ABSTRACT
While the training of clinical skills is a requirement for medical study, it is necessary to evaluate whether a student receives enough learning experience. Besides a standard test, the objective structure clinical examination (OSCE), another way to assess the clinical experience of student is the evaluation of the number of patients whom the medical student has take care, which is recorded in a logbook. In this study, the Department of Obstetrics and Gynecology , Faculty of Medicine, Srinakharinwirot University aimed to examine the relationship between the number of studied cases as shown in the student’s logbook and the score that the student got from OSCE. The data of number of patients were collected from 106 logbooks of 4th year medical students that were handed in the department after the 8-week training session in 2008. It was shown that the average number of cases of low risk pregnancy and high risk pregnancy that were taken care per a student were 9.0±3.4 and 5.7±3.7, respectively. The average number of labor cases that were attended by a student was 10.4±3.0. The average number of operative obstetric cases that were attended by a student was 16.7±4.3. The average number of obstetric cases that were attended by a student in obstetric operative room was 5.9±2.3. The average number of obstetric inpatient cases that were taken care per a student was 8.9±2.7. The average number of gynecologic outpatient cases that were taken care per a student was 11.8±11.5. The average number of obstetric cases that were attended by a student in gynecologic operative room was 5.5±2.4. The average number of gynecologic inpatient cases that were taken care per a student was 5.8±1.9. The average number of frequency of evening on-duty was 8.5±0.9. These data revealed that the students should practice the clinical skills from enough number of patients. However, the average score of total students from OSCE was only 53.4±9.7 percent. The statistical tests also showed that there was no relation between the numbers of studies cases and the scores taken by OSCE. Therefore, the criteria for checking the student’s logbook should be evaluated and adjusted for better assessment of clinical training in the department.
ABSTRACT
A 28-year old woman, P1-0-1-1 presented with 5-month amenorrhea after having had single--rod 68 mg--etonorgestrel contraceptive implant (Implanon) for 18 months. Pregnancy was diagnosed by physical examination and confirmed by ultrasonography. At first, she wanted to have her pregnancy terminated because of a financial problem and anxiety about fetal anomaly as well as pregnancy complication. However, after counseling, she decided to continue her pregnancy and had a normal male infant delivered by cesarean section. This pregnancy is considered as product failure, which is very rare and is the first report in Thailand. Clinical counseling on medical risk of pregnancy and fetal anomaly can reduce the mother's anxiety and assure her to carry on her pregnancy as done in this case.