This module is designed to test the student’s routine OB visit examination skills, their knowledge of placenta previa, and their communication skills in counseling a patient with this condition.
In this 15 minute module, the student is provided a descriptor that states:
Prenatal Visit
Marla Manikin is a 39 year old primigravida at 34 weeks gestational age. She’s here for her routine OB visit. Her prenatal course has been uncomplicated:
– Gestational age confirmed by 1st Trimester ultrasound
– No significant medical or surgical history
– TWG 24 pounds to date. Today’s weight is 147#.
– All labs have been normal, including 1st TM screening for Down’s and NTDs.
– Her glucose screen was negative.
At her 32 week antepartum visit, her doctor thought she was measuring small, so she ordered an ultrasound scan.
Go in and introduce yourself to Marla, ask her any questions you want to ask, and examine her. Then discuss your findings and recommendations with her, if any. No charting is required.
Student-3-Evaluate a patient in labor rev 2015
The manikin is wearing a pregnancy belly. The module is staffed by a faculty member who speaks for the manikin and also is the evaluator.
On entering the room, the student is handed a sheet of paper with the patient’s blood pressure (normal), urine testing (neg/neg), and weight (147#).
The student is expected to measure the fundal height of the manikin, and is evaluated on proper measurement. The student is then told to assume the measurement is 34 cm (normal).
The student is then provided with the ultrasound scan report, which shows a complete placenta and fetal transverse lie.
The student is then expected to explain these findings to the patient with enough detail to be safe. This includes:
- Need for C/S
- Early, scheduled delivery at 36 or 37 weeks
- Pelvic Rest
- Report any bleeding
- Report any contractions
- Followup 1 week
The module can be run with faculty present, or with just the manikin, the student, and video recording. It works better with faculty.
Good things about this module include:
- Testing of multiple skills (examination, communication, and knowledge of placenta previa)
- Integrates lab findings into clinical recommendations
- Fair test of student skills
Bad things about this module include:
- A lot of material to cover in 15 minutes (routine PN exam plus placenta previa counseling)
- Awkward having faculty speaking for the manikin. (You could also have the faculty remote, watching through the video, but speaking through the manikin).
- Pacing is a little difficult. Students tend to get focused on the routine exam and don’t leave enough time for the placenta previa discussion.