Direct Observation Learner Expectations

Obstetrics-Gynecology Direct Observation of History Taking Skills Learner Expectations

Scenario: You will be asked to interview a patient who presents to the emergency room with a gynecologic problem.

The student is expected to demonstrate the following behaviors:

• Setting the stage/preparation

  • Student reviews the presenting scenario and the patient information prior to the encounter.

• Greeting the patient/Establishing initial rapport

  • Student introduces self, using first and last name.

  • Student states their current level of training as a medical student.

  • Student states the primary purpose of the encounter.

  • Student actively verifies the patient’s name and date of birth.

• Initiating information gathering

  • Student asks the presenting problem or reason for the patient to present to the care site.

  • Student asks the duration of the presenting problem.

  • Student asks patient to quantify the severity of the problem.

  • Student asks about pain related to the presenting problem.

  • Student asks about prior occurrence of presenting problem.

• Exploring biomedical perspective of disease including relevant background and content

  • Student asks at least 2 relevant symptoms related to the presenting problem.

  • Student asks at least 6 critical questions about patient’s gynecologic history that relate to presenting problem.

  • Student asks about medication use related to presenting problem.

  • Student asks about history of pregnancy.

  • Student asks about contraception.

  • Student asks about past surgical history .

  • Student asks about tobacco, alcohol, and drug use .

  • Student asks about medical history .

  • Student asks about family history.

• Exploring patient's perspective of illness

  • Student demonstrates respect towards patient through behaviors, words and demeanor .

  • Student demonstrates empathy towards patient through behaviors, words and demeanor.

  • Student acknowledges feelings, concerns and anxieties of patient by verbally recognizing and legitimizing them.

• Closing the encounter

  • Student directly asks for any additional questions or concerns the patient may have.

  • Student explains the need to check specific blood work to check for at least 2 possible diagnoses. Student states the specific tests to be ordered.

  • Student explains specific imaging test(s) necessary for work-up.

  • Student verbalizes appropriate wrap-up and reference to next steps.

Obstetrics-Gynecology Direct Observation of Physical Examination Skills Learner Expectations

Scenario: You will be asked to perform a physical examination* on a patient presenting to the gynecology clinic for a regular visit.

*Exam will be performed on pelvic part-task simulator with an SP observer in the room

The student is expected to demonstrate the following behaviors:

• Greeting the patient/Establishing initial rapport

  • Student introduces self using first and last name

  • Student states the primary purpose of the encounter

  • Student reassures patient about potential discomfort during the examination

  • Student washes hands before the physical examination

• Preparation for examination

  • Student checks expiration date on specimen collection vial

  • Student processes specimen

  • Student adjusts light source

  • Student dons gloves

  • Student lubricates speculum

• Pelvic Exam

  • Student applies downward pressure on posterior vagina with hand

  • Student inserts speculum

  • Student visualizes cervix

  • Student inserts endocervical brush into cervical canal and rotates

  • Student inserts spatula into cervical canal

  • Student rinses endocervical brush and spatula in preservative fluid

  • Student removes speculum

• Closing the encounter

  • Student indicates need to send specimen to laboratory with form

  • Student directly asks for any additional questions or concerns the patient may have