تفاصيل المقرر

المقدمة


The aim of the obsterics/gynaecology clerkship is to provide a set of learning experiences in specified setting designed to foster acquision of the competencies required for the practice of the discipline; i.e. to master the presented basic performance objectives in accord with local conditions to meet local needs. The clerkship enables the student to acquire new skills and to refine already learned skills in history, physical examination and management. The student works as a member of a health care team and develops good interpersonal skills in dealing with patients and the health care team.
Students must meet all the objectives and be available for all phases of the clerkship



المحتويات


LIST OF SKILLS

A skill is defined as "a performance theat - once learned can be carried out rather accurately with little or no conscious attention to the component acts"
(Cromback, 1976).
At the completion of the clerkship the student should be able to :
Level I :

1. Take blood pressure of patient using the right technique and taking proper care of the sphygmomanometer
2. Estimate the hieght of the fundus of the pregnant uterus in weeks
3. Estimate the size of foetus (gastational age and weight)
4. Identify the foetal lie, presentation, attitude, position and engagement in pelivs after the thirtysecond week of pregnancy
5. Monitor the foetal heart using the foetal stethoscope
6. Monitor matenal vital signs: pulse,
temperature, respiratory rate
7. Perform vaginal examination during labour and identify:
a- important landmarks of the plevis,
b- servical dilatation in centimeters and effacement
c- presenting foetal part,
d- foetal position,
e- foetal station
8. Calculate Bishop's score
9. Perform clinical assessment of plvis
10. Rupture membrances during labour when necessary
11. Perform episiotomy and decircumcision
12. Stitch an episiotomy and a second degree tear.
13. Conduct normal delivery
14. Catheterize female bladder
15. Inspect the placenta and identify any important abnormalities
16. Identify the hieght of fundus, uterine size, consistency and shape after delivery of foetus
17. Calculate the Apgar score of the newborn at one and five minutes
18. Examine the neborn and detect major congenital anomalies
19. Resuscitate the newborn (suction, O2 , ect.)
20. Use the various vaginal speculae(Cuseo's and Sim's ) for inspection of the vagina and cervix
21. Perform gynaecological examination (pelvic and breast ) and identify normal and abnormal genital organs
22. Take a cervical smear
23. Take swabs for bacteriological examination from:
a- vagina ( HVS )
b- cervix,
c- urethra
24. Diagnose abortion : a- threatened,
b- inevitable,
c- incomplete
d- complete
25. Perform surgical scrubbing, gowning and dressing
26. Give an I.M. injection
27. Do a venepuncture
28. Set up an I.V drip for:
a- fluid infusion
b- blood transfusion
29. Perform vulval and perineal local anaesthetic infiltration
30. Fill in investigation forms
31. Perform general examination of urine
32. Examine blood for :
a- haemoglobin estimation
b- blood film for malaria (thick an thin film)
c- blood semer for red blood cells
33. Perform an immunological pergnancy test
(pregnosticon test)

Level II :

1. Perform low rupture of membranes for induction of labour
2. Perform amniocentesis
3. Perform pudendal block
4. Apply wrigley's forceps (low forceps)
5. Perform digital evacuation of retained
products of conception
6. Intubate a stillbirth
7. Insert I.U.C.D.
8. Demonstrate the application of the Dutch cap
9. Demonstrate the application of chemical barriers for contraception

LIST OF CURRENT MEDICATIONS IN OBSTETRICS & GYNAECOLOGY

This list is given as a practical guide and not to be learnt by rote. The more familiar roprietary names are written in parenthesis .
Some of the durgs given are either contra-indicated or best avoided during pregnancy and lactation. Thoughtful consideration should be taken when prescribing for a pregnant (or lactating) especially in the first trimester of pregnancy.

ANALGESICS

1. Inhalation analgesics (in labour)
a. Nitrous oxide :
Premixed with 50% Oxygen (with Entonox machine)
variable mixtures of N 2 O (10-50%) with oxygen with lucy Baldwin Equipment)
b. Trichlorethylene (Trilene) : 0.33 or 0.65%
c. Methoxyflurane (Penthrane) : 0.33( with Cardif Inhaler)

2. Parenteral
a. Pethidine
b. Morphine
c. Pentazocine (Sosegon)

3. Local
Dignosaine (Xylocains) 1% for :
- spinal
- epidural
- caudal
- paracervical
- pudendal
- field block
4. Oral
a. Acetyl-salicylic acid Aspirin)
b. Paracetamol (aoetaminophen-Panadol)
ANTICOAGULENTS & RELATED DRUGS

1. Heparin
2. Conmarin derivatives :
a. pheni
b. warfarin
3. aminocaproic acid
4. protamine sulphate

ANTIEMETICS (ANTIHISTAMINES)

1. Meclozine (Ancolan)
Meclozine + vit B6 combination (Ancoloxin)
2. Promethazine (Phenergan)
3. Promethazine theoclate (Avomine)
4. Dimenhydrinate (Dramamine)
etc.

ANTIHYPERTENSIVES

1. Methyldopa (Aldomet)
2. Guanithidine (Ismelin)
3. Hydrallazine (Apresoline)
4. Reserpine (Serpasil)
5. Propranolol (Inderal)

ANTI-INEFECTIVE AGENTS

1. Sulphonamides
a. Sulphadiazine (for general purpose)
b. Sulphadimidine ( " " " )
c. Sulphatriad (sulpha - thiazole, - diazine, - merazine)
(for general purpose)
d. Sulpha furazole (Gentrisin) (for urinary infections)
e. C0-trimoxazole (Sulphemethoxazole - trimethoprim)
combination, Bactrim, Septrin)

2. Penicillins
a. Penicillin G (benzyl penicillin)
b. Penicillin V (Phenoxymethyl peniocillin)
c. Procain penisillin (Seclopen)
d. Benzathine penicillin (Panadur)
e. Methincillin
f. Ampiclillin
g. Amoxil
h. Cloxacillin and dicloxacillin
i. Epicillin (Dexacillin)
j. Carbenicillin (Pyopen)

3. Cephalosporins :
a. Cephaloridine (Ceporin)
b. Cephalexin (Ceporex)
c. Cephradine (Velosef)
4. Aminoglycosides :
a. Streptomycin
b. Gentamycin

5. Chloramphenicol (Chloromycetin)
6. Erythromycin
7. Nitrofurantoin
8. Nalidixic acid (Wintomylon)
9. Tetracyclines

10. Anti-fungal drugs:
a. Nystatin (Mycostatin)
b. Amphotericin B (Fungilin)
c. Clotrimazole (Canesten)
d. Gentien violet 1% aquous solutions

11. Trichomonicide:
Metronidazole
12. Antimalarials
a. Chloroquine (Resochin,
b. Amodiaquine (Camoquin)
c. Pyrimethamine (Daraprim)
d. Proquanil (Paludrine)
13. Anti tuberculosis drugs :
a. Para-aminosalicylic acid (PAS)
b. acid hydrazide (INH) or Isoniazid
c. Streptomycin
d. Rifampicin (Rimactane, Rifadin)

ANTI-INFLAMTORY DRUGS

1. Paracetamole (acitominophen, Panadol)
2. Salicylates (Aspirin)
3. Indomethacin (Indocid)
4. Mefenamic acid (Ponstan)
5. Ibuprofen (Brufen)

ASTHMA DRUGS

1. Ephedrine
2. Amophylline and theophylline
3. Terbtualine (Bricanyl)
4. Salbutamole (Ventolin)

CARDIAC DRUGS

1. Cardiac glycorides
a. Digitalis
b. Digoxin
2. Antiarrhythmic drugs
a. Quinidine
b. Procainamide (Pronestyl)
c. Disopyramide (Rythmodan)

CYTOTOXIC DRUGS

1. Metholrexate' (folic acid antagonist)
2. Cyclophosphamide ( a nitrogen mustard)
etc..

DIURETICS

1. Thiazides :
a. chlorothiazide
b. hydrochlorothiazide
2. Fursemide (Lasix)
3. Mannitol

ELECTROLYTE & INFUSION DRUGS

1. Glucose and normal saline solutions
2. Darrow's selution
3. Ratmann's solution
4. Sodium bicarbonate solution
5. Dextran 40% solution
6. Fibrinogen infusion
7. Potassium chloride solution

GASTRO-INTESTINAL DRUGS

1. Antacids :
a. Aluminium hydroxide
b. Calcium carbonate'
c. Magnesium saltes (hyroxide, trisilicate and carbonat)
d. Sodium bicarbonate
2. Belladenna alkaloids (hydroxide , hyosine and atropine)
3. Laxatives :
a. Cascare
b. Senna
c. Phenophthalein
d. Bisacodyl
e. Castor oil
f. Magnesium salts (hydroxide = milk of magnesia,
sulphate = epsom salt

HORMONES & SYNTHETIC SUBSTITUTES

1. Sex-steroids
a. Oestrogens
i) Natural : oestradiol, oestroneand oestiol
ii) Synthetic ethinyloeslridiol and mestranol
b. Progestogens (Gestagens)
i) Progesterone derivalives : Dydrogesterane (Duphaston)
ii) 17 hydroxyprogesterone derivalives :
17 hydroxyprogesterone caproate (Primolut Depo)
hydroxyprogesterone acetate (Depo Provera)
iii) 19 - Nortestosterone derivatives : Morethisterone ( Primolut - N) , Norgesterel.
c. Contraceptive pill : Ethinyloestradiol or mestranol- progestogens ( e.g. norethisterone or norgesterel) combination .
2. Corticosteroids
a. Hydrocortisone (Solu-Certef)
b. Prednisone and prednisolone
c. Dexamethazone
3. Prostaglandins
4. Gonadotrophic hermones
a. Human chorionic gonadotrophin
b. Follicle stimulating hormone

5. Prolactin
(Inhibiter : Breomoriptine (Parlodel)
6. Insulins (and hypoglycaemic drugs)
a. Insulin preparations :
1- Soluble insulin
2- Insulin zinc suspensions (lente, semilente and ultralente)
3- Protamine zinc insulin
b. Sulphonylureas
1- Tolbutamide (Rastinon)
2- Chlorpropamide (Diabinese)
3- Glibenolamide (Daonil)

MINERALS & VITAMINES

1. Iron :
a. oral: 1) ferrous sulphate (Fersolin)
2) ferrous fumerate (Fersamal)
3) ferrous gluconate (Fergon)
b. Intramusoularing:
1) Iron - dextran (Imferon)
2) Iron - sorbitol ( )
c. Intravenousing : Iron - dextran
(insaline / glucose)
(in Infusion drug)
2. Folic acid

HYPNOTICS

1. Nitrazepam (Mogador)
2. Dichloralphenazone (Welldorm)
3. Barbiturates :
1- quinalbarbitone (seconal)
2- but barbitone (soneryl)
etc

OXYTOCIC DRUGS

1. Ergometrine
2. Oxytocin (Syntocinon)
3. Ergenetrine - oxytocin combination (syntometrine)
PSYCHOTROPIC DRUGS

1. Chlorpromacine (Largactil)
2. Diazepam (valium)
3. Chlordiazepoxide (Librium)
4. Lorazepam (Ativan)

DRUGS TAKEN SOCIALLY

1. Alcohol
2. Tobacco
3. Caffeine



المنسقون

Dr. Ahmed Elmustafa Mohamed Shiekh Edris
Dr. Elhadi Ibrahim Miskeen


المطلوبات



الأهداف


The objectives are ranked according to their priority into two levels :
Level I :
Includes the conditions which are common and/or serious and/or preventable, and which the student is expected to diagnose and manage or evaluate their management.
Level II
Includes the conditions which are considered to be less common, and/or serious, and/or preventable compared to Level 1 conditions. Accordingly, the required competency level of the student is less.
It is the student responsibility to meet all the clerkship objectives through teaching and independent self-learning. If there are problems, they should be immediately discussed with the doctor in charge of the unit and the coordinator of the clerkship.
At the completion of the clerkship in obstetrics and gynaecology, the student should be able to:

1: General Objective
2 : Specific Objectives:
A. History,Physical Examination and Professional Attitude and Behaviour

1. Develop the required interpersonal skills in working with patients and their families, peers , doctors , nureses and other members of the health care team.
2. Recognize, alleviate and consider psyco-social and economic concerns of patients in their management.
3. Refine skills in obtaining a pertinent history and physical examination with emphasis on the psycho-social, reproductive anatomy and pathology and foetal and newborn evaluation
4. Train, supervise, guide and direct performance of the health care team members.

OBSTETRICS
All obstetrical objectives are in level I.

B. Normal Pregnancy

1. Outline the physiological and anatomical changes of the developing ovum (Ref. Course 202: Growth and Development) and the changes in the mother accomanying pregnancy (Ref. Course 416 Genito-Urinary System) .
2. Describe the foeto-placental physiology , foetal circulation and its changes at birth (Ref. Course 202 Growth and Development) .
3. Diagnose and manage normal pregnant women in the ante-natal clinic and detect and refer patients with abnormalities and high risk factors .

4. Advise and educate mothers on :
- early and regular ante-natal care
- Hygiene of pregnancy
- Nutrition
- Use of drugs during pregnancy and lactation
- Labour
- Care of the newborn including immunization for tuberculosis and later immunization schedule
- Post-natal care
- Family planning and contraception

C. Normal Labour

1. Assess and alleviate the psychological stress of mother and family during labour
2. Define normal labour, and describe its onset, stages, physiology, mechanism, clinical course and the various methods for monitoring maternal and foetal status during labour.
3. Develop skills in the sterile obstetrial scrubbing, growing and dressing techniques.
4. Diagnose and manage normal labour with the use of a partogram).
5. Perform, decircumcision ( anterior episiotomy ) and postero-lateral episiotomies when needed for delivery and their stitching there after.

D. Normal Puerperium

1. Describe the physiology of normal puerperium
2. Manage the post partum patient with emphasis on early mobilization
- Breast care and breast feeding
- Perineal care (episiotomy)
- Post-partum contraception
- Motivation to attend post-natal clinic
- detection of abnormalities (see blew)

E. The Newborn

1. Assess the newborn (calculate the Apgar score at one minute and five minutes)
2. Diagnose and manage the depressed newborn
3. Perform a systematic examination of the newborn
4. Take blood from the umbilical vein, using the right techique and taking the necessary precautions.

F. Abnormal Pregnancy

1. Diagnose and manage or evaluate management of pregnant woman with the following medical and surgical disorders:
- Anaemia (especially iron and folic acid deficiency and nutritional anaemia)
- Malaria fever and cerbral malaria
- Diabetes mellitus
- Hypertensive disorders
- Janudice (especially infective hepatitis)
- Renal and urinary tract diseases (especially infections)
- Heart disease (especially rheumatic heart diseases)
- Dysentery
- Parasitic infestations (Bilharziasism, gardiasis and ankylostomiasis.
- Respiratory disease (especially tuberculosis, pneumonia and upper respiratory infections
- Psychiatric disease
- Enteric fever
- Rhesus iso-immunization and prophylaxis
- Thyroid disease
- Acute abdomen
- Abdominal trauma
- Varicose veins
- Vaginitis
- Haemorrhoids
- Epilepsy

2. Diagnose manage or evaluate the managemtnt of the following obstetric disorders:
- Pre-eclampsia
- Eclampsia
- Ante-partum haemorrhage
- Hyperemesis gravidarum and morning sickness
- Grand multiparity
- Adolescent pregnancy
- Elderly primigravidity
- Hydramnios
- Hydrocephalus
- Malpresentations of the foetus:
Breech and transverse
- Malopsitions of the foetal head:
Occipitio-porterior, brow and face
- Multiple pregnancy
- Cephalo-pelvic disproportion (and trial of labour)
- High head in primigravida after the 36th week of pregnancy
- Intra-uterine foetal death
- Previous caesarean section (and trial of Caesarean section scar)
3. Detect and explain the management of high risk pregnant patients

G. Abnormal Labour

1. Explain the management of labour which is complicated by a medical or obstetric disorder as stated above under abnormal pregnancy
2. Diagnose and manage post-partum haemorrhage
3. Evaluate obstetric emergencies and the complications of labour and their management :
- Shock
- Retained placenta
- Prolonged labour
- Precipitate labour
- Obstructed labour
- pre-term labour
- ruptured uterus
- cord prolapse
- Acute inversion of uterus
- Post-partum collapse
- Severe (second and third degree perineal tear).
- Lacerations of the perineum

H. Abnormal Puerperium

1. Manage or evaluate the management of patients with the following complications in the puerperium :
- Secondary post-partum haemorrhage
- Puerperal pyrexia and infections
- Deep veinous thrombosis
- Urinary problems
- Breast infection
- Post-partum psychosis

I. Operative obstetrics

1. Perform sterile surgical and obstetrical scrubbing, gowning and dressing techiques and observe all aseptic precautions
2. Outline indications, prerequisites, technique and complications of the following procedures:
- Blood transfusion
- Forceps delivery
- Caesarean section
- Induction of labour
- Vaccum extraction (ventouse)
- Manual removal of the placenta
3. Evaluate pre-operative and provide post-operative care for patients undergoing operative delivery

J. Obstetric Analgesia and Anaesthesia

1. Describe principles of general anaesthesia and analgesia for labour, forceps delivery, Caesarean section and vaccum extraction
2. Perform local anaesthetic infiltration in labour (Local infiltration and pudendal block)
3. Describe the use of various types of anaesthetics and analgesia used in labour and their side effects and management (with special emphasis on cardiac arrest)

GYNAECOLOGY

Level I :

A. Female Pelvic Anatomy Physiology and pathology
1. Describe the female pelvic anatomy
2. Descrive the pelvic organs anatomy embryology and histology
3. Recognize the difference between the male and female pelvis
4. Describe the various types of the female pelvis
5. Explain the physiology of menstruation
6. Describe the ednocrine changes during normal menstruation, puberty and the menopause and the common pathological changes

Level I :

B. Emergency Service
1. Explain the aetiology, management and complications of the following conditions:
- Abortion
- Septic abortion
- Trophoblastic disease
- Ectopic pregnancy
- Vaginitis
- Venereal diseases
- Pelvic infection
- Abnormal vaginal bleeding
- Post-menopausal bleeding
- Complications of female circumcision
- Genital injuries
- Rape

Level I :

C. Outpatient and Ward Service
1. Diagnose and explain the aetiology, management and complications of the following conditions:
- Amenorrhoea
- Congenital abnormalities (of clinical significance)
- Utero-vaginal prolapse
- Urological problem (infection, urinary fistulae & stress incontinence)
- Dysmenorrhoea
- Female and male infertility
- Dysparnuria and other sexual problems
- Tumours of the genital tract (benign and malignant) tumours of cervix, uterus, ovary, vagina and vulva
- Fistulae (obstetric)

Level II :

D. Operative Gynaecology
1. Provide pre-operative care
2. Assist and participate in the management of patients for evaluation D & C (and their complications), vulval abscess, excision of inclusion cyst marsupialization of Bartholin cyst, cervical cauterization & biopsy
3. Explain the pre-operative and post-operative care for gynaecological patients
4. Assist in the following operations for the patients if they are under his/her care:
- Myomectomy
- Hysterectomy (abdominal and vaginal)
- Laparotomy for acute abdomen
- Laparoscopy
- Ovarian cystectomy
- Repair of utero-vaginal prolapse
- Gynaecological malignancy operations
- Repair of fistulae

Level I :

E. Family Planning
1. Explain the various methods of contraception, their mode of action, appropriate use, effectiveness and cost, complications and their management
2. Explain the importance of family planning and the dangers of uncontrolled fertility
3. Motivate and advise individuals and families on family planning and contraception.

Level I :

RADIOLOGY
1. Interpret and advise pertinent radiological techniques for assessing pelvic anatomy and pathology and for the diagnosis of obstetric and gynaecological conditions
2. Explain and take into consideration when ordering a radiological investigation the risks of radiology especially during pregnancy.
See Appendix C for list of Skills
See Appendix D for common Medications in Ob/Gyn.

III. OUTLINE OF WORK

The clinical clerkship in obstetrics and gynaecology can be fascinating and challenging in many respects. The discipline requires:
1) a comperhensive biospychosocial approach to patients, i.e., involving the emotional and physical functions of the patient as well as her socio-cultural and environmental conditions; 2) knowledge and skills in many fields of medicine because the patients vary in age from prenatal and newborn to senscent stage; 3) dealing with the healthy to promote and maintain health and with the sick for alleviation and cure of symptoms. The results are often very rewarding and staisfying.
However, the obstetrics/gynaecology clerkship requires dedication and hard work which does not respect the time of day or night



طرق التدريس


1 Rotation Posting
Students are posted to both University and Ministry of Health Units in Wad Medani Teaching Hospital. The idea is to give the student the chance to work with various tutors (physicians) and therefore to develop a wider perospective. Posting and rotation of students will be annonced in the introductory class.
2 Seminars/lectures classes
These two-hour classes are held in the hospital lecture theatre at 7.00 to 9.00 a.m. three times a week on Saturday, Monday and wednesday. They are design to cover the most important topics in O/Gyn. (See Schedule Appendix A). They are very useful. Prior experience with a practical problem and advanced reading will greatly enhance their value Selected students will be given allocated seminar topics to present in some of these sessions. The lectures will guide the students in difficult tpics but most of the work will be done by them.
3 Basic Science Seminar/Practical
The two-hour class is held in the appropiate setting for each topic from 7.00 to 9.00 every Sunday. It covers organ pathology, pathophysiology, microbiology, pharmacology, endocrinology and ther basic science issue related to Ob/Gyn. (see schedule Appendix B).
4 Inpatient Work
Every student will be assigned five beds in each of the obstetrical and gynacological wards in his unit. Patients should be clerked within twenty four hours of admission. After clerking examination may be performed under the physician supervision in the first few weeks. Progress notes should be updated daily or as often as necessary. Students' notes must be attached to case records under their name for checking by Tutors. The students must keep their own case record on the discharge of the patient from hospital.
5 Ward Rounds
Wards rounds will be conducted with the unit team. Students shall take every advantage of ward rounds to present and duscuss their cases. They should also be prepared to present and discuss their cases in the Grand-Round (Sturday 10.00 to 12.00) at operation and in the Department Discharge Clinic (Thursday 8.00 to 9.00 a.m.) .
6 Tutorials
Each tutor will meet his group at least once a week for tutorials on topics related to inpatient or outpatient problem (s) or to discuss any difficulties in the students work.
Students have to hand in their case records after the tutorial (or weekly) for correction and comment.
7 Labour Wards
Students will undertake deliviries under suervision of the ward staff. The instructional unit on normal labour will help the student to aquire the required knowledge skills and attitudes inh the onduct of labour and delivery. The best strategy is to study one patient at atime from early labour until delivery instead of flitting from patient to patient or attending the mechanical' delivery of the baby only. The tudent is required to observe three normal deliveries before conducting normal deliveries.
8 Operating Theatre
Students are expected to be always present in the theatre with their unit. Students shall attend the operations and are expected to assist in their own patients. They should learn how to be good assistants in the operating room ( and the delivery room).
8 Antenatal Clinic
Students will attend once a week atenatal clinics held in their (Unit) Health Centre at 10.00 - 12.00 Students shall clerk and examine as many patients as possible under the health visitor's or physician's supervision. They shall assist in taking blood pressure, estimating haemoglobin level, weighing patients and examining urine ect.
10 Referred Clinics
Students will attend once a week, the hospital referred clinic of the Unit. They shall interview and examine patients as instructed by the physicin in chrge.
11 Special Clinics
Family planning and infertility clinics will be started in the near future. Each student is expected to attend two sessions.
12 Admitting Room (Outpatient Clinci)
With the recent introduction of the health centre-hospital referral system, the admitting room has been attached to the obstetric ward. Students shall clerk, examine and investigate patients under supervision of the physician in charge of admissions (usually the physician on call)
The system of admitting room experience (in the outpatient referred and antenatal clinics), inpatient experience (in the obstetric and gynaecological wards, labour wards and operating theatres) and follow up experience ( in the refeered clinics), provide an excellent opportunity for portinuity of patien care. Students will see the different aspects of illness and different nedds of patients and families at the various stages of illness.
13 Department Discharge Clinic
This clinic held in the Senior obstetrician Gynaecologist Office every Thursday at 8.00 to 9.00 a.m. involve audit review of discharged patients during the week. Its is useful for students in pointing out the optimum management with the available resources. All students are expected to attend.
14 Hospital Clinical Meeting
Students are wxpected to attend the multidisciplinary clinic meeting hedl in Hammadein Hall every Thursday at 12.00 - 2.00 a.m. 15 Night Duty
Students are assigned by roster to two night duties from 1.30 p.m. to 6.30 a.m. centered in the labour wards. At the commencement of each duty period, students shall report promptly to the team on duty, Students while on duty must be available at all time in known locations within the hospital premises for emergency calls which they should attend with the housman on-call.

IV. STUDENTS ASSIGNMENT

During the peiod of clerkship, every student is required to complete certain assignments in obstetrics and gynaecology.
1. Case Write-up :
The student shall write-up
a. Ten normal hospital deliveries and five home deliveries personally performed by the student. These deliveries are recorded in the student labour book .
b. Five abnormal obstetric cases , comments
c. Five gynaecological cases, with comments
d. Five vaginal and perineal stitching performed personally in recently delivered mothers. Extensive lacerations may not be sutured by students. The operations should be recorded in the student experience log.
The first case record must be handed in wihtin the first two weeks of the posting. The complete set of case records must be handed in before the last week of clerkship.
Students shall prepare all course work on regular daily basis and can meet deadlines in time by writing one case a week.
2. Student Experience log:
This log allows the student to record all his/ her efforts during the clerkship. All patient encounter should be recorded in the experience log form ( or block). The level of involvement, supervision and study should be indicated. A well kept log is the student's best evidence of accoplishment and it documents to the faculty the student's diligence. Each student is encouraged to update the log-book daily and each tutor should review the logs weekly



المصادر


تكمن الموارد الرئيسية لهذه االممارسة السريرية في مستشفى واد مدني التعليمي لامراض النساء والتوليد واقسام امراض النساء والتوليد بالمستشفيات الاخرى الحديثة بواد مدني ، مستشفى العلاج بالذرة ومستشفى الكلى وكذلك مركز تطوير التعليم الطبي والمتحف والمراكز الصحية بمدينة واد مدني ومكتبة كلية الطب – جامعة الجزيرة. - تتم مناقشة مواضيع محددة وموضوعة مسبقا بجدول المناقشات بواسطة احد المشرفين مع كل الطلاب والذين اضطلعوا على هذا الموضوع قبل بداية النقاش.


وسائل التقويم


1 Formative & Dignostic:
There will be :
a. mid term written test. This will be a dignostic test
b. mid term review of clinical performance & write up of at least half of the cases .
2 Summative:
The summative evaluation is composed of :
a. The end of term test: This will include written, oral and clinical tests
b. Fulfillment of assignments
c. Tutors report on clinincal performance
Each student's evaluation is returned to the student and his advisor by the coordinator.
3. Clerkship Evaluation ( Program Evaluation )
This evaluation seeks to improve the quality , organization administration and implementation of the clerkship. It is composed of :
a. Coordinator, tutors and students mid and end-of-term meeting
b. Students program evaluation forms which include evaluation of instruction, faculty , and facilities and learning environment.
Students feedback is earnestly requested and much appreciated in all phases of the clerkship and at all times.



المراجع


Ten Teachers:
  • الجزء الاول : طب التوليد
  • الجزء الثاني : أمراض النساء
Fundamental of Obstetric :
أساسيات طب التوليد وامراض النساء : Li ewellyn- jonew, D.; & Gynecology
الجزء الاول طب التوليد volume one Obstetrics – London, Faber & Faber limited, 1982
الجزء الثاني امراض النساء London – Faber & Volume tow Gynecology faber limited 1982


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