Clinic Concentration in Gynecology Test Plan
1. The purpose of the test is to provide a summative assessment of the learners after completion of
the coursework associated with a clinic concentration in gynecology. The test is not the only form
of evaluation to be used. Outcome measures will include: 1) formative and summative
evaluations of learners by the clinical supervisors; 2) completion of 96-108 hours of concentration
clinical rotation; 3) portfolio of cases treated, assignments completed, and evidence of
community of practice with non-TCM healthcare professionals; 4) learner surveys; 5)
summative written exam and practical exam within concentration; and 6) patient surveys for
selected interpersonal and professionalism objectives. Only elements of the course objectives
suitable for evaluation by written exam will be tested.
Concentration Learning Objectives:
(1)
Demonstrate TCM concepts in the diagnosis, syndrome differentiation, treatment and
prevention of symptoms related to gynecology. (MK-Conceptual)
(2)
Apply TCM differential diagnosis and create treatment plan for patients with symptoms
related to gynecology. (PC-Application-Synthesis)
(3)
Skillfully treat patients with symptoms related to gynecology according to the treatment
plan. (Skills: ComplexOvertResponse)
(4)
Conduct culturally appropriate patient interviews and physical exams to be able to
diagnose and treat symptoms related to gynecology. (ISC/Prof – Apply/Value/Organize) –
Focus of this assignment
(5)
Provide appropriate patient education and lifestyle recommendations for patients with
symptoms related to gynecology. (PBLI-Apply/Value)
(6)
Develop a community of practice with non-TCM healthcare providers with scope of
concentration and coordinate care within the overall health care system for patients with
symptoms related to gynecology. (SBP-Organize)
(7)
Routinely conduct literature research for current best evidence of potential herb-drug
interactions and effective treatment methods for patients with symptoms related to
gynecology. (PBLI-Apply-Analyze/Value-Organize)
2. Table of specifications, which includes items that would reflect the knowledge, skills, and
attitudes essential for your learner to meet the goals and objectives of your course or program.
Level
Knowledge
Comprehension
and Application
Objective Example
Identify typical TCM
differentiations for
gynecology (dysmenorrhea,
menopause, PMS, menstrual
irregularities, and fertility
issues).
Select appropriate treatment
methods for gynecology.
Item Example
Dysmenorrhea with stabbing fixed pain is
due to:
a. qi stagnation
b. wind-dampness
c. qi deficiency
d. blood stasis
Select the best combination of acupuncture
points for treatment of dysmenorrhea due
to blood stasis.
a. UB17, SP6, SP8, LV8
b. UB40, UB18, LI4, LV2
c. UB23, SP9, LV4, ST36
d. GB34, UB20, SP3, LV5
Clinic Concentration in Gynecology Test Plan
Explain your rationale: ________________
___________________________________
Analysis,
Evaluation
Diagnose and select
treatment plan for cases in
gynecology.
A 23 yo patient complains of severe
dysmenorrhea for 5 months. Menstrual
flow is dark purplish red with large clots.
Pulse is choppy and tongue has dark red
prickles. Your diagnosis is dysmenorrhea
due to:
a. Spleen qi deficiency
b. Liver qi stagnation
c. Liver blood stasis
d. Liver blood deficiency
For this case, the best treatment plan
would include:
a. Acupuncture, Ba Zheng Tang, bedrest
b. Medical qigong, Si Jun Zi Tang, hot
packs
c. Tuina, Chai Hu Shu Gan San, ice
packs
d. Acupuncture, Shi Xiao San,
cupping
Explain your rationale: ________________
___________________________________
Analysis,
Synthesis,
Evaluation –
detailed problemsolving
Attitude
Skills
Skills
Select appropriate classic
formula and modify for cases
in gynecology.
Incorporate socioeconomicappropriate patient education
into treatment plans for
gynecology.
For an obese Hispanic patient with
irregular menstrual cycles, you would:
a. Tell her she should eliminate
tortillas and rice from her diet
b. Inform her that she is at risk for
developing diabetes if she does not
lose weight
c. Give her a discount coupon for the
fitness gym across from the clinic
d. Invite her to the clinic’s nutritional
cooking classes on Wednesdays
Utilize various treatment
In cases of dysmenorrhea due interior cold
modalities as case
stagnation, treatment should include:
appropriate in gynecology.
a. Moxa burning on RN 4
b. Gua sha scrapping over UB 23
c. Zheng gu shui application on SP 4
d. Cupping of UB 26-29
Incorporate evidence-based practices into TCM gynecology.
This could be an interesting exam task – to have a couple of computers
available for learners to use to answer 1-2 questions that would require an
Clinic Concentration in Gynecology Test Plan
internet search for the answer and require citation of web-address or
literature accessed. – an idea to toy with…
Another approach would be to have several texts (i.e. drug reference and
herbal pharmacology) in class for 1-2 specific questions on herb-drug
interactions, which would require a search for the answer.
[1] http://www.utexas.edu/academic/diia/assessment/iar/students/plan/method/exams-mchoicestanford.php
[2] http://www.nbme.org/publications/item-writing-manual.html
3. The format will be primarily MCQ (with a couple of Stanford rationale type of MCQ), a few
extending matching (R-Type) and a couple moderate-length short answer.
4. The levels of cognitive ability to be tested: These are senior learners, therefore more advanced
levels will be assessed – application, analysis and synthesis.
5. Number of test items: This exam will have a 2 hour time limit. 30 MCQ (including 5 Stanford
rationale type); 5 extended matching, and 2 short-answer.
6. Preliminary model of the test – see at end.
7. reviewed, revised and finalized test plan – (done over time)
8. Administration and scoring (how it will be done): The paper-based exam will be given during
class time in the 11th week (out of 12) of the term. The instructor will score the test, and return it
in the final class time, and questions from the class will be discussed. Ideally, comments on MCQ
rationale and detailed feedback on the short-answer questions will be written on the test.
9. Plan for feedback to learners to ensure it is also a learning experience. – see above for feedback
in class. An alternative would be to have individual appointments with each student. Currently
our school’s faculty pay structure does not allow for this much face-time. In the course design of
this clinical-concentration, students would be interning concurrently as well as for the next 24
weeks in a gynecology specific clinical rotation. Feedback now would be valuable for the studentintern’s future rotations and post-graduate practice.
10. Course/Curriculum Evaluation – see form at end
Clinic Concentration in Gynecology Test Plan
Preliminary model of the test
Final Exam in Gynecology Clinical Concentration Course # AH0430
50% of entire course grade: 60 points test total
Multiple Choice Questions (30 questions, 1 point each)
In the following multiple-choice questions, select the best answer provided (circle the letter of your
choice). For some questions, space is provided for you to “explain your rationale” for the answer you
chose.
1. Dysmenorrhea with stabbing fixed pain is due to: (knowledge)
b. qi stagnation
c. wind-dampness
d. qi deficiency
e. blood stasis
2. Select the best combination of acupuncture points for treatment of dysmenorrhea due to blood
stasis. (comprehension, application)
a. UB17, SP6, SP8, LV8
b. UB40, UB18, LI4, LV2
c. UB23, SP9, LV4, ST36
d. GB34, UB20, SP3, LV5
Explain your rationale: ___________________________________________________
3. A 23 yo patient complains of severe dysmenorrhea for 5 months. Menstrual flow is dark purplish red
with large clots. Pulse is choppy and tongue has dark red prickles. Your diagnosis is dysmenorrhea
due to: (analysis)
a. Spleen qi deficiency
b. Liver qi stagnation
c. Liver blood stasis
d. Liver blood deficiency
4. For
a.
b.
c.
d.
this case (question #3), the best treatment plan would include: (analysis, application)
Acupuncture, Ba Zheng Tang, bed-rest
Medical qigong, Si Jun Zi Tang, hot packs
Tuina, Chai Hu Shu Gan San, ice packs
Acupuncture, Shi Xiao San, cupping
Explain your rationale: ___________________________________________________
5. For
a.
b.
c.
d.
6. In
a.
b.
c.
d.
an obese Hispanic patient with irregular menstrual cycles, you would: (analysis, value)
Tell her she should eliminate tortillas and rice from her diet
Inform her that she is at risk for developing diabetes if she does not lose weight
Give her a discount coupon for the fitness gym across from the clinic
Invite her to the clinic’s nutritional cooking classes on Wednesdays
cases of dysmenorrhea due interior cold stagnation, treatment should include: (analysis, skills)
Moxa burning on RN 4
Gua sha scrapping over UB 23
Zheng gu shui application on SP 4
Cupping of UB 26-29
Clinic Concentration in Gynecology Test Plan
Extended Matching (R-TYPE)
For each disorder set, select the most appropriate option for each case scenarios. Write the letter of your
choice in the Answer blank after each case scenario. (5 questions, 2 points each)
Disorder:
Dysmenorrhea
Options:
A.
B.
C.
D.
E.
(analysis, evaluation)
An Shen Ding Zhi Wan
Ba Zhen Tang
Chai Hu Shu Gan San
Da Bu Yin Wan
Long Dan Xie Gan Tang
F.
G.
H.
I.
J.
Jia Wei Xiao Yao San
Liu Wei Di Huang Wan
Shao Fu Zhu Yu Tang
Shao Yao Gan Cao Tang
Tong Qiao Huo Xue Tang
Case scenario: For each patient, select the most appropriate base formula:
1. 32 yo woman complains that her menstrual cramping is so severe she has been
missing 2 days of work every month for the past 4 months. She is agitated: she
cannot afford to miss work (seeking divorce and boss is not sympathetic). She
has reduced appetite and her menstrual flow is light-colored. Her pulse is wiry,
and tongue slightly red with a thin coat. Her biomedical OBGYN has found no
cause for the pain.
Answer: ___
2. A 47 yo woman says her periods have been becoming more painful over the past
year. She has been experiencing periodic hot flashes, particularly at night, with
sweating and sometimes feeling very hot deep “to her bones.” She has become
short tempered and easily irritated, and having restless sleep. Her tongue is thin
and red with a dry coat, and her pulse is thready.
Answer: ___
Short-Answer (2 cases: 10 points each)
For each case, list the disorder diagnosis, syndrome differentiation(s), treatment plan, acupuncture
points, additional treatment modalities, base herbal formulation name, list of individual herbs, raw
dosages for each, special preparation methods, as well as any patient instructions/educational needs and
sensitivity issues (cultural, socioeconomic, situational). (analysis, application, synthesis,
skills(comprehension/application), attitude-value)
1. A 28 yo woman has been having severe lower abdominal pain during sex and during her menses
flow since her return from tour in Iraq. Although she is happily married, she can no longer
tolerate intercourse with her husband. Her pelvic exam revealed no reasons for the pain. The
pain is focal, sharp, and stabbing with intercourse but is a more generalized ache during the first
day of menstrual flow. She has a prescription Xanax (alprazolam) from the VA for PTSD but has
not taken any. No masses or tenderness upon palpation. BMI ~22, BP 112/68, appears agitated,
tongue is red, thin and quivers slightly, pulse is thin, wiry.
Disorder diagnosis:
____________________________________________________
Syndrome differentiations:
____________________________________________________
____________________________________________________
TCM treatment plan:
____________________________________________________
Clinic Concentration in Gynecology Test Plan
Acupuncture points & techniques____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
Other modalities
____________________________________________________
____________________________________________________
Herbal base formulation
Individual ingredients with
Raw dosage
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
Herbal preparation methods
____________________________________________________
____________________________________________________
____________________________________________________
Patient instructions/education/ ____________________________________________________
lifestyle recommendations / ____________________________________________________
and/or sensitivity issues
____________________________________________________