ABSTRACT
PURPOSE: To determine the preliminary benefits of a Women's Health Objective Structured Clinical Exam (OSCE) which integrates psychiatry and obstetrics and gynecology principles into communication-focused doctor-patient paradigms. METHOD: The authors extracted medical student survey data from pre- and post-OSCE program evaluations (n = 193). Using McNemar's tests, the authors compared pre- and post-OSCE proportions of students reporting comfort levels with interactions involving terminally diagnosed patients, domestic violence, breast feeding, and other areas relevant to women's health. RESULTS: The proportion of students reporting comfort with each communication domain increased between pre- and post-OSCE assessments. The greatest improvements were observed for discussions related to domestic violence (41% gain), terminal illness (37% gain) and postpartum depression/psychosis (23% gain). Ninety-four percent felt that this Women's Health OSCE was a valuable learning experience. CONCLUSION: The authors conclude that this Women's Health OSCE was a successful addition to the medical student clinical curriculum as measured by student satisfaction and self-reported improved comfort levels with challenging communication paradigms. Future studies will investigate the effect that this learning activity has on competency.
Subject(s)
Gynecology/education , Obstetrics/education , Students, Medical , Women's Health , Adult , Clinical Competence , Curriculum , Domestic Violence , Female , Humans , Physical Examination , PregnancyABSTRACT
Episodes of diabetic ketoacidosis (DKA) can represent a life-threatening emergency for mother and fetus. The cornerstones of treatment of DKA are aggressive fluid replacement and insulin administration while ascertaining which precipitating factors brought about the current episode of DKA, and then treating accordingly to mitigate those factors. The incidence of DKA and factors unique to pregnancy are discussed in this article, along with the effects of the disease process on pregnancy. Clinical presentation, diagnosis, and treatment modalities are covered in detail to offer ideas to improve maternal and fetal outcome.
