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. Students will sign an Honor Pledge (electronically or manually) each time an assignment is turned in or an examination is started to reaffirm their complete understanding of the Honor Code of Elon University and their affirmation that their work abides by that Code.

Required Textbooks:

1.  All first-year required textbooks.

2.  Clinician's Pocket Reference, 11th Edition [Paperback]

3.  Current Diagnosis and Treatment: Obstetrics and Gynecology by Decherney and Nathan, 10th Edition

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
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 (25%), Preceptor Evaluation (65%), 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, including the following:
  3. Pelvic exam – bimanual and speculum
  4. Breast examination
  5. Know the components of a complete and focused prenatal examination including the following:
  6. Pelvic exam
  7. Fundal height
  8. Fetal exam
  9. Select and interpret diagnostic studies to evaluate the differential diagnosis, including the following for each study:
  10. Risks and benefits
  11. Sensitivity and specificity
  12. Cost effectiveness
  13. Informed consent
  14. Describe the indications for colposcopic cervical examination following an abnormal PAP smear.
  15. Perform or be able to describe the following diagnostic procedures under the direction of and according to standards as established by the clinical preceptor:
  16. Cultures (vaginal and rectal) and rapid antigen tests (e.g., Gonorrhea, chlamydia, Herpes simplex, Group B strep)
  17. Papanicolau smear/Thin prep
  18. Vaginal smears
  19. Discuss the methods of contraceptives and family planning, including indications, contraindications, efficacy, advantages, disadvantages, safety, mutagenicity, patient education, cost and cultural/religious issues.
  20. 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.
  21. Recognize the presentation of common breast masses and identify the appropriate work-up and treatment.
  22. List the physiologic changes and signs of pregnancy.
  23. Describe routine prenatal care.
  24. Define and discuss the use of screening and diagnostic instruments used in prenatal obstetrics (again can substitute prenatal care), 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).
  25. Identify medical problems that may result in complications during pregnancy, including diabetes, anemia, thyroid disorders, cardiovascular problems and vaginal bleeding.
  26. Discuss and describe normal embryonic/fetal development.
  27. Discuss the indications for, correct use and administration of obstetric pharmacologic therapies (i.e., RhoGam, Magnesium sulfate)
  28. Demonstrate knowledge of appropriate gynecologic and obstetric (antepartum and postpartum) management plans, including screening, treatment, follow-up and patient education.
  29. Discuss the appropriate use of medications for gynecologic and obstetrical patients including such issues as indications, contraindications, interactions, complications, dosage, metabolism, excretion and mutagenicity.
  30. Identify first-line therapeutic recommendations for treating common or life threatening conditions when they occur in pregnant patients.
  31. 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
  32. Nutrition – including need for supplementation during pregnancy
  33. Genetic counseling
  34. Accident and violence prevention (e.g., seat belts, helmets, screening for domestic violence)
  35. Physical activity, exercise
  36. Pertinent risk factors, including occupation, environment, tobacco, alcohol, other drugs and genetic factors
  37. Warning signs/symptoms of disease
  38. Plan for age appropriate screening and periodic health assessment
  39. Immunizations (HBV, rubella, Tdap)
  40. Recognize and institute the initial management of emergency gynecologic and obstetric emergencies in the absence of a physician, such as:
  41. Ectopic pregnancy
  42. Obstetrical hemorrhage
  43. Preeclampsia/eclampsia/PIH
  44. Preterm labor
  45. Intrapartum fetal distress
  46. Postpartum hemorrhage/infection
  47. Sepsis
  48. Embolic phenomena
  49. Dysfunctional uterine bleeding
  50. Pelvic inflammatory disease
  51. Torsion of an ovarian cyst
  52. Medical evaluation of rape/domestic abuse
  53. 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.
  54. Prepare patient records that follow the SOAP format.
  55. Effectively and efficiently communicate patient presentations to the clinical preceptor.
  56. If presented with the opportunity, assist the gynecologist, as directed, during surgical procedures

4

Revised 10/23/13