Department of Physician Assistant Studies
Learning. Caring. Serving. Leading.
PAS 640: Women’s Health
1.5 Semester Hours
Course Director:
Diane Duffy, MD
Tracey Tonsor, PA-C
Office
FC 205
FC 207
Phone
336-278-6848
336-278-6852
E-mail
Dduffy2@elon.edu
tbrownback@elon.edu
Course Description: The Women’s Health rotation is designed to give the student practical experience
in the diagnosis, evaluation, and management of problems and issues associated with women’s health
care. Emphasis is placed on learning experiences in family planning and birth control, the recognition
and treatment of sexually transmitted infections, cancer detection and prevention, prenatal care and
the evaluation and treatment of common ambulatory gynecologic problems. During this rotation the
students augment and strengthen their skills in regard to a wide variety of problems seen in the primary
care setting.
Course Goals: The educational goals of the Women’s Health rotation include:
1. To apply the medical content and principles central to women’s health.
2. To provide opportunities for each student to develop the core PA competencies in a supervised
women’s health setting.
3. To expose each student to an experienced and competent medical provider role model for the
care of women.
Learning Outcomes:
Upon completions of this course the clinical phase PA students will:
1. Demonstrate the ability to elicit a complete gynecological, prenatal and, when appropriate,
obstetric history.
2. Demonstrate proficiency and sensitivity in performing an appropriate problem-focused
women’s health exam.
3. Utilize diagnostic modalities when appropriate which are based on initial impressions
determined from the history and physical or are pertinent to the evaluation of the patient.
4. Formulate a comprehensive management plan that is consistent with the diagnosis and includes
diagnostic modalities, clinical therapeutics, clinical interventions, patient education, counseling
and proper referrals.
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5. Provide and record pertinent patient education regarding disease prevention and health
maintenance.
6. Know, and counsel the patient about, the current screening recommendations for women.
Teaching Methodologies: The content of this module will be presented through a variety of methods
that include observation and participation at the clinical site, independent reading and participation in
online activities developed to guide experiential learning.
Accommodations: Students requiring academic accommodations must follow the “Academic Support”
policy in the Elon University DPAS Student Handbook.
Academic Honesty: All Elon PA students acknowledged their commitment to abide by the Elon Honor
Code by signing the Honor Pledge during orientation. Students will sign an Honor Pledge (electronically
or manually) each time an assignment is turned in or an examination is started to reaffirm their
complete understanding of the Honor Code of Elon University and their affirmation that their work
abides by that Code.
Required Textbooks:
1. All first-year required textbooks.
2. Clinician's Pocket Reference, 11th Edition [Paperback]
3. Current Diagnosis and Treatment: Obstetrics and Gynecology by Decherney and Nathan, 10th
Edition
Other Resources:
1. *Moodle: Please check the course site frequently for new announcements, updated schedules,
assignments and other course communication.
2. Practicing physician assistants, physicians, allied health care providers and laboratory teaching
aids.
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TOPICS LIST - GYNECOLOGY
Neoplasms
Endometrial cancer
Ovarian neoplasms
Breast cancer
Cervical carcinoma
Cervical dysplasia
Vaginal/vulvar neoplasms
Menstruation
Normal physiology
Dysfunctional uterine bleeding
Amenorrhea
Dysmenorrhea
Menopause
Premenstrual syndrome
TOPICS LIST – OBSTETRICS
Prenatal Care/Normal
Pregnancy
Prenatal diagnosis/care
Normal labor and delivery
Stages
Duration
Mechanism of delivery
Monitoring
Physiology of pregnancy
Fetal position
Multiple gestation
APGAR scoring
Infections
Vaginitis
Trichomoniasis
Bacterial vaginosis
Atrophic vaginosis
Candidiasis
Cervicitis
Gonorrhea
Chlamydia
Herpes simplex
Human papilloma virus
Pelvic inflammatory disease
Syphilis
Chancroid
Lymphogranuloma venereum
Disorders of the Breast
Breast abscess
Breast Fibroadenoma
Fibrocystic disease
Mastitis
Structural Abnormalities
Cystocele
Uterine prolapse
Rectocele
Ovarian torsion
Other
Contraceptive methods
Endometriosis
Ovarian cyst
Leiomyoma
Domestic violence
Urinary incontinence
Infertility
Pregnancy Complications
Abortion
Abruptio placentae
Ectopic pregnancy
Incompetent cervix
Placenta previa
Gestational diabetes
Pregnancy induced hypertension
Preeclampsia/eclampsia
Gestational trophoblastic disease
Molar pregnancy
Choriocarcinoma
Rh-incompatibility
Labor and Delivery
Complications
Dystocia
Fetal distress
Premature rupture of
membranes
Prolapsed umbilical cord
Preterm labor
Breech presentation
Postpartum Care
Postpartum hemorrhage
Endometritis
Perineal laceration/episiotomy
care
Normal physiology changes
of puerperium
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Assessment Activities:
Exams/quizzes (25%), Preceptor Evaluation (65%), Professionalism (10%).
Grade Scale and Grade Points:
Percentage
89.50-100
85.50-89.49
79.50-85.49
75.50-79.49
69.50-75.49
Below 69.50
There is no rounding of grades.
Letter Grade
A
B+
B
C+
C
U
Grade points
4.0
3.3
3.0
2.3
2.0
0
Note: For further information regarding academic standing in the Department of Physician
Assistant Studies, please see the Student Handbook.
Grading Criteria:
1. Demonstrate acquisition of a strong basic science and medical science knowledge base as
demonstrated on the written examination/quizzes.
2. Demonstrate satisfactory self-directed learning skills, clinical reasoning skills, interpersonal
communication, commitment to patient-centered care, professionalism and practice-based
learning as evidenced by satisfactory performance on the preceptor evaluation.
3. Demonstrate a commitment to learning and professionalism by actively participating in all
clinical activities and exceeding the professional behavior standards and minimum requirements
for clinical rotations available in the Elon PA Student Handbook.
Instructional Objectives:
1. Elicit and record a complete and focused history, appropriate for the patient’s age, including
chief complaint and history of present illness with pertinent review of systems, past medical,
family and social history.
2. Perform a complete and focused gynecological examination, with a focus on ensuring patient
comfort, including the following:
a. Pelvic exam – bimanual and speculum
b. Breast examination
3. Know the components of a complete and focused prenatal examination including the following:
a. Pelvic exam
b. Fundal height
c. Fetal exam
4. Select and interpret diagnostic studies to evaluate the differential diagnosis, including the
following for each study:
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5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
a. Risks and benefits
b. Sensitivity and specificity
c. Cost effectiveness
d. Informed consent
Describe the indications for colposcopic cervical examination following an abnormal PAP smear.
Perform or be able to describe the following diagnostic procedures under the direction of and
according to standards as established by the clinical preceptor:
a. Cultures (vaginal and rectal) and rapid antigen tests (e.g., Gonorrhea, chlamydia, Herpes
simplex, Group B strep)
b. Papanicolau smear/Thin prep
c. Vaginal smears
Discuss the methods of contraceptives and family planning, including indications,
contraindications, efficacy, advantages, disadvantages, safety, mutagenicity, patient education,
cost and cultural/religious issues.
Discuss the physiologic changes that occur during menopause, competently prescribe therapies
for the management of menopausal symptoms, and counsel patients on prevention of diseases
that are more prevalent after menopause.
Recognize the presentation of common breast masses and identify the appropriate work-up and
treatment.
List the physiologic changes and signs of pregnancy.
Describe routine prenatal care.
Define and discuss the use of screening and diagnostic instruments used in prenatal obstetrics
(again can substitute prenatal care), care paying particular attention to indications, timing,
normal and abnormal findings and maternal risk factors (e.g., ultrasound, one hour postprandial glucose tolerance test, maternal serum alpha fetal protein monitoring).
Identify medical problems that may result in complications during pregnancy, including
diabetes, anemia, thyroid disorders, cardiovascular problems and vaginal bleeding.
Discuss and describe normal embryonic/fetal development.
Discuss the indications for, correct use and administration of obstetric pharmacologic therapies
(i.e., RhoGam, Magnesium sulfate)
Demonstrate knowledge of appropriate gynecologic and obstetric (antepartum and postpartum)
management plans, including screening, treatment, follow-up and patient education.
Discuss the appropriate use of medications for gynecologic and obstetrical patients including
such issues as indications, contraindications, interactions, complications, dosage, metabolism,
excretion and mutagenicity.
Identify first-line therapeutic recommendations for treating common or life threatening
conditions when they occur in pregnant patients.
Provide and record pertinent patient education regarding disease prevention and health
maintenance, which is clearly explained to the patient and checked for understanding, to
include
a. Nutrition – including need for supplementation during pregnancy
b. Genetic counseling
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20.
21.
22.
23.
24.
c. Accident and violence prevention (e.g., seat belts, helmets, screening for domestic
violence)
d. Physical activity, exercise
e. Pertinent risk factors, including occupation, environment, tobacco, alcohol, other drugs
and genetic factors
f. Warning signs/symptoms of disease
g. Plan for age appropriate screening and periodic health assessment
h. Immunizations (HBV, rubella, Tdap)
Recognize and institute the initial management of emergency gynecologic and obstetric
emergencies in the absence of a physician, such as:
a. Ectopic pregnancy
b. Obstetrical hemorrhage
c. Preeclampsia/eclampsia/PIH
d. Preterm labor
e. Intrapartum fetal distress
f. Postpartum hemorrhage/infection
g. Sepsis
h. Embolic phenomena
i. Dysfunctional uterine bleeding
j. Pelvic inflammatory disease
k. Torsion of an ovarian cyst
l. Medical evaluation of rape/domestic abuse
Formulate a comprehensive management plan that is consistent with the diagnosis and includes
diagnostic modalities, clinical therapeutics, clinical interventions, patient education, counseling,
and proper referrals.
Prepare patient records that follow the SOAP format.
Effectively and efficiently communicate patient presentations to the clinical preceptor.
If presented with the opportunity, assist the gynecologist, as directed, during surgical
procedures
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