Rajiv Gandhi University of Health Sciences

UNDERGRADUATE LOGBOOK

DEPARTMENT OF OBSTETRICS & GYNAECOLOGY

Name of college

College emblem

1
 Purpose of this logbook

The log book is a verified record of the progression of the learner documenting the
Acquisition of there quisite knowledge, skills, attitude and competencies. It is a record of
the academic/co-curricular activities of the designated student, who would be
responsible for maintaining his/her logbook.

Entries in the logbook will reflect the activities undertaken in the department and has to
be scrutinized by the head of the concerned department.

The logbook is a record of various activities by the student like:

 Overall participation & performance
 attendance
 participation in sessions
 record of completion of pre-determined activities
 acquisition of selected competencies

The logbook is the record of work done by the candidate in the department and shall be
verified by the college before submitting the application of the students for the university
examination.

The purposes of this logbook are:

a. To orient the students to holistic patient management by completing the case

record, observing and recording procedures and discussing patient treatment in the
therapeutics section.
b. To facilitate the student’s learning process, document the learning process and
assist in student assessment
c. To keep a record of the student’s progressing development of the desired skills and
attitudes
d. To ensure that the time spent in the department is well utilized
e. To form a basis for continual assessment of the student
This log book is a documentation of cases seen, clerked and witnessed by you during
your posting in OBG .It is also a record of various seminars, case-based learning,
simulation exercises and other academic activities that the learner has been a part of
during course. Though efforts are made to cover as much as possible, in no way should
this be considered the syllabus.

Please carry this book whenever you attend the non-lecture academic activities of the
department and get it duly signed by the concerned staff at the end of the academic activity.
We expect discipline, honesty, sincerity and punctuality.
The responsibility of completing the logbook and getting it verified/assessed by the
faculty lies with the student. The logbook must be carried by the student as per the
given instructions.

2
 General Instructions
1. It is expected that the students will adhere to the highest ethical standards and
Professionalism.

2. Shall maintain punctuality in respect to arrival and completion of the assigned work

3. Maintain a cordial relationship with peers, unit staff and hospital staff

4. Not indulge in any act which would bring disrepute to the institution.

5. You should wear a clean apron and follow the dress regulations as laid down by the
college and maintain proper hygiene with wearing respective identification badge while
in college and hospital.

6. You should carry the following with you for the clinics
a. Clinical textbook
b. Stethoscope
c. Clinical kit for examination

7. Respect the patient as an individual and recognize that she also has rights.

8. Cases that are discussed only have to be documented and not the dummy cases.

9. Loss of this logbook at any time may affect the formative assessment results and
Impair the student appearing in the summative assessment.

10. Student is solely responsible for maintaining the Logbook and the records. If the
student loses the logbook, he/she would be withheld from appearing for the
University examination unless Suitable back up proof is provided.

3
Objectives of learning in OBG Department:

A. KNOWLEDGE

At the end of course, the student should be able to:

1. Outline the anatomy, Physiology and pathophysiology of the reproductive system and
the common conditions affecting it.
2. Detect normal pregnancy, labour, puerperium and manage the problems likely to be
encounter therein.
3. List the leading causes of maternal and perinatal morbidity and mortality.
4. Understand the principles of contraception and various techniques employed, methods
of medical termination of pregnancy, sterilization and their complications.
5. Identify the use, abuse and side effects of drugs in pregnancy, Pre-menopausal and
post menopausal periods.
6. Describe the national programme of maternal and child health and family welfare and
their implementation at various levels.
7. Identify the common gynecological diseases and describe principles of their
management.
8. State the indications, techniques and complications of surgeries like Caesarian
section, laprotomy, abdominal and vaginal hysterectomy , Fothergill’s operation and
vacuum aspiration for MTP

B. SKILLS:

At the end of course, the student should be able to:

1. Examine a pregnant woman: recognize high risk factors.

2. Conduct a normal delivery, recognize complications and early referral. Provide
post-natal care.
3. Resuscitate the newborn and recognize congenital anomalies.
4. Advise a couple on the use of various available contraceptive devices and assist in
insertion and removal of intra uterine contraceptive devices
5. Perform pelvic examination, diagnose and manage common gynaecological
problems including early detection of genital malignancies
6. Make a vaginal cytological smear.
7. Interpretation of data of investigations like biochemical, histopathological,
radiological, ultrasound etc.

4
Name of the student

Roll No

University Registration Number

Batch

Contact No

E mail Id

Guardian/Parent

Name
Contact Number

Signature of the student

Signature of the HOD

5
 LOGBOOK CERTIFICATE

This is to certify that the candidate ……………………………………………

Reg No……………...... has satisfactorily completed all requirements

mentioned in this Logbook for OBG including related AETCOM modules

as per the Competency-Based Undergraduate Medical Education

Curriculum, Graduate Medical Regulation 2019 during the period from

…….... ……….to ……………...

He/ She is eligible to appear for the summative (University) assessment.

Head of Department: Faculty Name:

Name: Signature:
Signature:

Date:

6
 INDEX

Topic Page No.

1. Attendance extract 8

2. Overall Assessment 9-11

3. Clinical posting 1 12-26

4. Clinical posting 2 27-34

5. Clinical posting 3 35-46

6. Clinical posting 4 47-56

7. Labour Room Procedures 57-59

8. Certifiable skill 60

9. Check lists for skills assessments 61-67

10. AETCOM modules 68-69

11. Integrated sessions 70

12. Self- Directed Learning sessions 71

13. Seminars presented 72

14. Research projects/publications 72

15. Co - Curricular Activities 73

(Quiz, Poster, Debate, Essay, Skits)
16. CME/ Conference / Workshop 74

17. Awards / recognition 74

ATTENDANCE EXTRACT

Theory classes

7
Professional Year Number Number Percentage of Signature of HOD
attended conducted Attendance

Second
Professional

Third Professional
Part I

Third Professional
Part II

Bedside clinics:

8
 Professional Unit Number Number Percentage Signature Signature
Year From attended conducted of of Unit of HOD
(date) Attendance Head
To
(date)
Second
Professional
year Posting 1

Third
Professional
year Part I
Posting 2

Third
Professional
Part II
Posting 3

Third
Professional
year Part II
Posting 4

Note:

Every candidate should have attendance not less than 75% of the total classes
conducted in theory which includes didactic lectures and self-directed learning
and not less than 80% of the total classes conducted in practical which includes
small group teaching, tutorials, integrated learning and practical sessions in
each calendar year calculated from the date of commencement of the term to the last
working day in each of the subjects prescribed to be eligible to appear for the
university examination.

SUMMARY OF INTERNAL ASSESSMENT (IA)

9
 Total marks Marks scored Signature Signature
Sl. Date of
Internal of of
No Assessmen
Assessment Theory Practical Theory Practical student teacher
. t
with date with date

1 First

2 Second

3 Third

4 Remedial

Total marks obtained on a total of 200 is -----

A student will be permitted to appear for final university exams only if he/she
obtains more than 100 marks in the assessments.
Final remarks if any -

Note: A candidate who has not secured requisite aggregate in the internal
assessment may be subjected to remedial assessment by the institution. If he/she
successfully completes the same, he/she is eligible to appear for University
Examinations. The remedial assessment shall be completed before submitting
the internal assessment marks online to the University.

Formative Assessment at the end of each posting:

10
 Second Third Third Professional
Professional Professional year Part II
MCQ marks obtained year year Part I

1 Posting 2 Posting 3 Posting 4 Posting

Date Date Date Date

Academic Performance
(Case Presentation & Viva Voce)
(25+10)

Marks Obtained
Feedbac Positive
k Could be
Provided improved
Professionalism

Timely submission of
record Book (5)
Behaves respectfully with
peers and teachers (5)
Grooming and adherence
to Dress code (5)

Total (out of 35+15)

Signature of Student

Signature of Teacher

Guidelines for scoring ( to be shown to the student and discussed with them)

Attendance – 95 -100% - 5 ; 90-94%-4;85-89%-3 80-84%-2;> 80%-1

Timely submission of record – Always submits the record on time – 5; Often submits the record on
time -4; Sometimes submits the record on time -3 ; Rarely submits the record on time – 2 ; Never
submits the record on time -1

Behaves respectfully with peers and teachers - Always speaks politely and demonstrates the
appropriate body language with peers and teachers -5; Often speaks politely and demonstrates the
appropriate body language with peers and teachers -4; Sometimes speaks politely and demonstrates
the appropriate body language with peers and teachers – 3 ; Rarely speaks politely and demonstrates
the appropriate body language with peers and teachers – 2; Never speaks politely and demonstrates
the appropriate body language with peers and teachers -1

11
 Clinical posting 1

Duration 4 weeks

Date of posting From

To
Unit

Competency to be achieved

1) Obstetric History taking & examination

2) Gynaecological History taking & examination
3) Assessment of postnatal mother
4) Monitoring of labour
5) Active management of 3rd stage of labour

12
 Clinical Posting 1

SLNO ACTIVITY

1. Obstetric history taking(OG.8.2)

Determine gestational age, EDD and obstetric formula(OG35.5)

2. Obstetric examination(OG 8.3)

3. Gynec history taking(OG 24.1)

4. Gynec examination (OG 24.1)

5. Monitoring of labour(OG 13.1)

6. Active Management of third stage of labour(OG 16.1)

7. History taking and examination of postnatal mother(OG 19.1)

Compete Name of Date Attempt Rating Decision of Initial of Feedba

ncy # Activity completed at faculty faculty ck
addresse dd-mm- activity Below (B) and date Receiv
expectations Completed (C)
d yyyy Meets(M) ed
First or Only Repeat(R)
expectations Remedial(Re)
(F) Repeat Exceeds(E)
(R) expectations
Remedial
(Re)

13
OG 8.2 Obstetric
history taking
OG35.5 Determine
gestational
age, EDD and
obstetric Initial of
formula learner

OG 8.3 Obstetrics
examination

Initial of
learner
OG 24.1 Gynae history

Initial of
learner

OG 13.1 Monitoring of
Labour

OG 16.1 Active
management
3rd stage of
labour

OG 19.1 History taking

and
examination
of postnatal
mother

Learner doctor method 1

Posting 1

A. Competency to be achieved-
1. History taking
2. Examination - General physical examination

14
 - Systemic examination
- Obstetrics examination
3. Communication skills-

One antenatal patient will be allotted to the student. The student is expected to take the
history of the patient and examine her. Case record has to be written and daily follow-
up till discharge has to be entered. The students will communicate with the patient and
doctor about the patient care.

A brief summary is to be written at the time of patient discharge and discuss the case with the
teacher.

Learner doctor method

15
Learner doctor method

16
Learner doctor method

17
Learner doctor method

18
Reflection on the learner doctor method of learning;

What happened?

So what ?

What next?

Signature of faculty :Date :

19
Learner doctor method 2

B. Competency to be achieved

1. History taking
Examination - General physical examination

- Systemic examination
- Gynaecological examination

One patient will be allotted to the student. The student is expected to take the history of
the patient and examine her. Case record has to be written and daily follow-up till
discharge has to be entered. The students will communicate with the patient and doctor
about the patient care.

A brief summary is to be written at the time of patient discharge and discuss the case with the
teacher.

20
Learner doctor method

21
Learner doctor method

22
Learner doctor method

23
Learner doctor method

24
Reflection on the learner doctor method of learning;

What happened?

So what ?

What next?

Signature of faculty: Date :

25
 Posting 2

Duration 8 weeks

Date of posting From

To

Unit :

Competency to be achieved

1) Diagnosis of early pregnancy

2) Antenatal care and advice
3) Identify the high risk factors in pregnancy
4) Methods of Induction of labour
5) Develop a partogram
6) Postnatal care & Advice
7) Pre & Post operative care

Clinical posting 2

SLNO
ACTIVITY
( Case Presentation)

1. Diagnosis of early pregnancy (OG 6.1)

2. Antenatal care and advice (OG 8.1,8.6)

3. Diagnosis of high risk (OG 8.1)

4. Partogram ( OG 13.1)

5. Postnatal care and advice (OG 19.1)

6. Pre and postoperative care including consent for surgery (OG 34.4, 35.7)

26
Competency Name of Date Attempt Rating Decision of Initial Feedback
# addressed Activty completed at activity faculty of Received
Below (B)
dd-mm- First or expectations Completed (C)
faculty
yyyy Only (F) Meets(M) Repeat(R) and
Repeat (R) expectations Remedial(Re) date
Remedial Exceeds(E)
(Re) expectations

OG6.1 Diagnosis of
early
pregnancy

Initial of
students

OG 8.1, Antenatal
OG 8.6 care and
advice

Initial of
students

OG 8.1 Diagnosis of
high risk

Initial of
students
OG 13.1 Partogram

Initial of
students

OG 19.1 Postnatal
care and
advice
Initial of
students
OG 34.4, Pre and
OG 35.7 postoperativ
e care
including
consent for Initial of
surgery students

27
Learner doctor method.

Posting 2

Competency to be achieved
1. History taking
2. Examination - General physical examination
- Systemic examination
- Obstetrics examination
3. Indentifying High Risk factors
4. Communication & patients education
5. Selection of appropriate investigation
6. Approach towards the diagnosis

One patient will be allotted to the student. The student is expected to take the history of
the patient and examine her. Case record has to be written and daily follow-up till
discharge has to be entered. The students will communicate with the patient and doctor
about the patient health.

A brief summary is to be written at the time of patient discharge and discuss the case with the
teacher.

28
Learner doctor method.

29
Learner doctor method.

30
Learner doctor method.

31
Learner doctor method

32
Reflection on the learner doctor method of learning :

What happened?

So what ?

What next?

Signature of the faculty: Date:

33
 Posting 3

Duration 8 weeks

Date of posting From

To

Unit :

Competency to be achieved
1) Obstetric History taking and complete examination
2) Gynaecological History taking and complete examination
3) Management of medical and obstetric disorders in pregnancy
4) Management of Gynaecological disorder

34
 Clinical Posting 3

SLNO ACTIVITY (Case Presentation )

1. Describe clinical features; diagnosis and
investigations, complications, principles of management of multiple
pregnancies (OG11.1)

2. Define, classify and describe the aetiology, clinical features,

ultrasonography, differential diagnosis and management of
antepartum haemorrhage in pregnancy (OG10.1)
3. Define, classify and describe the early detection, investigations;
principles of management of hypertensive disorders of pregnancy
and eclampsia, complications of eclampsia.( OG12.1)

4. Define, classify and describe the diagnosis, investigations, adverse

effects on the mother and foetus and the management during
pregnancy and labor, and complications of anemia in pregnancy .
( OG12.2)

5. Define, classify and describe diagnosis, investigations, criteria,

adverse effects on the mother and foetus and the management during
pregnancy and labor, and complications of diabetes in pregnancy
(OG12.3)

6. Define, classify and describe the etiology, diagnosis, investigations,

criteria, adverse effects on the mother and foetus and the management
during pregnancy and labor, and complications of heart diseases in
pregnancy (OG12.4)
7. Describe the mechanism, prophylaxis, fetal complications, diagnosis
and management of isoimmunization in pregnancy (OG12.8)

8. Describe and discuss causes, clinical features, diagnosis,

investigations; monitoring of fetal well-being, including ultrasound
and fetal Doppler; principles of management; prevention and
counselling in intrauterine growth retardation (OG16.3)

9. Define, classify and discuss abnormal uterine bleeding, its aetiology,

clinical features, investigations, diagnosis and management (OG24.1)

10. Describe and discuss the clinical features; differential diagnosis;

investigations; principles of management, complications of fibroid
uterus (OG29.1)
11. Describe and discuss the etiology, classification, clinical features,
diagnosis, investigations, principles of management and preventive
aspects of prolapse of uterus (OG31.1)

35
Competenc Name of Date Attempt Rating Decision of Initial Feedbac
y# Activity completed at faculty of k
addressed dd-mm- activity Below (B) facult Received
yyyy expectation Completed y and
First or s (C) date
Only (F) Meets(M) Repeat(R)
Repeat expectation Remedial(Re
(R) s )
Remedia Exceeds(E)
l (Re) expectation
s
OG11.1 Describe the
clinical features;
diagnosis and
investigations,
complications,
principles of
management of
multiple
pregnancies Initial of
students
OG10.1 Define, classify
and describe the
aetiology,
clinical features,
ultrasonography
, differential
diagnosis and
management of
antepartum
haemorrhage
in pregnancy
Initial of
students
OG12.1 Define, classify
and describe the
early detection,
investigations;
principles of
management of
hypertensive
disorders of
pregnancy and
eclampsia,
complications of
eclampsia Initial of
students
Competenc Name of Date Attempt Rating Decision of Initial Feedback

36
y# Activity complete at faculty of Received
addressed d dd-mm- activity Below (B) faculty
yyyy expectation Completed and
First or s (C) date
Only (F) Meets(M) Repeat(R)
Repeat expectation Remedial(Re
(R) s )
Remedial Exceeds(E)
(Re) expectation
s

OG12.2 Define, classify

and describe the
diagnosis,
investigations,
adverse effects
on the mother
and foetus and
the management
during pregnancy
and labor, and
complications of
anemia in Initial of
pregnancy students

OG12.3 Define, classify

and describe the
diagnosis,
investigations,
criteria, adverse
effects on the
mother and
foetus and the
management
during pregnancy
and labor, and
complications of Initial of
diabetes in students
pregnancy
OG12.4 Define, classify
and describe the
etiology,
diagnosis,
investigations,
criteria, adverse
effects on the
mother and
foetus and the
management
during pregnancy
and labor, and
complications of Initial of
heart diseases in students
pregnancy

37
Competenc Name of Date Attempt Rating Decision of Initial Feedbac
y# Activity complete at faculty of k
addressed d dd-mm- activity Below (B) facult Received
yyyy expectation Completed y and
First or s (C) date
Only (F) Meets(M) Repeat(R)
Repeat expectation Remedial(Re
(R) s )
Remedia Exceeds(E)
l (Re) expectation
s

OG12.8 Describe the

mechanism,
prophylaxis, fetal
complications,
diagnosis and
management of
isoimmunizatio Initial of
n in pregnancy students
OG16.3 Describe and
discuss causes,
clinical features,
diagnosis,
investigations;
monitoring of
fetal well-being,
including
ultrasound and
fetal Doppler;
principles of
management;
prevention and
counselling in Initial of
intrauterine
growth
students
retardation
OG24.1 Define, classify
and discuss
abnormal
uterine
bleeding, its
aetiology,
clinical features,
investigations, Initial of
diagnosis and
management
students

38
Competenc Name of Date Attempt Rating Decision of Initial Feedbac
y# Activity complete at faculty of k
addressed d dd-mm- activity Below (B) facult Received
yyyy expectation Completed y and
First or s (C) date
Only (F) Meets(M) Repeat(R)
Repeat expectation Remedial(Re
(R) s )
Remedia Exceeds(E)
l (Re) expectation
s

OG29.1 Describe and

discuss the
clinical
features;
differential
diagnosis;
investigations
; principles of
management,
complications
of fibroid Initial of
uterus students
OG31.1 Describe and
discuss the
etiology,
classification,
clinical
features,
diagnosis,
investigations
, principles of
management
and
preventive
aspects of
prolapse of
uterus
Initial of
students

39
Learner doctor method.

Posting 3

Competency to be achieved

1. History taking
2. Examination - General physical examination
- Systemic examination
- Obstetrics examination
3. Identifying High Risk factors
4. Communication & patients education
5. Selection of appropriate investigation
6. Approach towards the diagnosis
7. Plan of Management.

One patient will be allotted to the student. The student is expected to take the history of
the patient and examine her. Case record has to be written and daily follow-up till
discharge has to be entered. The students will communicate with the patient and doctor,
about the patient care & plan of management

A brief summary is to be written at the time of patient discharge and discuss the case with the
teacher.

40
Learner doctor method.

41
Learner doctor method.

42
Learner doctor method.

43
Learner doctor method

44
Reflection on the learner doctor method of learning :

What happened?

So what ?

What next?

Signature of the faculty: Date:

45
Posting 4

Duration 4 weeks

Date of posting From

To

Unit :

Competency to be achieved

1) Gynaecological history taking and complete examination

2) Early detection of genital malignancies
3) Document and maintain a case record
4) Write a discharge summary for the given case
5) Write a Referral note for the given case
6) Take an informed consent for the given procedure

46
 Clinical posting 4

SLNO ACTIVITY
( Case Presentation )

1. Classify, describe and discuss the etiology, clinical features, differential diagnosis,
investigations and staging of cervical cancer( OG33.1)

2. Describe and discuss aetiology, staging clinical features, differential diagnosis,

investigations, staging laparotomy and principles of management of endometrial
cancer (OG34.1)
3. Describe and discuss the etiology, classification, staging of ovarian cancer, clinical
features, differential diagnosis,
investigations, principal of management including staging
laparotomy (OG34.2)
4. Obtain a logical sequence of history, and perform a humane and thorough clinical
examination, excluding internal examinations (perrectal and per-vaginal) (OG35.1)

5. Arrive at a logical provisional diagnosis after examination. (OG35.2)

6. Write a complete case record with all necessary details (OG35.8)

7. Write a proper discharge summary with all relevant information (OG35.9)

8. Write a proper referral note to secondary or tertiary centres or to other physicians

with all necessary details (OG35.10)

9. Take an informed consent from the patient and family for Staging laprotomy
(OG34.4, OG35.7)

47
Competenc Name of Date Attempt Rating Decision of Initial Feedback
y# Activity completed at faculty of Received
addressed dd-mm- activity Below (B) faculty
yyyy expectations Completed and
First or Meets(M) (C) date
Only (F) expectations Repeat(R)
Repeat Exceeds(E) Remedial(Re
(R) expectations )
Remedial
(Re)
OG33.1 Classify,
describe and
discuss the
etiology, ,
clinical features,
differential
diagnosis,
investigations
and staging of Initial of
cervical cancer students
OG34.1 Describe and
discuss
aetiology,staging
clinical features,
differential
diagnosis,
investigations,
staging
laparotomy and
principles of
management of
endometrial Initial of
cancer students
OG34.2 Describe and
discuss the
etiology,
classification,
staging of
ovarian cancer,
clinical features,
differential
diagnosis,
investigations,
principal of
management Initial of
including staging students
laparotomy
Competenc Name of Date Attempt Rating Decision of Initial Feedback
y# Activity completed at faculty of Received
addressed dd-mm- activity Below (B) faculty
yyyy expectation Completed and
First or s (C) date

48
 Only (F) Meets(M) Repeat(R)
Repeat expectation Remedial(Re
(R) s )
Remedial Exceeds(E)
(Re) expectation
s

OG35.1 Obtain a
logical
sequence of
history, and
perform a
humane and
thorough
clinical
examination, Initial of
excluding students
internal
examinations
(perrectal and
per-vaginal
OG35.2 Arrive at a
logical
provisional
diagnosis
after
examination.

Initial of
students
OG35.8 Write a
complete
case record
with all
necessary
details

Initial of
students

Competency Name of Date Attempt Rating Decision of Initial Feedback

# addressed Activity completed at faculty of Received
dd-mm- activity Below (B) faculty

49
 yyyy expectations Completed and
First or Meets(M) (C) date
Only (F) expectations Repeat(R)
Repeat Exceeds(E) Remedial(Re)
(R) expectations
Remedial
(Re)

OG35.9 Write a
proper
discharge
summary
with all
relevant
information
Initial of
students
OG35.10 Write a
proper
referral
note to
secondary
or tertiary
centres or
to other Initial of
physicians students
with all
necessary
details
OG34.4, Take an
OG 35.7 informed
consent
from the
patient and
family for Initial of
Staging students
laprotomy

Learner doctor method.

Posting 4

50
 Competency to be achieved
1. Arriving at diagnosis
2. Planning management
3. Taking consent from the patient for the procedure
4. Assessing post procedure complication
5. Writing discharge summary
6. Advise on discharge

One patient will be allotted to the student. The student is expected to take the history of
the patient and examine her. Case record has to be written and daily follow-up till
discharge has to be entered. The students will communicate with the patient and doctor
about patient care and plan of management.

A brief summary is to be written at the time of patient discharge and discuss the case with the
teacher.

Learner doctor method.

51
Learner doctor method.

52
Learner doctor method

53
Reflection on the learner doctor method of learning :

What happened?

So what ?

What next?

Signature of the faculty: Date:

54
 LABOUR ROOM PROCEDURES

SLNO ACTIVITY

1. Obtain a logical sequence of history, and perform a humane and thorough

clinical examination, excluding internal examinations (perrectal and per-
vaginal) (OG35.1)

2. Arrive at a logical provisional diagnosis after examination. (OG35.2)

3. mechanism of labor in occipito-anterior presentation (OG13.1)

4. monitoring of labor including partogram (OG13.1)

5. Induction of Labour

6. acceleration of labor(OG13.1)

7. Amniotomy (OG 13.3)

8. Enumerate and describe the indications, steps and complications of

Caesarean Section (OG15.1)
9. Observe/Assist in operative obstetrics case – Forceps/ vacuum extraction
(OG15.2)

10 Describe and discuss the classification; diagnosis; management of abnormal

labor (OG 14.4)

55
Competenc Name of Date Observed Assisted Initial of Feedback
y# Activity completed faculty and Received
addressed dd-mm- date
yyyy

OG35.1 Obtain a
logical
sequence of
history, and
perform a
humane and
thorough
clinical
examination,
excluding
internal
examinations Initial of
(perrectal and students
per-vaginal

OG35.2 Arrive at a
logical
provisional
diagnosis after
examination. Initial of
students

OG13.1 mechanism of
labor in
occipito-
anterior
presentation

Initial of
students

56
 Name of Date Observed Assisted Initial of Feedback
Competenc Activity completed faculty Received
y# dd-mm- and date
addressed yyyy

OG13.1 monitoring
of labor
including
partogram Initial of
students

OG13.1 Induction of
labour
Initial of
students
OG13.1 acceleration
of labor

Initial of
students
OG 13.3 Amniotomy

Initial of
students
OG15.1 Caesarean
section,

Initial of
students
OG15.2 Instrumental
delivery
Initial of
students

OG14.4 diagnosis;
management
of abnormal
labor Initial of
students

57
 Certifiable Skills

Name of Activity: Observe and assist the conduct of a normal vaginal

delivery
Competency # Date Performed Initial of Feedback
addressed completed under faculty Received
dd-mm- supervision and date
yyyy

OG13.5

OG13.5

OG13.5

OG13.5

OG13.5

OG13.5

OG13.5

OG13.5

OG13.5

OG13.5

58
Checklist for assessment of skills in Skill lab

Sl. no Skills

1 Speculum Examination /Pap Smear

2 Prevaginal examination

3 Normal Delivery

4 Episotomy

5 Female Urinary Catheterization

1. Speculum Examination / Pap Smear

59
 Sl No Step/Task Yes No
1 0
1 Introduce yourself
2 Verbal consent
3 Explain procedure to woman
4 Ask to empty bladder
5 Provide adequate privacy
6 Place in dorsal position
7 Scrub hands
8 Wear sterile gloves
9 Encourage the woman to take deep breath and relax during
examination
10 Separate the labia with left hand, introduce cuscos speculum
into vagina with right hand.
11 Points to observe:
a) Direction of cervix
B )Cervical lips
c) External os
d) abnormal discharge or bleeding from any side
e) abnormal growth from any side
12 Take Pap Smear using Ayre’s spatula from the cervix \,
rotate in a 3600 movement. The longer projection of the
spatula is inserted into the endocervix and shorter end to
the ecto cervix
13 Another sample is collected from the posterior fornix with
the flat end of the spatula
14 The material collected is immediately spread over 2 slides
and at once put into the fixative ethyl alcohol 95% before
drying or fixed with confixative spray.
15 The slides are labelled and send to the lab with brief patient
history and examination findings and proper patient
identification number.
16 Proper disposal of the gloves
17 Documentation of findings

Level of expertise expected - advanced / beginner

Level of expected expertise attained- Yes/no
Needs to repeat the session – Yes/ No
Repeat session: level of expected expertise attained- Yes/ No.

2.Prevaginal examination

60
 Sl No Step/Task Yes No
1 0
1 Introduce yourself
2 Verbal consent
3 Ask to empty bladder
4 Provide adequate privacy
5 Explain procedure to woman
6 Place in dorsal position
7 Scrub hands
8 Wear sterile gloves
9 Lubricate fingers with jelly
10 Separate the labia with left hand, introduce index and middle
finger of right hand into vagina,
11 Encourage the woman to take deep breath and relax during
examination
12 Bimanual examination – to note down
a) Direction of the cervix
b) consistency of the cervix (firm / hard)

c)cervical motion tenderness (tenderness present / absent)

d)Whethercervix bleeds on touch

e)Uterus - anteverted/ retroverted
f)Size of uterus
g)Consistency of uterus

h)Mobility of uterus
i)Surface of Uterus –regular/ irregular
j) Palpation of Adnexa – appendages / fornices / describe the
mass if palpable

13 Proper disposal of gloves

14 Document findings

Level of expertise expected– advanced/ beginner

Level of expected expertise attained- Yes/no
Needs to repeat the session – Yes/ No
Repeat session: level of expected expertise attained- Yes/ No.

61
 3. Normal delivery

Sl. No. Procedure Yes No Comments if any

1. Put on personal protective barriers. (Wear
Goggles, Mask, Cap, Shoe cover, Plastic Apron).

2. Perform hand hygiene and put on sterile glove

3. Empty the bladder

4. Paint & drape the parts

5. Talk to the woman and encourage woman for

breathing & small pushes with contractions
6. Once crowning give liberal episiotomy after
infiltrating lignocaine
7. Control the birth of the head with the fingers of
one hand to maintain flexion, allow natural
stretching of the perineal tissue, ask the assistant
to support perineum
8. Feel around the baby’s neck for the cord and
respond appropriately if the cord is present.
9. Allow the baby’s head to turn spontaneously and
with the hands on either side of the baby’s head,
delivers the anterior shoulder
10. Pull the head upward as the posterior shoulder is
born over the perineum
11. Support the rest of the baby’s body as it slides
out and place the baby on the mother’s abdomen
over the clean towels
12. Note the time of birth and sex of the baby

13 Active management of third stage of labor

(AMTSL)
a) Administer uterotonic Drug –
Inj.oxytocin10 IU IM or tab. Misoprostol
(600ug) orally

b) Perform controlled cord Traction during a

contraction by placing one hand on the
lower abdomen to support the uterus and
gently pulling the clamped cord by the
other hand close to perineum

14. Examine the vagina and perineum

62
15. Examine the placenta, membranes, and umbilical
cord
● Maternal surface of placenta
● Foetal surface
● Membranes
Umbilical cord

Level of expertise expected – advanced / beginner

Level of expected expertise attained – Yes / No
Needs to repeat the session – Yes / No
Repeat session: level of expected expertise attained- Yes/ No

63
 4. Episotomy

Sl No Step/Task Yes No
1 0
1 Informs patient about need for episiotomy and local
infiltration
2 Gives local Inj. Xylocaine in fan shaped manner after
checking for inadvertent needle in vessel
3 Performs the incision with fingers guarding the fetus from
injury
4 Confirms integrity of rectum
5 Changes gloves
6 Identifies the apex of the mucosal layer
7 Ask for appropriate suture material
8 Sutures vaginal mucosa first by continuous suturing
9 Sutures muscle layer intermittently after vaginal mucosa
10 Sutures skin after muscular layer
11 Confirms haemostasis, looks for any forgotten gauze
12 Do a per rectal examination to feel for any suture passing
through rectal mucosa

Level of expertise expected– advanced/ beginner

Level of expected expertise-attained- Yes/no
Needs to repeat the session – Yes/ No
Repeat session : level of expected expertise attained- Yes/ No.

64
 5. Female Urinary Catheterization

Sl No Step/Task Yes No
1 0
1 Self-Introduce, Explainprocedure & take consent
2 Arrange Catheter set
3 Paint external gentialiaupto mid-thigh
4 Painting- separate labia minora & clean urethral & vaginal
region
5 Draping
6 Keep kidney tray over drape
7 Lubricate the tip of the foley ‘s Catheter with xylocaine gel
8 Separate labia minora with left hand
9 Introduce the catheter into the urethra
10 Drain the urine into the kidney tray
11 Foley bulb to be inflated with 5 ml distilled water
12 Connecting the urosac bag
13 Dispose appropriately (yellow linen – gauze, paper) ( red
linen – glove)

Level of expertise expected– advanced/ beginner

Level of expected expertise attained- Yes/no
Needs to repeat the session – Yes/ No
Repeat session : level of expected expertise attained- Yes/ No.

65
AETCOM MODULES

Module number: Date:

Name of the activity:
Department of Internal Medicine

Competencies
The student should be able to :

Reflection

Feedback

Signature of the student:

Assessment: Signature of the faculty

66
AETCOM MODULES

Module number: Date:

Name of the activity:
Department of Internal Medicine

Competencies
The student should be able to :

Reflection

Feedback

Signature of the student:

Assessment: Signature of the faculty

Integrated sessions :

67
 Date of Topics covered Competency Departments Signature Signature
session numbers involved in the of the of the
addressed conduct of the student faculty
session
1

Self-directed learning sessions:

68
Sl. Date Topic Competency number Signature of
No. The Faculty

1.

2.

3.

4.

5.
6

7
8

10

Seminars presented

Date Topic Content(5) Clarity of Interaction Knowledge Use of Total

69
 presentation (5) (5) Audio
(5) Video
aid (5)

Research projects and publications

Sl.no Name of the topic Date Signature of the

faculty

Co curricular activities –(quiz, poster, debates, essays, skit)

Sl.no Name of the topic Date Signature of the
faculty

70
1

10

Participation in CME, conference, workshops

Sl..no Name of the topic Date Signature of the
faculty

71
1

Awards and recognition

Sl. Name of the topic Date Signature of the

no faculty
1

72