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CHICAGO MEDICAL SCHOOL ____________________________________________________ Obstetrics and Gynecology Clerkship MOBG700 9 Credit Hours SYLLABUS 2019-2020 ACADEMIC YEAR Education Co-Directors: Josef Blankstein, M.D. and Richard Trester, M.D. [email protected], [email protected] Clinical Education Specialist: Jessica Taylor, MSN, APN, CNS, CEN [email protected] Undergraduate Medical Education Specialist: Sandra Guzeldere [email protected] CMS office: 847-578-8620 Sinai office: 773-257-5098 Cell phone: 847-477-9285 CMS location: RWCLC 1.094 6/17/19 1 CLERKSHIP DESCRIPTION The 3rd Year Obstetrics and Gynecology Clerkship is a 6 week rotation, with the following components: Obstetrics 55%; Gynecology 36%; Urogynecology 3%; Gynecologic Oncology 3%; Reproductive Endocrinology/Infertility 3%. The rotation 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 1. Perform routine medical, diagnostic and surgical procedures for obstetrics and gynecology patients. (1.1, 1.6) 2. Describe the bio-physical, clinical and epidemiological scientific principles underlying mechanisms and methods of diagnostic and therapeutic decision-making of care in emergent and non-urgent obstetrics and gynecology cases to include history and physical patient information gathering and prioritizing, screening, ordering and interpreting laboratory, pathologic and imaging studies. (1.2, 1.3, 1.4, 1.5, 2.1, 2.2, 2.3, 2.4) 3. Demonstrate effective written and oral communication skills when interacting with all members of the healthcare team including the ability to prepare and organize appropriate, legible and timely medical records for obstetrics and gynecology patients. (1.2, 1.3, 4.5, 5.4) 4. Demonstrate interpersonal and communication skills that result in effective education, with patients and family members. (1.7, 3.8) 5. Demonstrate effective working relationships and communication to include respect, patient autonomy, dignity, compassion, integrity, honesty, trust, cultural sensitivity and compassion when engaging with patients, their families, peers, the public, the university community and other healthcare providers in the obstetrics and gynecology rotations. (1.8, 3.8, 3.9, 4.1, 4.2, 4.3, 4.4, 4.6, 4.7, 5.1, 5.3, 5.6, 6.1, 7.1, 7.3) 6. Identify factors that place individuals at risk for disease or injury including social-behavioral sciences and cost awareness and use strategies to prevent or slow the disease process. (1.9, 2.4, 2.5, 3.9, 6.3) 6/17/19 2 7. Use information technology to search for, evaluate, and apply evidence-based medicine for solving obstetrics and gynecologic clinical problems. (2.1, 3.6, 3.7, 3.10) 8. Identify strengths, gaps and deficiencies, and limits in one's knowledge and skill through self-awareness, feedback seeking behaviors, setting of improvement goals and learning activities with the goal of improving practice. (3.1, 3.2, 3.3, 3.4, 3.5, 8.1) 9. Use the knowledge of one’s own role and the roles of other health professionals to appropriately assess and address the health care needs and advance the health of the patients and populations served. (6.2, 7.2, 7.4) 10. Identify system failures and find ways to minimize error and improve patient safety. (6.5) Reference D2L for COMPETENCY MAP CLERKSHIP-SPECIFIC PERFORMANCES, PROJECTS, REQUIREMENTS Requirement Due 1 Complete Clerkship Acknowledgment form By end of 1st week 2 Mandatory reading assignment from Beckmann and Ling’s Obstetrics and Gynecology By end of 2nd week The chapters are: 6-Preconception and Antepartum Care 9-Abnormal Labor and Intrapartum Fetal Surveillance 12- Postpartum hemorrhage 16- Third trimester bleeding 19- Ectopic pregnancy and abortion 30- Pelvic support defects, urinary incontinence, and urinary tract infection 32- Dysmenorrhea and Chronic Pelvic Pain 37-Reproductive cycles 39- Amenorrhea and Abnormal Uterine Bleeding 45-Gestational trophoblastic neoplasia 6/17/19 3 3 Attend mandatory combined lectures By end of 3rd week 1. First Wednesday 2. Third Thursday 4 Complete Midterm Feedback form By end of 3rd week - Present to your Site Director at midterm then download the signed feedback form into D2L dropbox. 5 Complete ethics assignment By end of 3rd week - Present to your Site Director at midterm then download into D2L dropbox. 6 Complete the Direct Observation H&P form and download into D2L dropbox By end of 3rd week 7 H&P submitted for review at midterm meeting- feedback to follow By end of 3rd week 8 Midterm Quiz-two questions based on reading assignment By end of 3rd week 9 UWISE- complete all questions with a score 50% or greater By the end of 5th week 10 Complete all required patient encounters and log encounters on One45 By end of 5th week - Students who do not complete all required encounters by the end of the 5th week should contact the Education Director. 11 Complete Alternative Encounter Log and download into D2L dropbox By last Thursday of clerkship - Form required whether or not an alternative encounter was needed. 12 Attend simulation labs at Mount Sinai By end of clerkship 1. Delivery Sim Lab 2. Ultrasound Sim Lab 13 Complete a presentation as assigned by your site and download into D2L dropbox By end of clerkship - List all references on last slide of presentation 14 Complete the End of Clerkship Survey Friday after the rotation ends 6/17/19 4 Remediation of Clerkship-Specific Performances: • Students who do not complete all clerkship requirements by 11:59 pm on Sunday following the clerkship end date will receive an Unsatisfactory for “Clerkship-Specific Performances, Requirements or Activities,” resulting in a temporary notation of Needs Remediation for the clerkship. • Students will have one additional week (ending at 11:59 pm the following Sunday) to remediate any missing/insufficient requirements. • Per the CMS Clerkship Grading Policy, if the student passes the remediation, they will receive a grade of “Pass” for the rotation. If the student fails to remediate within this one-week remediation period, they will receive a grade of “Fail” for the rotation. REQUIRED PATIENT ENCOUNTERS Type of Patient/ Clinical Level of Student Benchmark/Explanation Alternative Clinical Condition Setting Responsibility Vaginal Delivery I OB, PP, FP Encounter must include the following 3 elements (element 3 Student notifies Site Director and/or Clerkship determines the level of student responsibility): Director at the end of week five of the rotation that 4 at any level 1. Student creates a therapeutic relationship with the patient the required encounter for Vaginal Delivery has not by any of the following: been met. - History taking/data gathering/chart review - Introduction to patient as team member Site Director and/or Clerkship Director will - Performs physical examination determine the course of action from the following: 2. Student uses clinical reasoning to recognize patient is in the (a) Locate patient for student to participate in a second stage of labor. Vaginal Delivery OR 3. Student will Observe, Partially Participate or Fully (b) Arrange for simulation of a Vaginal Delivery Participate in the following elements of Vaginal Delivery. under direct faculty supervision, where the Observed = Observation Only faculty member will document a post- Partial Participation = Participation in at least 4 of the encounter discussion and that the requirement following elements: has been met. 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 6/17/19 5 • 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. Cesarean Section I OB, PP, FP Encounter must include the following 2 elements (element 2 Student notifies Site Director and/or Clerkship determines the level of student responsibility): Director at the end of week five of the rotation that 2 at any level 1. Student creates a therapeutic relationship with the patient the required encounter for Cesarean Section has not by any of the following: been met. - History taking/data gathering/chart review - Introduction to patient as team member Site Director and/or Clerkship Director will - Performs physical examination determine the course of action from the following: 2. Student participates in the following elements of Cesarean (a) Locate patient for student to participate in a Section: Cesarean Section OR Observed = Student observes greater than 50% of (b) Arrange for simulation of a Cesarean Section procedure. under direct faculty supervision, where the Partial Participation = Student scrubs/gowns/gloves and faculty member will document a post- assists with at least 50% procedure. encounter discussion and that the requirement Full Participation = Student scrubs/gowns/gloves and has been met. assists with greater than 50%