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R3 Objectives

Highland Hospital

The HH rotation is six to seven weeks in length. The R3 first assists on appropriate OR cases including complex laparotomies and laparoscopies. The R3 is available for backup on L&D and for consults. The R3 takes call at HH two to three times during this block on weekends only to maximize operative experience.

Medical Knowledge

  • Expand on a core knowledge of:
    • Surgical management of chronic pelvic pain
    • Surgical management of abnormal uterine bleeding
    • Normal obstetrics
    • Disease processes that adversely affect pregnancy
    • Disease processes that pregnancy adversely affects
    • Obstetrical complications of pregnancy
    • Premalignant lesions of the female reproductive tract
    • Laparoscopic surgery principles
    • Preoperative preparation for surgery
    • Common postoperative complications

Patient Care

  • Perform:
    • Hysteroscopy and endometrial resection
    • Complex total abdominal hysterectomy
    • Complex laparotomy for adnexal masses and endometriosis
    • Laparoscopic management of ectopic pregnancy
    • Outlet forceps delivery
    • Complicated cesarean delivery

Interpersonal and Communication Skills

  • Communicate effectively with services requesting gynecology consult
  • Provide an adequate check out to the on call team to ensure excellent patient care and adequate continuity of care
  • Counsel patients in regard to:
    • Management options for parents with a periviable fetus
    • Initial grief counseling for a fetal loss
    • Management plans for their pregnancy
    • Management of hyperemesis
    • How a specific disease state impacts pregnancy
  • Continue to improve communications with anesthesia, neonatology, and the charge nurse

Professionalism

  • Accept teaching responsibility of the junior members of the team
  • Accept teaching responsibility of third and fourth year students
  • Accept constructive criticism to improve surgical skills
  • Increase awareness of racial disparities in obstetrical outcomes

Practice Based Learning

  • Increase awareness of ACOG resources regarding standards of practice
  • Use online services to research clinical questions
  • Critique a research article

System Based Practice

  • Increase awareness of hospital utilization
  • Identify discharge coordinator and work with the individual to assure patient has appropriate needs at home
  • Become aware of the hospital utilization review process and how it impacts patient care.

Learning Resources

  • The Resident Room has major obstetrics and gynecology textbooks and access to computers
  • Residents attend Thursday morning Grand Rounds followed by protected teaching time from 9-11am
  • Daily sign-outs at 7AM and 5PM. Team members will give short educational lectures at the morning sign-out.

Evaluations

  • Faculty and resident colleagues are encouraged to provide direct verbal feedback so that resident performance can be commended or improved during the rotation.
  • Residents are evaluated via a Web-based evaluation system at MyEvaluations.com at the end of each rotation using a standardized evaluation form given to supervising OB/GYN attendings and upper-level residents. Attending evaluations are available for immediate review by the resident once completed.
  • Problems, which appear to be of a more urgent nature, will be brought immediately to the attention of the resident and residency program director for discussion.
  • Residents will receive a form at the end of each rotation via MyEvaluations.com soliciting feedback regarding the rotation, upper-level residents, and faculty. This information is shared anonymously and used for course/faculty improvement activities.