M3 Clinical Skills Experience Portfolio Obstetrics & Gynecology You have access to electronic version to fill

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1 M3 Clinical Skills Experience Portfolio & You have access to electronic version to fill Name Hospital Rotation Dates DIAGNOSTIC/CLINICAL PROBLEM SOLVING SKILLS (Medical Knowledge): Students must document exposure to each of the following problems or diagnoses. Symptoms Patient Encounter Streaming Video uwise (WEB Cases) Required Text Diagnosis Patient Encounter Streaming Video uwise (WEB Cases) Required Text Patient Abnormal Uterine Bleeding Contraception Amenorrhea Ectopic Pregnancy Contraception request Endometriosis Dysmenorrhea Evaluation of Pelvic Masses Pelvic Discomfort Evaluation of Urinary Incontinence Postmenopausal bleeding Gestational Trophoblastic Disease Vaginal Discharge Infertility Urinary symptoms Menopause Related Health Issues Pregnant Patient Menstrual abnormalities Bleeding pregnancy Ovarian Neoplasms Contractions Puberty- Normal and Abnormal Reduced Fetal Activity Sexually Transmitted Diseases Leakage of Fluid Spontaneous and Induced Abortion Vaginal Discharge Uterine Cervix Neoplasms Uterine Corpus Neoplasms Abnormal Fetal Growth Antepartum Care Antepartum Hemorrhage Asthma in Pregnancy Common fetal anomalies and aneuploidies Diabetes in Pregnancy Gestational Diabetes Hypertensive Disorders in Pregnancy Infectious Diseases in Pregnancy Intrauterine Fetal Demise Isoimmunization Labor and Delivery Multiple Pregnancy Postpartum Care Postpartum Hemorrhage Preterm Labor Premature Rupture of Membranes

2 PHYSICAL EXAMINATION SKILLS (Patient Care, Communication Skills): Students must demonstrate application of knowledge through proper technique, draping, and patient communication when performing physical examination skills. (Reference: Lynn S. Bickley, M.D. Bates' Guide to Physical Examination and History Taking. Lippincott Williams & Wilkins. 10 th Edition. December 2008.) Physical Examination Skills Patient Abdominal Exam - Branched (Focused Gyn) Breast Exam Examination Under Anesthesia Female Genitalia/Pelvic Life Stage Exam- Reproductive Era/ Menopausal Orthostatic Vital Signs Physical Examination Skills Pregnant Patient Abdominal Focused Exam First Trimester Abdominal Focused Exam Second Trimester Abdominal Focused Exam Third Trimester Abdominal Focused Exam Immediate Postpartum Pelvic Exam (Assess Labor Progress) Pelvic Exam (Cervical Suitability for Labor Induction) Pelvic Exam (Exclude Rupture of Membranes) Vital Signs TECHNICAL PROCEDURAL SKILLS (Patient Care, Communication): Students must demonstrate application of knowledge through proper technique for each skill; and, student must be able to define, describe, and discuss indications, contraindications, risks, benefits, and techniques for these skills. Technical Procedural Skills Bench Microscopy for Fern Test during Pregnancy Bench Microscopy for Infection Gravid Uterus Assessment Labor Progress Check Technical Procedural Skills Sterile Draping Technique Sterile Technique Surgical Knot Tying

3 PHYSICAL EXAMINATION & PROCEDURE/LAB DATA INTERPRETATION SKILLS (Medical Knowledge): Student must demonstrate the ability to solve clinical problems through interpretation of physical examination findings, procedural skill findings, and lab data outcomes in the following areas. (Reference: Lynn S. Bickley, M.D. Bates' Guide to Physical Examination and History Taking. Lippincott Williams & Wilkins. 10 th Edition. December 2008.) Physical Examination and Procedure/Lab Data Interpretation Skills Physical Examination Interpretation Skills Intra-Operative Abnormal Surgical Findings of Adnexa and/or Uterus Normal Pelvic Anatomy Symphysial-Fundal Height Procedure/Lab Data Interpretation Skills Abnormal Colposcopy Bench Microscopy for Infection Evaluation of Pelvic Masses Evaluation of Urinary Incontinence Papanikolaou (PAP) Smear Antepartum FHR Strip Antepartum Fetal Ultrasound Gestational Diabetes Screen Oral Glucose Tolerance Test (3 Hour) Serum Aneuploidy Screen Ultrasound Amniotic Fluid Ultrasound Biophysical Ultrasound (Limited-Bedside) Urine Dipstick for Proteinuria Physical Examination and Procedure/Lab Data Interpretation Skills Surgical Case Exposure Colposcopy Gynecologic Abdominal Surgery Gynecologic Vaginal Surgery Laparoscopic Surgery Cesarean Delivery Immediate Neonatal Care Vaginal Delivery

4 PATIENT CARE MANAGEMENT SKILLS (Patient Care, Systems-Based Practice, and Communication): Students must demonstrate application of medical knowledge, effective communication skills (oral and written), and collaboration with other health care providers in the following areas. Written Oral Communication Skills Communication Skills Therapeutic Management Admissions Orders Depression/Mental Health Complete History and Physical Inpatient and Outpatient Patient Education Discharge Summary Breast Feeding/Lactation Gyn Post-Operative Inpatient Note Breast Health/Disease Prevention Gyn Outpatient Note Contraception Counseling Ob Inpatient Note Gynecological Health Ob Outpatient Note Informed Consent Orders (Meds, Diagnostics, Consults) Non-Compliance Post Operative Orders Obstetric Health Prescriptions Inpatient and Outpatient Obesity Counseling Procedures Inpatient and Outpatient Smoking Counseling Progress Note (SOAP Format) - Post- Operative Gyn Collaboration of Care Progress Note (SOAP Format) - Inpatient Ob Care of the Underserved Case Management Antepartum Outpatient Discharge Planning Emergency Department Assessment Domestic /Social Adversity Gyn Inpatient Nutrition Counseling Gyn Outpatient Utilization of other Health Care Providers Intrapartum Inpatient Preventive Care Postpartum Inpatient Preoperative Risk Assessment Presentation Morning Report, Transfer of Care Health Maintenance/Prevention

5 PROFESSIONAL BEHAVIORS (Professionalism): Students must demonstrate conduct and behaviors expected of, and consistent with, their commitment to professional responsibilities. Professional Responsibilities PACE Experience DATE COMPLETED DUTY HOURS (TIME OF DAY) PRECEPTOR NAME (PRINT) Faculty Verbal Feedback DATE Was CSEP reviewed? Y/N WEEK 1 WEEK 2 WEEK 3 WEEK 4 WEEK 5 WEEK 6 Practice-Based Learning & Improvement Project DATE PRESENTED TOPIC Clinical Skills Experience Portfolio (CSEP) Review Submission of the completed CSEP to the clerkship site director is a clerkship requirement. The student attests to the accuracy and validity of the documentation with its submission. Confabulated or misrepresented information is considered and Honor Code violation. DATE COMPLETED CSEP Submitted to Clerkship Site Director Student Signature Clerkship Site Director Signature Clerkship Site Director will document completed CSEP on final grade report form and forward to Clinical Curriculum Director.