Beruflich Dokumente
Kultur Dokumente
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:
• Sex & gender matter
in health and illness
• Medical students
must know how to
care appropriately
for female patients,
regardless of specialty
Why Sex and Gender?
• Critically impact:
– Incidence (how common)
• HOWEVER…
– Etiology (cause) despite increasing
– Presentation (symptoms) recognition of the
– Progression (severity) importance of sex
– Likelihood of being and gender
offered screening, testing,
and treatment (access)
differences,
– Approach to testing undergraduate
(appropriateness) medical curricular
– Response to treatment reform has been slow
(outcome)
Henrich, Acad Med 2004
Undergraduate Medical Education
Challenges to Curricular Reform
Challenges Questions
Explosion in knowledge/skills What topics should be included?
How to organize/search efficiently?
Shift in teaching environment How to improve communication
and collaboration between multiple
sites/disciplines?
Assessment of competency How to ensure that evaluation tools
are appropriate/accurate?
Emphasis on evidence base How to ensure accuracy/currency?
How can information be updated?
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
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
Women’s Health Care Competencies Project
8 Core Competencies:
• Explain sex and gender differences in normal development
and pathophysiology
3. Effectively communicate demonstrating awareness of gender
and cultural differences
5. Perform sex, gender, & age appropriate physical exam
7. Discuss impact of genderbased societal and cultural roles on
health care
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 genderappropriate
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
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
Women’s Health Care Competencies Project
Explanation of the 5 column format:
1. Normal Physical & Psychological Differentiation & Development
Eval ACGME
Learning Objective Level References
Method Link
Larsen, W.J. et al (eds), Human
Embryology, 3rd ed. Churchill
Associate the male and female MCQ Livingstone, 2001. / Moore, K &
Dalley, AF. Clinically Oriented
urogenital embryological structures KH Oral 2b Anatomy, 4th ed. Lippincott,
with their adult counterparts KF Williams & Wilkins, 1999. / Netter, F
& Hansen, JT. Atlas of Human
Anatomy, 3rd ed. Novartis, 2003.
Compare the changes seen in the MCQ
Larsen, W.J. et al (eds), Human
Embryology, 3rd ed. Churchill
male and female urogenital tracts Oral 2a, 2b
Livingstone, 2001. / Vander A.J.,
KH Sherman J.S., Luciano, D.S., Human
from birth through senescence KF Physiology, 8th ed. McGraw Hill,
2000.
Larsen, W.J. et al (eds), Human
Embryology, 3rd ed. Churchill
Learning Objective Level
Associate the male and female
urogenital embryological structures KH
with their adult counterparts
Compare the changes seen in the
male and female urogenital tracts
KH
from birth through senescence
Describe the role of androgens in the
differentiation of the urogenital tract K
Miller’s Triangle
mpetency Based Education Why
It?
Does
Beha vi or
ssiona l Sho w s How
e nt icity Professional
K no w s How authenticity
Cogni ti on
K no w s
Eval ACGME
Learning Objective Level
Method Link
Associate the male and female MCQ
urogenital embryological structures KH Oral 2b
with their adult counterparts KF
Compare the changes seen in the MCQ
male and female urogenital tracts Oral 2a, 2b
KH
from birth through senescence KF
Describe the role of androgens in the MCQ
Oral 2b
differentiation of the urogenital tract K
KF
Evaluation Methods:
ACGME Outcome Project
www.acgme.org
ACGME Toolbox of Assessment Methods
ACGME Competency Skills
• Six competency areas
• Skill sets defined
Women’s Health Care Competencies Project
Explanation of the 5 column format:
1. Normal Physical & Psychological Differentiation & Development
Eval ACGME
Learning Objective Level References
Method Link
Larsen, W.J. et al (eds), Human
Embryology, 3rd ed. Churchill
Associate the male and female MCQ Livingstone, 2001. / Moore, K &
Dalley, AF. Clinically Oriented
urogenital embryological structures KH Oral 2b Anatomy, 4th ed. Lippincott,
with their adult counterparts KF Williams & Wilkins, 1999. / Netter, F
& Hansen, JT. Atlas of Human
Anatomy, 3rd ed. Novartis, 2003.
Compare the changes seen in the MCQ
Larsen, W.J. et al (eds), Human
Embryology, 3rd ed. Churchill
male and female urogenital tracts Oral 2a, 2b
Livingstone, 2001. / Vander A.J.,
KH Sherman J.S., Luciano, D.S., Human
from birth through senescence KF Physiology, 8th ed. McGraw Hill,
2000.
Larsen, W.J. et al (eds), Human
Embryology, 3rd ed. Churchill
• 200304 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
Women’s Health Care Competencies
Methodology (cont.):
• 2004 Webbased, 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
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
Women & Disabilities Conference:
List of Final Learning Objectives
1. Describe sex and gender differences in the prevalence and
presentation of physical disabilities
2. 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
3. List quality of life indicators for women with disabilities
4. List barriers to care for women with physical disabilities, and
describe measures to increase health care access
5. 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
6. Describe the prevalence of interpersonal violence among women
with physical disabilities, and outline a management approach
Women & Disabilities Conference:
Final Learning Objectives (cont.)
1. 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, ‘coexpert’
patientclinician 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