation and a hard copy of the references I used for my presentation will be given to the Clerkship Coordinator on the last day of clerkship- before the NBME.

During this evaluation I received formative feedback about my performance during the first three weeks of my rotation

Student Signature Date:

List any issues or concerns that the Clerkship Director should be aware:

Site Director’s section No problem seen to complete log on time_____

There may be a problem completing the required items on the log_____ Remind students to submit references from presentation at end of clerkship Site Director Signature and/or designee:______________________________________________

ROSALIND FRANKLIN UNIVERSITY/THE CHICAGO MEDICAL SCHOOL DEPARTMENT OF OBSTETRICS AND GYNECOLOGY ALTERNATIVE ENCOUNTER DOCUMENTATION FORM

Medical Student

Site

Page 1 of 2

NSVD Vaginal Delivery Faculty Signature

Date

Observed Full participation partial participation

Observed Full participation partial participation

Observed Full participation partial participation

Observed Full participation partial participation

Alternative Alternative Alternative Alternative

Cesarean Section Faculty Signature

Date

Observed Full participation partial participation

Observed Full participation partial participation

Alternative Alternative

Document supervision of Alternative Encounters/Procedures on this form. Once you have completed an alternative encounter, the supervising faculty must sign off

below. This form is intended to supplement your case logs on one45 and is not meant to replace the log.

Faculty Signature acknowledges that a alternative encounter was performed by

the student under direct faculty supervision with post encounter

discussion.

General Obstetrics

Faculty Signature

Date

Full participation Full participation Full participation Full participation Full participation Full participation Alternative Alternative Alternative Alternative Alternative Alternative

NO ALTERNATIVE ENCOUNTERS REQUIRED

Pelvic Exam Faculty Signature

Date

Full participation partial participation

Full participation partial participation

Full participation partial participation

Full participation partial participation

Alternative Alternative Alternative Alternative

Breast Exam Faculty Signature

Date

Observed Full participation partial participation

Observed Full participation partial participation

Alternative Alternative

ROSALIND FRANKLIN UNIVERSITY/THE CHICAGO MEDICAL SCHOOL DEPARTMENT OF OBSTETRICS AND GYNECOLOGY ALTERNATIVE ENCOUNTER DOCUMENTATION FORM

Medical Student

Site

Page 2 of 2

Cervical Cytology screen / Pap Test

Faculty Signature Date

Observed Observed Full participation Full participation partial participation partial participation Alternative Alternative

Colposcopy

Faculty Signature Date

Observed Full participation partial participation Alternative

Gyne Oncology Faculty Signature

Date

Full participation partial participation

Alternative

Post Menopause

Faculty Signature Date

Full participation Alternative

General Gynecology

Faculty Signature

Date

Full participation Full participation Full participation Full participation Full participation Full participation Alternative Alternative Alternative Alternative Alternative Alternative

Gyne Surgery

Faculty Signature

Date

Observed Full participation partial participation

Observed Full participation partial participation

Alternative Alternative

Gyne-Endocrine Faculty Signature

Date

Full participation Alternative

Uro-Gyne or Pelvic Floor Disorder Faculty Signature

Date

Full participation Alternative

Download this to D2L DROPBOX by the day of

final exam.

Faculty and Staff

Hospital Site Director Coordinator Location

Mount Sinai (MSH)

Advocate Lutheran General (ALGH)

Mercy (MHMC)

St Anthony (SAHO)

St Joseph (STJM)

Dr Richard Trester

Also the Clerkship Director- [email protected]

Pager-16342

Dr Ian Jasenof Ian.jasenof@advocate

health.com (847) 723-6994

Dr Sharon Handelsman [email protected]

Pager-(312) 567-2000 #15809

Dr Mukesh Patel [email protected]

Dr Eden Takhsh [email protected]

Sandra Guzeldere

[email protected] Office (773) 257-5098

Cell (847) 477-9285

Marisol Hernandez-Martinez Marisol.hernandez-

[email protected] Office-(847) 723-6464

Deborah Swanson [email protected]

(312) 567-2182

Belinda Cadena [email protected]

(773) 484-4338

Myrna Samoy [email protected]

(773) 665 3132

Office-F202 in Mount Sinai

Office- 6 South Medical

Education office

Office in

Room 2-253

Department of Medical Education

th

Library