OBGU-4065 - Dive Deep Into Gynecologic Investigations

OBGU-4065 - Dive Deep Into Gynecologic Investigations

Elective Title: Dive Deep Into Gynecologic Investigations
Course Number: OBGU-4065
Elective Type: career Duration/Weeks: 2 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: Consult with Dr. Hossain (amhossai@utmb.edu) at least 30 days prior to signing up for the elective. C-form is required and needs to be sent to Brandie Denton (bldenton@utmb.edu).
Responsible Faculty Director: Amjad Hossain, PhD and Perry Fulcher, MD Periods Offered: 1AB, 4AB, 6AB, 7AB, 10AB, 13B excluding holiday period 8 
Coordinator: Brandie Denton Other Faculty: Otto Pantoja, MD
Location to Report on First Day:
335 clinical science bldg. (CSB), Conference room in Gynecology Suite (3rd floor near CSB auditorium), contact: (O) 409-772-2610 or (C) 281-785-6804

The elective will guide students to properly examine patients' gynecologic problems so that the expected level of knowledge that is necessary to address the issue is attained, and secondly will acquaint the students with ACOG (American college of obstetricians and gynecologists) guidelines which are followed in gynecologic investigations.

Through gaining experience in the Gyn clinic and from reading pertinent literature, the students will be able to: 1) familiarize with the ACOG guidelines applicable in gynecologic examinations, 2) understand the incidence, prevalence and etiologies of the detected problem, 3) hypothesize basic science explanation of the possible method of pathogenesis, 4) appraise options for effective management of the problem, and 5) predict future pathologies in the event of an effective intervention as opposed to no intervention.

Description of course activities
To prepare the students for the elective, a 2-page information about the course will be shared with the students in advance (at least 24 hours prior to orientation) via email. In orientation (first day of rotation), the course syllabus, schedule, and requirements will be discussed. How the requirements can be achieved will also be explained. The students will get the specific information of their daily roles and responsibilities. The orientation should sufficiently prepare the students to perform their assigned activities independently and thoroughly.
During the first three days in week 1, the students will spend time in the Gyn clinic under the supervision of a course faculty to explore different gynecologic issues of patients. In addition, to expand their acquaintance with more gynecologic problems that woman may face in different phages in life, the students will be asked to watch select gynecologic videos.
Based on the above clinical experience, the students will be asked to choose a specific gynecologic topic in which they have interest to explore for further knowledge. Guidance will be provided on a one-on-one basis on how to effectively investigate the topics they chose. On day 5 of week 1, a session will be arranged to discuss the students’ plans, progress, problems encountered, or any other issues they might have. Appropriate feedback and guidance will be provided so that they can carry on their projects in the second week.
In week 2, the students will study their topics by reviewing the literature. The goal will be to figure out existing knowledge to date on their chosen topic. The students will be required to prepare a written report to demonstrate their depth of knowledge on respective topics with particular emphasis on the required learnings that are indicated in the course learning objectives. We see about 50+ patients weekly.

Type of students who would benefit from the course
The elective should be of particular interest to students who wish to pursue a career in obstetrics and gynecology. Students interested in women's health issues in primary care or related surgical subspecialties would also benefit from this elective.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM

 Average number of patients seen per week:
 Call Schedule: N/A

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
  B. Frequency / Duration of Presentation(s)?
  C. Format - What guidelines are set for the student's presentation?
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
  B. Format - What guidelines are set for the student's written work?
    Will be set jointly by the faculty and student upon discussion
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
    Yes. The references are selected following instructor's recommendation, should not exceed 10
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Student Selected
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    In addition to clinic duties and written report, the student is expected to demonstrate professionalism and interpersonal skills reflecting content knowledge during interaction with the faculty.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.
    A. Clinical observation 30%: Fail (score < 75) / Pass (score > or equal to 75)
B. Written assignment 70%: Fail (score <75); meet expectation (score 75-84); exceed expectation (score 85-90); Outstanding (score > 91)

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.