OBGU-4031 - Urogynecology and Robotic Surgery

OBGU-4031 - Urogynecology and Robotic Surgery

Elective Title: Urogynecology and Robotic Surgery
Course Number: OBGU-4031
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: Successful Completion of an OB Gyn Clerkship. Visiting students must seek prior approval. All students being enrolled within 3 weeks of the start date must seek prior approval.
Responsible Faculty Director: Elisha Jackson, MD Periods Offered: 1-7, 9-13 excluding holiday period 8 
Coordinator: Brandie Denton Other Faculty: Gokhan Kilic, MD; Gabriela Halder, MD
Location to Report on First Day:
Clearlake campus Urogynecology clinic (3rd floor)

Enhance student competencies in the newest technology in gynecology. Develop a basic understanding of evaluation and management of female pelvic floor disorders; including but not limited to urinary incontinence, pelvic organ prolapse, overactive bladder, and painful bladder syndrome. Introduce students to surgical management of pelvic floor disorders and other gynecology disorders. Recognize the importance of the interdisciplinary approach to patient care as we collaborate with multiple sub-specialties regularly.

Combining research and hands on clinical experience to facilitate futures pelvic surgeons career development. Evaluate and propose management plans for pelvic floor disorders in both inpatient and outpatient settings. Provide daily comprehensive hospital management of patients after surgeries. Participate in the positive impact of adapting new technology and enhanced recovery after surgery (ERAS)

Description of course activities
Students will participate in the Urogynecology clinics; where they will interview/present patients and perform exams under faculty supervision. Students will have opportunities to observe clinic procedures that are used to evaluate and/or treat patients with pelvic floor disorders. Students will have multiple days in the operating room and participate in “hands-on” experience during surgical cases. For students interested in clinical research, there are opportunities to join existing projects and/or develop and complete new quality improvement projects.

Type of students who would benefit from the course
Any 3rd and 4th year students interested in experiencing new technology in medicine, participate in sub-specialty care, pursue an academic career, and are planning to apply to Obstetrics and Gynecology residency. Consent only required for visiting students.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 7:00 5:00
Tuesday 7:00 5:00
Wednesday 7:00 5:00
Thursday 7:00 5:00
Friday 7:00 5:00
Saturday Off Off
Sunday Off Off

 Average number of patients seen per week: 30
 Call Schedule: N/A

Research / Other Course 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?
    3 days a week
  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?
    Pre-operative Gynecology conference: Gynecology residents and faculty. Local gynecology meetings based on the availability: Gynecologists, Obstetricians, fellows and residents
  B. Frequency / Duration of Presentation(s)?
    At the end of the rotation.
  C. Format - What guidelines are set for the student's presentation?
    Academic abstract presentation Urogynecology topic 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)?
    Abstract at the end of the rotation
  B. Format - What guidelines are set for the student's written work?
    Academic abstract formation for peer review journals (if research) 30 minute PowerPoint presentation
  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?
    PubMed online
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    I will select the research project
  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)?
    Resident lecture attendance.

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.
    Simulation: Detailed feedback from computer recorded performance scores
Surgery: Ability to perform basic surgical skills in a live case
Academic: Completion of an abstract in a given project OR Urogynecolgy topic presentation

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.