GYNAECOLOGICAL PROBLEMS

Transcription

1 GYNAECOLOGICAL PROBLEMS

2 Mdule 13 : Gynaeclgical Prblems Learning utcmes: T understand and demnstrate apprpriate knwledge, skills and attitudes in relatin t cmmn gynaeclgical disrders. T understand paediatric and adlescent gynaeclgical disrders. Knwledge criteria Clinical cmpetency Prfessinal skills and attitudes Training supprt Evidence/assessment T understand the epidemilgy, aetilgy, bilgical behaviur, pathphysilgy, clinical characteristics, prgnstic features and management f: Menstrual disrders Benign cnditins f the genital tract Endcrine disrders Prblems f the climacteric Pelvic pain Vaginal discharge Emergency gynaeclgy Cngenital abnrmalities f the genital tract Paediatric gynaeclgy Puberty Diagnse, investigate and manage cmmn gynaeclgical disrders Perfrm ultrasund scan t diagnse and facilitate apprpriate management f wmen with cmmn varian and uterine abnrmalities Perfrm transvaginal ultrasund scan and diagnse uterine fibrids and endmetrial plyps Diagnse plycystic varies and hydrsalpinges n ultrasund Perfrm saline snhystergraphy Endmetrial assessment Diagnstic hysterscpy Diagnstic laparscpy: staging f endmetrisis See Mdule 7 fr ther surgical cmpetencies Demnstrate the ability t cmmunicate prgnsis and cunsel wmen sensitively abut the ptins available Have the necessary skills t explain the nature, cmplicatins and adverse effects f medical and surgical treatments Demnstrate the ability t frmulate and implement a plan f management and have the ability t mdify this as necessary Recgnise the need fr apprpriate referral fr mre cmplex r detailed evaluatin with ultrasund r ther imaging techniques Have the skills t liaise with clleagues in ther disciplines where required Demnstrate an understanding f the use apprpriate referral pathways and lcal prtcls if abnrmal findings suspected StratOG.net: Gynaeclgical Prblems and Early Pregnancy Lss e-tutrials Supervised clinical sessins Specific curses and academic meetings Lcal and reginal curses in paediatric gynaeclgical prblems and prblems f puberty Useful websites: Lgbk SOE MRCOG Part 2 Audit prject EXIT EXAMINATION OSATS: Diagnstic laparscpy Mdule 13 Gynaeclgical Prblems Curriculum

3 Appendix t Curriculum Mdule 13: details f knwledge criteria Menstrual disrders: Menstrual irregularity Excessive menstrual lss Investigatin f menstrual disrders Medical and surgical management f menstrual disrders. Fibrids. Nnmenstrual bleeding (intermenstrual, pstcital). Premenstrual syndrme. Prblems f the climacteric: Abnrmal bleeding Pstmenpausal bleeding Hrmne replacement therapy Nn hrmnal therapy Ostepenia and steprsis Breast cancer in relatin t the climacteric. Amenrrhea and endcrine disrders: Investigatin and interpretatin Hypthalamic/pituitary disrders Hyperprlactinaemia Premature varian failure Plycystic varies and plycystic vary syndrme Other causes f hyperandrgenism Thyrid/adrenal disrders Autimmune endcrine disease Cngenital abnrmalities f genital tract: Ambiguus genitalia Imperfrate hymen Vaginal septae Uterine anmalies Müllerian duct develpment Gnadal dysgenesis. Puberty: Physilgy and chrnlgy Preccius puberty Delayed puberty Excessive menstrual lss. Benign cnditins f the lwer genital tract: Vulva: Pruritus vulvae Nn-neplastic cysts Nn-neplastic epithelial disrders Vulvdynia. Vagina: Vaginal discharge (nn-sexually transmitted causes) Pelvic pain: Dysmenrrhea Dyspareunia Endmetrisis (staging, treatment) Pelvic inflammatry disease Nn-gynaeclgical disrders. Ovary: Benign varian neplasms Functinal varian cysts. Emergency gynaeclgy: Pelvic inflammatry disease Barthlin s and vulval abscess Ovarian cyst accidents Acute vaginal bleeding utwith pregnancy Miscarriage and ectpic pregnancy Mdule 13 Gynaeclgical Prblems Curriculum

4 Mdule 13 : Gynaeclgical Prblems Fill in as a recrd f experience. Skills Cmpetence level Basic Intermediate Advanced Nt required Observatin Direct supervisin Independent practice Date Signature f trainer Date Signature f trainer Date Signature f trainer Diagnse, investigate and manage the fllwing clinical prblems: Menstrual disrders: Menstrual irregularity Excessive menstrual lss Premenstrual syndrme Amenrrhea/ligmenrrhea Dysmenrrhea Pelvic pain: Dyspareunia Endmetrisis (medical management) Endmetrisis (surgical management) Pelvic inflammatry disease Nn-gynaeclgical disrders Prblems f the climacteric: Pstmenpausal bleeding Hrmne replacement therapy Mdule 13 Gynaeclgical Prblems Lgbk

5 Fill in as a recrd f experince. Mdule 13 : Gynaeclgical Prblems Skills Cmpetence level Basic Intermediate Advanced Nt required Observatin Direct supervisin Independent practice Date Signature f trainer Date Signature f trainer Date Signature f trainer Others: Benign varian cysts Vaginal discharge Fibrids Hirsutism Nn-neplastic vulval disrders Use transvaginal ultrasund t diagnse: Plycystic varies and hydrsalpinges Uterine fibrids and endmetrial plyps Perfrm saline infusin snhystergraphy Mdule 13 Gynaeclgical Prblems Lgbk

6 Authrisatin f signatures (t be cmpleted by the clinical trainers) Name f clinical trainer (please print) Signature f clinical trainer OSAT Recrd all frmal assessments until trainee passess. Recrd date f satisfactry assessment. Diagnstic Date Date Date Date Date laparscpy Signature Signature Signature Signature Signature COMPLETION OF MODULE 13 I cnfirm that all cmpnents f the mdule have been successfully cmpleted: Date Name f educatinal supervisr Signature f educatinal supervisr Mdule 13 Gynaeclgical Prblems Lgbk

7 DIAGNOSTIC LAPAROSCOPY Trainee Name: StR Year: Date: Assessr Name: Clinical details f cmplexity/ difficulty f case Pst: Perfrmed Needs Nt independently help Applicable Preparatin f the patient: Ensures crrect psitining f the patient Checked r bserved catheterisatin, pelvic examinatin and insertin f uterine manipulatr where apprpriate Establishing pneumperitneum Demnstrates knwledge f instruments and can truble sht prblems Check patency and functin f Veress (if used) Crrect incisin Cntrlled insertin f Veress (if used) Insufflatin t at least 20 mmhg Cntrlled insertin f primary prt Cntrlled insertin f secndary prt under direct visin Operative prcedure Maintains crrect psitin f ptics Clear inspectin f pelvic and abdminal structures Mvements: fluid and atraumatic Apprpriate use f assistants (if applicable) Crrect interpretatin f perative findings Remval f prts under direct visin Deflatin f pneumperitneum Apprpriate skin clsure Bth sides f this frm t be cmpleted and signed PLEASE TICK RELEVANT BOX Mdule 13 Gynaeclgical Prblems OSATS

8 GENERIC TECHNICAL SKILLS ASSESSMENT Assessr, please ring the candidate s perfrmance fr each f the fllwing factrs: Respect fr tissue Time, mtin and flw f peratin and frward planning Knwledge and handling f instruments Suturing and kntting skills as apprpriate fr the prcedure Technical use f assistants Relatins with patient and the surgical team Insight/attitude Dcumentatin f prcedures Frequently used unnecessary frce n tissue r caused damage by inapprpriate use f instruments. Many unnecessary mves. Frequently stpped perating r needed t discuss next mve. Lack f knwledge f instruments. Placed sutures inaccurately r tied knts insecurely and lacked attentin t safety. Cnsistently placed assistants prly r failed t use assistants. Cmmunicated prly r frequently shwed lack f awareness f the needs f the patient and/r the prfessinal team. Pr understanding f areas f weakness. Limited dcumentatin, prly written. Careful handling f tissue but ccasinally causes inadvertent damage. Makes reasnable prgress but sme unnecessary mves. Sund knwledge f peratin but slightly disjinted at times. Cmpetent use f instruments but ccasinally awkward r tentative. Kntting and suturing usually reliable but smetimes awkward. Apprpriate use f assistant mst f the time. Reasnable cmmunicatin and awareness f the needs f the patient and/r f the prfessinal team. Sme understanding f areas f weakness. Adequate dcumentatin but with sme missins r areas that need elabrating. Cnsistently handled tissues apprpriately with minimal damage. Ecnmy f mvement and maximum efficiency. Obviusly planned curse f peratin with effrtless flw frm ne mve t the next. Obvius familiarity with instruments. Cnsistently placed sutures accurately with apprpriate and secure knts and with prper attentin t safety. Strategically used assistants t the best advantage at all times. Cnsistently cmmunicated and acted with awareness f the needs f the patient and/r f the prfessinal team. Fully understands areas f weakness. Cmprehensive legible dcumentatin, indicating findings, prcedure and pstperative management. Based n the checklist and the Generic Technical Skills Assessment, Dr has achieved/failed* t achieve the OSAT cmpetency Needs further help with: Cmpetent t perfrm the entire * prcedure withut the need fr * supervisin Date Date Signed (trainer) Signed (trainee) Delete where applicable, and date and sign the relevant bx Signed Signed Mdule 13 Gynaeclgical Prblems OSATS