OB507M.23

Family Planning

Credits: 4.00 CREDITS (Clinical Elective)
Sites: BWH
Directors: Bartz, Deborah Anne
Offered: Full time every month.
Open to Exclerks: No (HMS only)
Description:
This course will expose the student to the range of clinical experiences and issues related to family planning, in order to provide a comprehensive knowledge base, an opportunity for skill development, and a context for clarification of values related to family planning. Seventy percent (7-half day sessions) of the student's time will be spent in family planning and gynecology clinics where she will gain exposure to abortion and contraceptive care. This clinical training will include exposure to abortion in a hospital setting and with community-based abortion providers, as well as time spent in outpatient gyn services within a community health center (CHC). By observing the full spectrum of family planning care delivery sites—from the integrated approach to primary prevention within the CHC medical home model to the tertiary care afforded to more complex cases in the hospital—the student will gain appreciation of the role of family planning in the full spectrum of women’s health. Across these settings, advanced instruction will be provided in patient counseling and health promotion related to reproductive decision-making.

Thirty percent of the student’s time (3 half day sessions) will be dedicated to didactics and research, including the 4 hours of regularly scheduled didactic time dedicated to the BWH-MGH combined ob/gyn residency and including the 2 hours of weekly seminar provided at BWH Family Planning Center. Didactic sessions will supplement the knowledge base built in prior core clerkships, covering issues rarely addressed elsewhere in the curriculum, including abortion, reproductive health policy, and domestic and global family planning concerns. Seminars will provide an opportunity for discussion and values clarification regarding family planning care provision. Students will be required to generate a substantive scholarly product on a topic of chosen interest and to prepare a presentation of this work to the family planning faculty and staff.
Learning Goals:
1) Experience clinical care in delivery of abortion and contraceptive services
2) Understand domestic and international family planning concerns including the epidemiology of unplanned pregnancy and the impact of reproductive health policy on quality of care
3) Understand the role of family planning as a component of primary prevention in the community-based medical home model
4) Understand the role of family planning, including abortion, in the full context of the health of reproductive age women (15-45)
Incorporation of Basic Science Content and Evidence-Based Medicine:
In addition to exposure to the evidence-based best clinical practices employed in the clinical context, students will be exposed to basic science and evidence-based medicine content through three primary channels:
1) readings in the written curriculum designed to accompany the course;
2) participation in ongoing resident lectures, family planning seminars, and family planning simulations scheduled concurrently with the student's time in
the course;
3) individual research mentored by family planning faculty.
Evaluation:
Students will be evaluated based on four criteria:
1) his/her performance in the clinical context of abortion care delivery;
2) his/her performance in the clinical context of contraceptive care delivery; 3) his/her performance in the clinical context of community-based outpatient gynecologic care;
4)the quality of his/her final scholarly product and accompanying presentation.

Students will be evaluated on the quality of clinical care delivery based on their demonstrated ability to perform the following tasks in the following
domains:

Interpersonal and Communication Skills
*Counsel patients regarding: Contraceptive options & First and second trimester abortion procedures
*Provide care to patients experiencing pregnancy loss in an emotionally sensitive manner
*Understand and acknowledge the complex reasons patients choose to terminate a pregnancy

Professionalism
*Understand the components of informed consent
*Demonstrate tolerance of value systems different than one’s own
*Demonstrate a commitment to patient confidentiality

Practice-Based Learning
*Use consultative services to improve patient care
*Analyze systems of care and discuss how they may influence quality of care

System-Based Practice
*Facilitate abortion and contraceptive services to young women
*Understand the global consequences of unsafe abortion
*Understand importance of operating procedures such as safety pause to minimize medical errors
*Increase understanding of operative planning in context of financial, insurance and social constraints

In evaluating the scholarly product, faculty will consider the extent to which the product is:
-fruitful for the advancement of basic science and/or grounded in the principles of evidence-based medicine;
-applicable in the field either immediately or at some future date as the
basis for a study design, grant proposal, or clinical protocol;
-demonstrative of either
1)in-depth knowledge of a clinical issue/question of timely relevance, or
2)in-depth exploration of the public health or epidemiological literature on a population health issue pertinent to family planning.
Grade Criteria:
High Honors:

The student demonstrates: 1) professionalism and empathy for all patients; 2) the highest commitment to delivering safe, efficient, and high-quality care for all patients and all presenting concerns; 3) significant improvement in clinical skills including the taking of history and physical; interpretation of ultrasound images and laboratory test results as applicable; surgical skills; 4) substantial mastery of resources for optimizing the management of care for women with complex medical needs, such as evidence-based contraceptive use guidelines. The student's scholarly product is of sufficient quality such that it may form the basis for a future grant proposal; manuscript targeting peer-reviewed publications; oral abstract and/or conference poster; grand rounds lecture; or be appropriate for another dissemination channel of scholarly significance.

Honors:

At a minimum, the student demonstrates: 1) professionalism and empathy for all patients; 2) the highest commitment to delivering safe, efficient, and high-quality care for all patients and all presenting concerns; 3) moderate improvement in clinical skills including the taking of history and physical; interpretation of ultrasound images and laboratory test results as applicable; surgical skills; 4) emerging mastery of resources for optimizing the management of care for women with complex medical needs, such as evidence-based contraceptive use guidelines. The student's scholarly product is of sufficient quality to demonstrate mastery of a subject area of clinical significance. It may form the basis for further research.

Satisfactory:

At a minimum, the student demonstrates: 1) professionalism and empathy for all patients; 2) the highest commitment to delivering safe, efficient, and high-quality care for all patients and all presenting concerns; 3) limited improvement in clinical skills including the taking of history and physical; interpretation of ultrasound images and laboratory test results as applicable; surgical skills; 4) limited mastery of resources for optimizing the management of care for women with complex medical needs, such as evidence-based contraceptive use guidelines. The student's scholarly product is of high quality and may form the basis for future research.

Unsatisfactory:

The student demonstrates: 1) professionalism and empathy for most patients; 2) high commitment to delivering safe, efficient, and high-quality care for most patients and presenting concerns; 3) little or no improvement in clinical skills including the taking of history and physical; interpretation of ultrasound images and laboratory test results as applicable; or surgical skills; 4) little or no mastery of resources for optimizing the management of care for women with complex medical needs, such as evidence-based contraceptive use guidelines. The student's scholarly product is of moderate or poor quality.
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