Outpatient Gynecology
View Milestones, EPAs and Basic Clinical Skills
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This case incorporates the following Milestones:
GY 1a: Patient Care, Gynecology Technical Skills: Laparotomy
- Demonstrates knowledge of basic abdominal and pelvic anatomy
- Demonstrates basic surgical principles including use of universal precautions and aseptic technique
- Positions patient appropriately for surgery
- Demonstrates knowledge of basic abdominal and pelvis anatomy
- Demonstrates basic knowledge of what constitutes normal and abnormal uterine bleeding
- Verbalizes the phases of the normal menstrual cycle
- Demonstrates a basic understanding of patients presenting with a pelvic mass, including differential diagnosis signs and Symptoms
- Recognizes limitations and failures of a team approach (e.g. handoffs, miscommunication) in health care as the leading cause of preventable patient harm
- Demonstrates adequate listening skills
- Communicates effectively in routine clinical situations
- Understands the importance of informed consent
- EPA 1: Gather a history and perform a physical examination
- EPA 2: Prioritize a differential diagnosis following a clinical encounter
- EPA 3: Recommend and interpret common diagnostic and screening tests
- EPA 5: Document a clinical encounter in the patient record
- EPA 7: Form clinical questions and retrieve evidence to advance patient care
- EPA 11: Obtain informed consent for tests and/or procedures
- EPA 13: Identify system failures and contribute to a culture of safety and improvement
Basic Clinical Skills:
This case incorporates the following Basic Clinical Skills (BCS) checklists:
- Pelvic Examination
- Sterile Technique
- Patient Positioning
- Informed Consent
- Surgical Timeout
Case: JoAnna Cunningham, a 40-year-old G4P3 woman, presents to your office complaining of continuous vaginal bleeding for three weeks.
Tasks:
- Develop a differential diagnosis for abnormal uterine bleeding in a reproductive-aged woman
- Describe the phases of the menstrual cycle
- Obtain a medical history in a reproductive-aged woman
- Perform a focused physical examination on a reproductive-aged woman
- Develop a differential diagnosis for pelvic mass in a reproductive-aged woman
- Order diagnostic tests in a reproductive-aged woman with pelvic mass
- Interpret diagnostic tests in a reproductive-aged woman with pelvic mass
- Perform an evidence-based medicine search on treatment options for abnormal uterine bleeding
- Understand the importance of informed consent
- Document a clinical encounter in the patient record
- Communicate effectively with patient and family
- Perform a surgical time out
- Demonstrate proper patient positioning for surgery in the low lithotomy position with the arms tucked
- Perform a surgical scrub, gown and glove using sterile precautions and aseptic technique
- Identify elements of pelvic anatomy
