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OG19.3,OG35.{15-18,20},OG36.3 | Core Procedural Skills — Assignment
CLINICAL SCENARIO
This assignment asks you to critically analyse two core obstetric/gynaecological procedures — one from the gynaecological skills set (Pap smear or IUCD) and one from the obstetric intrapartum set (ARM, episiotomy repair, or urinary catheterisation) — demonstrating your understanding of correct technique, aseptic principles, and the identification and management of procedure-specific complications. You will also reflect on your simulation-based learning experience.
Instructions
Select ONE gynaecological procedure (Pap smear or IUCD insertion) AND ONE intrapartum procedure (ARM, episiotomy repair, or urinary catheterisation). For each procedure, write a structured critical analysis covering the four sections below. Draw on your SDL study and simulation-based learning. Use evidence from standard textbooks (DC Dutta, Shaw's, Williams Obstetrics) to support your points. Include specific technique steps, not generic principles.
Length: 1,200–1,600 words total (approximately 300–400 words per section). Quality and specificity are prioritised over length — every statement should be clinically specific.
What to Submit
Section 1: Indications, Contraindications and Pre-procedural Assessment
Guidance: For each chosen procedure: (a) State the specific clinical indications that justify performing this procedure. (b) Identify the key contraindications — both absolute and relative — that would cause you to defer or cancel the procedure. (c) Describe what pre-procedural patient assessment is required (history, examination, investigations, consent). For IUCD: include WHO MEC category framework. For ARM: include the critical assessment of presenting part engagement and cord presentation. Demonstrate reasoning, not just a list.
Section 2: Step-by-Step Technique with Aseptic Principles
Guidance: Walk through the complete technique for each procedure in structured steps, incorporating aseptic technique at each relevant stage. For Pap smear: include speculum insertion, TZ identification, spatula rotation, fixation. For IUCD: include sounding, loading, insertion mechanism, string trimming, post-insertion check. For ARM: include instrument choice, membrane identification, controlled flow of amniotic fluid, immediate fetal heart check. For episiotomy repair: include apex identification, layer-by-layer closure, suture material. For catheterisation: include meatus identification, sterile field maintenance, balloon inflation check. Highlight the one or two steps most critical to success and state why.
Section 3: Complications — Recognition, Prevention and Management
Guidance: For each procedure, describe: (a) The two or three most clinically significant complications. (b) The specific clinical signs that allow early recognition. (c) How the complication is prevented by correct technique. (d) The immediate management steps. For IUCD: cover both perforation and PID. For ARM: cover cord prolapse. For episiotomy: cover haematoma and wound dehiscence. Explain the causal link between technical error and the complication — do not simply list.
Section 4: Simulation Learning Reflection
Guidance: Reflect on your experience practising one of these procedures on a simulation model. Address: (a) Which specific technique steps were most difficult to master and why. (b) What feedback (from the checklist, peers, or faculty) identified your errors. (c) How simulation competency translates to supervised clinical readiness — and what specific behaviours would demonstrate you are ready for a supervised patient encounter. Keep this section analytical, not a diary narrative.
Grading Rubric — Procedural Competence Portfolio Rubric
| Criterion | Points | Full-marks descriptor |
|---|---|---|
| Clinical accuracy of indications, contraindications, and pre-procedural assessment | 20 pts | Indications and contraindications are clinically precise and evidence-based. WHO MEC or engagement criteria applied correctly. Pre-procedural assessment fully described with clear reasoning. |
| Technical accuracy and completeness of step-by-step technique with aseptic principles | 25 pts | All critical technique steps described accurately in correct sequence. Aseptic principles integrated at every relevant step. Critical steps identified with clear anatomical and procedural justification. |
| Clinical analysis of complications: recognition, prevention, and management | 25 pts | Clinically significant complications correctly identified for each procedure. Early recognition signs, specific preventive technique steps, and immediate management described accurately with clear causal links between technical error and complication. |
| Quality of simulation learning reflection | 15 pts | Reflection is analytical and specific: identifies precise technique steps that were challenging with clear reasoning, accurately describes errors identified through feedback, and articulates a concrete behavioural threshold for clinical readiness. |
| Structure, evidence base, and written communication | 15 pts | All four sections present and clearly structured. Arguments supported by specific references to standard textbooks. Writing is clear, concise, and professional with correct medical terminology throughout. |
PEER REVIEW
Review your peer's portfolio critically. For each criterion: (1) Identify one specific strength with a clinical reason. (2) Identify one specific gap or clinical inaccuracy with a suggested correction. Use the rubric criteria to guide your review. Do not rewrite your peer's answer — guide them to self-correct. Aim for 200–300 words total feedback.