# Presentation: 656485

## WHEO Task Force
Joanna Cain, MD
Glenda Donoghue, MD
Sonya Erickson, MD
Diane Magrane, MD
Jennifer Potter, MD
Tamara Stein, PhD
Roberta Rusch, MPH

**Joanna Cain, MD**
**Glenda Donoghue, MD**
**Sonya Erickson, MD**
**Diane Magrane, MD**
**Jennifer Potter, MD**
**Tamara Stein, PhD**
**Roberta Rusch, MPH**

**APGO/WHEO Women’s Health Care Competencies for Medical Students**

## Women’s Health Care Competencies Project

**Medical students must know how to care appropriately for female patients, regardless of specialty**

**Sex & gender matter in health and illness**

**Women’s Health Care Competencies Project**
**         ****Purpose:**

## Why Sex and Gender?

**Critically impact:**
**Incidence (how common)**
**Etiology (cause)**
**Presentation (symptoms)**
**Progression (severity)**
**Likelihood of being offered screening, testing, and treatment (access)**
**Approach to testing (appropriateness)**
**Response to treatment (outcome)**

**HOWEVER... despite increasing recognition of the importance of sex and gender differences, undergraduate medical curricular reform has been slow**

- Henrich, Acad Med 2004

## Undergraduate Medical EducationChallenges to Curricular Reform

- <date/time>

**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

- Explain sex and gender differences in normal development and pathophysiology
- Effectively communicate demonstrating awareness of gender and cultural differences
- Perform sex, gender, & age appropriate physical exam
- Discuss impact of gender-based societal and cultural roles on health care

**Women’s Health Care Competencies Project**
**    ****8 Core Competencies:**

## Women’s Health Care Competencies Project

**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 gender-appropriate 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****:**

***Normal Physical & Psychological Differentiation & Development***

## Women’s Health Care Competencies Project

**    ****Explanation of the 5 column format****:**

***Normal Physical & Psychological Differentiation & Development***

## Miller’s Triangle

**Professional**
**authenticity**

- Miller GE. Academic Med 1990; 65:S63-67.
- Van der Vleuten, C. Ottawa Conference, 2000

**Notes:**
George Miller described a pyramid of ascending competency
from basic cognitive understanding to spontaneous application
of knowledge and skill.  The demonstration of understanding shows
an integration of knowledge and skill and implies a higher level of 
professional competency in the field being studied.

## Women’s Health Care Competencies Project

**    ****Explanation of the 5 column format****:**

***Normal Physical & Psychological Differentiation & Development***

## Evaluation Methods:ACGME Outcome Project

- <date/time>

- Evaluation Methods:ACGME Outcome Project

- www.acgme.org

## ACGME Toolbox of Assessment Methods

- <date/time>

## ACGME Competency Skills

- <date/time>

- a

- b

- c

- d

- 1

- • Six competency areas
- • Skill sets defined

## Women’s Health Care Competencies Project

**    ****Explanation of the 5 column format****:**

***Normal Physical & Psychological Differentiation & Development***

## Women’s Health Care Competencies Project

**    ****Methodology *****(cont.)*****:**

**2003** - Interdisciplinary Group of Women’s Health Experts gathered to develop curricular tool for each competency using UMEC/NCoE model
**2003-04** - 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.):

- <date/time>

**Women’s Health Care Competencies **** ****Methodology *****(cont.)*****:**

- 2004- Web-based, 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***

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## Curriculum Building Example: Women & Disabilities Conference

- <date/time>

- 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

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##  Women & Disabilities Conference:List of Final Learning Objectives

- <date/time>

-  Women & Disabilities Conference:List of Final Learning Objectives

- Describe sex and gender differences in the prevalence and presentation of physical disabilities
- 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
- List quality of life indicators for women with disabilities
- List barriers to care for women with physical disabilities, and describe measures to increase health care access
- 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
- Describe the prevalence of interpersonal violence among women with physical disabilities, and outline a management approach

## Women & Disabilities Conference: Final Learning Objectives (cont.)

- <date/time>

- Women & Disabilities Conference: Final Learning Objectives *(cont.)*

- 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, ‘co-expert’ patient-clinician 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

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