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APGO/WHEO Women’s Health Care Competencies for Medical Students

APGO/WHEO Women’s Health Care Competencies for Medical Students. WHEO Task Force Joanna Cain, MD Glenda Donoghue, MD Sonya Erickson, MD Diane Magrane, MD Jennifer Potter, MD Tamara Stein, PhD Roberta Rusch, MPH. Women’s Health Care Competencies Project Purpose:.

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APGO/WHEO Women’s Health Care Competencies for Medical Students

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  1. APGO/WHEO Women’s Health Care Competencies for Medical Students WHEO Task Force Joanna Cain, MD Glenda Donoghue, MD Sonya Erickson, MD Diane Magrane, MD Jennifer Potter, MD Tamara Stein, PhD Roberta Rusch, MPH

  2. Women’s Health Care Competencies Project Purpose: • Sex & gender matter in health and illness • Medical students must know how to care appropriately for female patients, regardless of specialty

  3. Critically impact: Incidence (how common) Etiology (cause) Presentation (symptoms) Progression (severity) Likelihood of being offered screening, testing, and treatment (access) Approach to testing (appropriateness) Response to treatment (outcome) HOWEVER… despite increasing recognition of the importance of sex and gender differences, undergraduate medical curricular reform has been slow Why Sex and Gender? Henrich, Acad Med 2004

  4. Undergraduate Medical EducationChallenges to Curricular Reform

  5. Women’s Health Care Competencies Project Goals: • To identify women’s health care competencies for medical students • To develop a tool to evaluate, improve, and integrate these competencies into undergraduate medical education

  6. Women’s Health Care Competencies Project Methodology: • November 2000 Interdisciplinary Retreat - Women’s Health Experts • “Women’s Health Care Competencies for Medical Students” developed Competency: basic knowledge, skills, and attitudes needed in order to provide appropriate preventive care and treatment to women

  7. Women’s Health Care Competencies Project 8 Core Competencies: • Explain sex and gender differences in normal development and pathophysiology • Effectively communicate demonstrating awareness of gender and cultural differences • Perform sex, gender, & age appropriate physical exam • Discuss impact of gender-based societal and cultural roles on health care

  8. Women’s Health Care Competencies Project 8 Core Competencies (cont.): Identify and assist victims of physical, emotional and sexual violence & abuse Assess and counsel women for sex- and gender-appropriate reduction of risk Access and critically evaluate new information & adopt best practices of sex and gender differences in health and disease Discus the impact of health care delivery systems on populations and individuals

  9. Women’s Health Care Competencies Project Methodology (cont.) • 2001 - Curricular tool/resource developed for two of the eight core competencies: • APGO Undergraduate Medical Education Committee (UMEC) • Professional Education Working Group of the National Centers of Excellence in Women’s Health (NCoE) • WHEO Multidisciplinary Task Force

  10. Learning Objective Eval Method ACGME Link References Level Associate the male and female urogenital embryological structures with their adult counterparts MCQ Oral KF 2b Larsen, W.J. et al (eds), Human Embryology, 3rd ed. Churchill Livingstone, 2001. / Moore, K & Dalley, AF. Clinically Oriented Anatomy, 4th ed. Lippincott, Williams & Wilkins, 1999. / Netter, F & Hansen, JT. Atlas of Human Anatomy, 3rd ed. Novartis, 2003. KH Compare the changes seen in the male and female urogenital tracts from birth through senescence MCQ Oral KF 2a, 2b Larsen, W.J. et al (eds), Human Embryology, 3rd ed. Churchill Livingstone, 2001. / Vander A.J., Sherman J.S., Luciano, D.S., Human Physiology, 8th ed. McGraw Hill, 2000. KH Describe the role of androgens in the differentiation of the urogenital tract MCQ Oral KF 2b Larsen, W.J. et al (eds), Human Embryology, 3rd ed. Churchill Livingstone, 2001. / Knobil E., Neill J.D. (eds.), Encyclopedia of Reproduction. San Diego, Academic Press, 1998, 4 vols. / Vander A.J., Sherman J.S., Luciano, D.S., Human Physiology, 8th ed. McGraw Hill, 2000. K Women’s Health Care Competencies Project Explanation of the 5 column format: Normal Physical & Psychological Differentiation & Development

  11. Learning Objective Level Associate the male and female urogenital embryological structures with their adult counterparts KH Compare the changes seen in the male and female urogenital tracts from birth through senescence KH Describe the role of androgens in the differentiation of the urogenital tract K Women’s Health Care Competencies Project Explanation of the 5 column format: Normal Physical & Psychological Differentiation & Development

  12. Miller’s Triangle Professional authenticity Miller GE. Academic Med 1990; 65:S63-67. Van der Vleuten, C. Ottawa Conference, 2000

  13. Learning Objective Eval Method ACGME Link Level Associate the male and female urogenital embryological structures with their adult counterparts MCQ Oral KF 2b KH Compare the changes seen in the male and female urogenital tracts from birth through senescence MCQ Oral KF 2a, 2b KH Describe the role of androgens in the differentiation of the urogenital tract MCQ Oral KF 2b K Women’s Health Care Competencies Project Explanation of the 5 column format: Normal Physical & Psychological Differentiation & Development

  14. Evaluation Methods:ACGME Outcome Project www.acgme.org

  15. ACGME Toolbox of Assessment Methods

  16. ACGME Competency Skills • Six competency areas • Skill sets defined a b 1 c d

  17. Learning Objective Eval Method ACGME Link References Level Associate the male and female urogenital embryological structures with their adult counterparts MCQ Oral KF 2b Larsen, W.J. et al (eds), Human Embryology, 3rd ed. Churchill Livingstone, 2001. / Moore, K & Dalley, AF. Clinically Oriented Anatomy, 4th ed. Lippincott, Williams & Wilkins, 1999. / Netter, F & Hansen, JT. Atlas of Human Anatomy, 3rd ed. Novartis, 2003. KH Compare the changes seen in the male and female urogenital tracts from birth through senescence MCQ Oral KF 2a, 2b Larsen, W.J. et al (eds), Human Embryology, 3rd ed. Churchill Livingstone, 2001. / Vander A.J., Sherman J.S., Luciano, D.S., Human Physiology, 8th ed. McGraw Hill, 2000. KH Describe the role of androgens in the differentiation of the urogenital tract MCQ Oral KF 2b Larsen, W.J. et al (eds), Human Embryology, 3rd ed. Churchill Livingstone, 2001. / Knobil E., Neill J.D. (eds.), Encyclopedia of Reproduction. San Diego, Academic Press, 1998, 4 vols. / Vander A.J., Sherman J.S., Luciano, D.S., Human Physiology, 8th ed. McGraw Hill, 2000. K Women’s Health Care Competencies Project Explanation of the 5 column format: Normal Physical & Psychological Differentiation & Development

  18. Women’s Health Care Competencies Project Methodology (cont.): • 2003 - Interdisciplinary Group of Women’s Health Experts gathered to develop curricular tool for each competency using UMEC/NCoE model • 2003-04 - WHEO presented Competency project at NCoE conference, AMWA meeting, CREOG/APGO meeting, AAMC meeting, VCU School of Medicine Women’s Health Conference, IAMSE meeting • 2004 - AMWA linked RHI Curriculum with APGO Competencies and we referenced RHI Curriculum modules throughout our resource

  19. Women’s Health Care Competencies Methodology (cont.): • 2004- Web-based, interactive curricular tool: www.apgo.org/wheocomp • 2005- Next step: RFA for Demonstration Projects (funded by the Ford Foundation). Available 4/05. Look for information soon at: www.apgo.org

  20. Curriculum Building Example: Women & Disabilities Conference Step 1: Search database Keywords = ‘Disability’, ‘Disabled’ • Step 2: Select desired competencies • Step 3: Organize and edit competency list • Step 4: Edit learning objectives

  21. Women & Disabilities Conference:List of Final Learning Objectives • Describe sex and gender differences in the prevalence and presentation of physical disabilities • Describe cultural issues related to disabilities, including attitudes of people from different cultures about women with disabilities, and the role of the family in caregiving • List quality of life indicators for women with disabilities • List barriers to care for women with physical disabilities, and describe measures to increase health care access • Outline age- and risk- appropriate preventive care recommendations for disabled women across the lifespan, including screening for sexually transmitted illnesses and cervical cancer, contraceptive practice, mammograms, and bone density testing • Describe the prevalence of interpersonal violence among women with physical disabilities, and outline a management approach

  22. Women & Disabilities Conference:Final Learning Objectives (cont.) • Describe the diagnosis and treatment of acute medical problems in women with disabilities, including autonomic dysreflexia 8. Describe the prevalence, presentation, and management of secondary complications that occur commonly in women with physical disabilities, including obesity, osteoporosis, pain, skin problems, sexual problems, bladder and bowel incontinence, depression, and fatigue 9. Describe the importance of developing participatory, ‘co-expert’ patient-clinician relationships with disabled women 10. Describe special equipment and modifications of the physical exam (including the pelvic exam) that facilitate comprehensive health assessment 11. Demonstrate how to perform a functional assessment of a disabled woman, and describe appropriate mobility aids

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