# Direct Observation Learner Expectations

<h2 align="center"><mark style="color:purple;">Obstetrics-Gynecology</mark> <mark style="color:purple;">Direct Observation of History Taking Skills</mark><br><mark style="color:purple;">Learner Expectations</mark></h2>

**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.

<h2 align="center"><mark style="color:purple;">Obstetrics-Gynecology Direct Observation of Physical Examination Skills</mark><br><mark style="color:purple;">Learner Expectations</mark></h2>

**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
