/ Department of Physician Assistant Studies
Learning. Caring. Serving. Leading.
PAS 640: Women’s Health
1.5 Semester Hours

Course Description: The Women’s Health rotation is designed to give the student practical experience in the diagnosis, evaluation, and management of problems and issues associated with women’s health care. Emphasis is placed on learning experiences in family planning and birth control, the recognition and treatment of sexually transmitted infections, cancer detection and prevention, prenatal care and the evaluation and treatment of common ambulatory gynecologic problems. During this rotation the students augment and strengthen their skills in regard to a wide variety of problems seen in the primary care setting.

Course Goals: The educational goals of the Women’s Health rotation include:

1.  To apply the medical content and principles central to women’s health.

2.  To provide opportunities for each student to develop the core PA competencies in a supervised women’s health setting.

3.  To expose each student to an experienced and competent medical provider role model for the care of women.

Course Director: / Office / Phone / E-mail
Diane Duffy, MD / FC 205 / 336-278-6848 /
Tracey Tonsor, PA-C / FC 207 / 336-278-6852 /

Learning Outcomes:

Upon completions of this course the clinical phase PA students will:

1.  Demonstrate the ability to elicit a complete gynecological, prenatal and, when appropriate, obstetric history.

2.  Demonstrate proficiency and sensitivity in performing an appropriate problem-focused women’s health exam.

3.  Utilize diagnostic modalities when appropriate which are based on initial impressions determined from the history and physical or are pertinent to the evaluation of the patient.

4.  Formulate a comprehensive management plan that is consistent with the diagnosis and includes diagnostic modalities, clinical therapeutics, clinical interventions, patient education, counseling and proper referrals.

5.  Provide and record pertinent patient education regarding disease prevention and health maintenance.

6.  Know, and counsel the patient about, the current screening recommendations for women.

Teaching Methodologies: The content of this module will be presented through a variety of methods that include observation and participation at the clinical site, independent reading and participation in online activities developed to guide experiential learning.

Accommodations: Students requiring academic accommodations must follow the “Academic Support” policy in the Elon University DPAS Student Handbook.

Academic Honesty: All Elon PA students acknowledged their commitment to abide by the Elon Honor Code by signing the Honor Pledge during orientation.

Required Textbooks:

1.  All first-year required textbooks.

2.  Current Diagnosis and Treatment: Obstetrics and Gynecology, 11e

Other Resources:

1.  *Moodle: Please check the course site frequently for new announcements, updated schedules, assignments and other course communication.

2.  Practicing physician assistants, physicians, allied health care providers and laboratory teaching aids.

TOPICS LIST - GYNECOLOGY
Neoplasms / Infections / Disorders of the Breast
Endometrial cancer / Vaginitis / Breast abscess
Ovarian neoplasms / Trichomoniasis / Breast Fibroadenoma
Breast cancer / Bacterial vaginosis / Fibrocystic disease
Cervical carcinoma / Atrophic vaginosis / Mastitis
Cervical dysplasia / Candidiasis / Structural Abnormalities
Vaginal/vulvar neoplasms / Cervicitis / Cystocele
Menstruation / Gonorrhea / Uterine prolapse
Normal physiology / Chlamydia / Rectocele
Dysfunctional uterine bleeding / Herpes simplex / Ovarian torsion
Amenorrhea / Human papilloma virus / Other
Dysmenorrhea / Pelvic inflammatory disease / Contraceptive methods
Menopause / Syphilis / Endometriosis
Premenstrual syndrome / Chancroid / Ovarian cyst
Lymphogranuloma venereum / Leiomyoma
Domestic violence
Urinary incontinence
Infertility
Sexual assault
TOPICS LIST – OBSTETRICS
Prenatal Care/Normal / Pregnancy Complications / Labor and Delivery
Pregnancy / Abortion / Complications
Prenatal diagnosis/care / Abruptio placentae / Dystocia
Normal labor and delivery / Ectopic pregnancy / Fetal distress
Stages / Incompetent cervix / Premature rupture of
Duration / Placenta previa / membranes
Mechanism of delivery / Gestational diabetes / Prolapsed umbilical cord
Monitoring / Pregnancy induced hypertension / Preterm labor
Physiology of pregnancy / Preeclampsia/eclampsia / Breech presentation
Fetal position / Gestational trophoblastic disease / Postpartum Care
Multiple gestation / Molar pregnancy / Postpartum hemorrhage
APGAR scoring / Choriocarcinoma / Endometritis
Rh-incompatibility / Perineal laceration/episiotomy
care
Normal physiology changes
of puerperium

Assessment Activities:

Exams/quizzes (30%), Preceptor Evaluation (60%), Professionalism (10%).

Grade Scale and Grade Points:

Percentage / Letter Grade / Grade points
89.50-100
85.50-89.49
79.50-85.49
75.50-79.49
69.50-75.49
Below 69.50 / A
B+
B
C+
C
U / 4.0
3.3
3.0
2.3
2.0
0

There is no rounding of grades.

Note: For further information regarding academic standing in the Department of Physician Assistant Studies, please see the Student Handbook.

Grading Criteria:

  1. Demonstrate acquisition of a strong basic science and medical science knowledge base as demonstrated on the written examination/quizzes.
  2. Demonstrate satisfactory self-directed learning skills, clinical reasoning skills, interpersonal communication, commitment to patient-centered care, professionalism and practice-based learning as evidenced by satisfactory performance on the preceptor evaluation.
  3. Demonstrate a commitment to learning and professionalism by actively participating in all clinical activities and exceeding the professional behavior standards and minimum requirements for clinical rotations available in the Elon PA Student Handbook.


Instructional Objectives:

  1. Elicit and record a complete and focused history, appropriate for the patient’s age, including chief complaint and history of present illness with pertinent review of systems, past medical, family and social history.
  2. Perform a complete and focused gynecological examination, with a focus on ensuring patient comfort
  3. Know the components of a complete and focused prenatal examination
  4. Select and interpret diagnostic studies to evaluate the differential diagnosis, including the following for each study:
  5. Risks and benefits
  6. Sensitivity and specificity
  7. Cost effectiveness
  8. Informed consent
  9. Describe the indications for colposcopic cervical examination following an abnormal PAP smear.
  10. Perform or be able to describe diagnostic procedures under the direction of and according to standards as established by the clinical preceptor
  11. Discuss the methods of contraceptives and family planning, including indications, contraindications, efficacy, advantages, disadvantages, safety, mutagenicity, patient education, cost and cultural/religious issues.
  12. Discuss the physiologic changes that occur during menopause, competently prescribe therapies for the management of menopausal symptoms, and counsel patients on prevention of diseases that are more prevalent after menopause.
  13. Recognize the presentation of common breast masses and identify the appropriate work-up and treatment.
  14. List the physiologic changes and signs of pregnancy.
  15. Describe routine prenatal care.
  16. Define and discuss the use of screening and diagnostic instruments used in prenatal obstetrics, care paying particular attention to indications, timing, normal and abnormal findings and maternal risk factors (e.g., ultrasound, one hour post-prandial glucose tolerance test, maternal serum alpha fetal protein monitoring).
  17. Identify medical problems that may result in complications during pregnancy.
  18. Discuss and describe normal embryonic/fetal development.
  19. Discuss the indications for, correct use and administration of obstetric pharmacologic therapies.
  20. Demonstrate knowledge of appropriate gynecologic and obstetric (antepartum and postpartum) management plans, including screening, treatment, follow-up and patient education.
  21. Discuss the appropriate use of medications for gynecologic and obstetrical patients including such issues as indications, contraindications, interactions, complications, dosage, metabolism, excretion and mutagenicity.
  22. Identify first-line therapeutic recommendations for treating common or life threatening conditions when they occur in pregnant patients.
  23. Provide and record pertinent patient education regarding disease prevention and health maintenance, which is clearly explained to the patient and checked for understanding, to include
  24. Nutrition – including need for supplementation during pregnancy
  25. Genetic counseling
  26. Accident and violence prevention (e.g., seat belts, helmets, screening for domestic violence)
  27. Physical activity, exercise
  28. Pertinent risk factors, including occupation, environment, tobacco, alcohol, other drugs and genetic factors
  29. Warning signs/symptoms of disease
  30. Plan for age appropriate screening and periodic health assessment
  31. Immunizations (HBV, rubella, Tdap)
  32. Recognize and institute the initial management of emergency gynecologic and obstetric emergencies in the absence of a physician
  33. Formulate a comprehensive management plan that is consistent with the diagnosis and includes diagnostic modalities, clinical therapeutics, clinical interventions, patient education, counseling, and proper referrals.
  34. Prepare patient records that follow the SOAP format.
  35. Effectively and efficiently communicate patient presentations to the clinical preceptor.
  36. If presented with the opportunity, assist the gynecologist, as directed, during surgical procedures

Women’s Health Rotation Expectations

Successful completion of the Women’s Health rotation will be evidenced by:

  1. Completion of the 3 week Women’s Health rotation.
  2. Documentation in the Typhon database of a minimum of 25 patient encounters over the course of the rotation to include visits for:
  3. Prenatal care
  4. Gynecologic evaluation and treatment
  5. Evaluation and treatment or self-study of the diagnoses listed in the Topic List of the Women’s Health syllabus.
  6. Completion of appropriate deliverable for Clinical Year Seminar (may include prenatal note).
  7. Participation/observation and documentation of the following procedures, as available:
  8. Pelvic exam
  9. Breast exam
  10. PAP smear and endocervical sampling
  11. Have achieved a passing grade (69.5% or greater) for the course from the following assessments:
  12. End of Rotation exam
  13. Preceptor Evaluation
  14. Professional Assessment Tool
  15. Contacting Clinical Education Team at any point in rotation to discuss concerns regarding the ability to achieve the above.

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Revised 1/15/16