MODULE 2-3: TEACHING-APPRAISAL-CLINICAL GOVERNANCE-RESEARCH

This blog post provides an outline of Modules 2 and 3. These are very important topics tested frequently in MRCOG exams. As these two modules are closely related so it is best to cover these together. Most of the exam candidates find themselves lost while thinking about these dry topics. It is very important to understand the basic principles which can be applied to ANY clinical scenario

• As I always advise the first step is to have a look at the details of modules on the RCOG website which will clarify what are you expected to demonstrate under these modules
• The best source for these modules is StratOG. It provides the most authentic information and can be subscribed by visiting this page StratOG Home
• You should first collect all the reading material and arrange/compile it as it suits your study needs
• The following tables may help you to collect and organize your study material in one place
• If you use gadgets (iPad/Laptop/Smartphone) its easier to arrange but if you prefer hard copies, you can get the printouts and arrange them as per your convenience
• I would suggest making ONE big folder and you can name it "Clinical Governance, Teaching & Statistics"
• Then make sub-folders based on the following outline. This will ensure that you do not miss any topic
• For each topic, you can make a ‘NOTE’ file which should be a summary of the points taken from all resources
• The format of your notes is very important. It should be concise and easy to retain information
• Keep practising SBAs and EMQs from different sources as these topics are tested in a variety of ways. You need to focus on EACH and EVERY word in the question to get the right answer
• I have made an outline just to give an idea about how these topics can be covered. If you find some topic is missing kindly modify your list 

I hope you find this compilation helpful and that it saves you precious time. Suggestions to improve future posts are welcome.

Thanks

Module 2: Teaching, Appraisal and Assessment Details RCOG

Teaching Role of clinical teacher Recent trends in Medical Education Principles of Adult Learning
TOG	The teacher, the learner and the method 2010 The key features of highly effective training units in ob/gyn 2020 Giving effective feedback in medical education 2017 Spotlight on education 2017 Providing an obstetric teaching programme in resource poor country 2014 Making simulation stimulating-how to set up a simulation workshop 2011 How can recruitment be improved in ob / gyn 2010 A guide to ATSM in Medical Education Article 1 - Principles of teaching and learning 2009  Article 2 - Assessment, feedback and evaluation 2010 Article 3 - Teaching and assessment in clinical setting 2010 Article 4 - Quality assurance and research in medical education 2010
Dr Tom	Education Answer
EMQ	Teaching Methods
Appraisal
TOG	A practical guide to appraisal and revalidation 2018
RCOG	Supporting information for appraisal and Revalidation: Guidance for Obstetrics and Gynaecology
Revalidation	Conducted by GMC to confirm that a doctor can retain license to practice in UK. Done every 5 years. GMC Website Link: Click Here
Assessment
TOG	Workplace-based assessment: a new approach to existing tools 2014
StratOG	RCOG eLearning Workplace Behavior and Skills tutorial on: Improving workplace behavior Step Up RCOG Communications Skills module
Mentoring
RCOG	RCOG eLearning case study on Leadership and Management Royal College of Mentorship and Support
Reflective Practice
TOG	Clinical Reflective Practice 2020
GMC	The reflective practitioner
Miscellaneous
TOG	Managing burnout in obstetrics and gynaecology 2019 The relevance of non-technical skills in ob/gyn 2013 Bullying in workplace-recognition and management 2012

Module 3: Information Technology, Clinical Governance & Research Details RCOG

Clinical Governance Main things to focus on are Quality improvement within a framework Patient Safety Consent Ethics Confidentiality Risk management Audit cycle Dealing with complains/legal matters Developing & applying clinical guidelines
TOG	The value of obstetric surveillance systems within NHS 2013 Implementation Strategies - moving guidance into practice 2013 What have maternity networks ever done for us? 2012 A practical guide to quality improvement 2017
CGA	Improving Patient Safety: Risk Management for Maternity and Gynaecology CGA 2 Presenting Information on Risk CGA 7 Understanding Audit CGA 5
Good Practice Guidance	Maternity Dashboard GP 7 Responsibility of Consultant On-Call GP 8 Gynaecology: Emergency Services Standards of Practice and Service Organization GP 9 Labour Ward Solutions GP 10 Improving Patient Handover GP 12  Reconfiguration of women's services in UK GP 15
Kindly go through the blog post which covers this topic along with explanations: Click Medical Law and Ethics
Consent
TOG	Understanding the Mental Capacity Act 2005 2010 Consent in Clinical Practice 2015 Medico-legal update on consent 'The Montgomery Ruling' 2016 Decision making framework in gynaecology for patients who lack mental capacity 2018
RCOG	Obtaining valid consent CGA 6 Obtaining valid consent for complex gynaecological surgery CGA 6b Obtaining Valid Consent to Participate in Perinatal Research CGA 6a
BlogPost	Consent Advice: Risk Figures Compilation
Legal Issues
TOG	Litigation in Gynaecology 2014 Dealing with serious incident requiring investigations in ob/gyn 2014 Surrogate Pregnancy: ethical and medico-legal issues in modern obstetrics 2013 Tackling female genital mutilation in the UK 2017
Research
TOG	A guide to RCOG Advanced Professional Module in Clinical Research 2018 A Practical introduction to medical statistics 2014 Participation in research as means of improving quality care 2015
RCOG	Understanding Audit CGA 5
Assessing evidence
TOG	The art of reviewing a paper 2014

You may also like:

Module 5,6,7: Core Surgical Skills, Post-op Care & Surgical Procedures

Module 8: Antenatal Care — Part 1

Module 8: Antenatal Care — Part 2

Module 9: Maternal Medicine

Module 10/11: Labour & Delivery 12: Puerperium

Module 13: General Gynaecology

Module 14: Subfertility

Module 15: Sexual and Reproductive Health

Module 16: Early Pregnancy Care

Module 17: Gynaecological Oncology

Module 18: Urogynaecology & Pelvic Floor Problems

Starting Point for MRCOG Part 2

3Ws and General Advice for MRCOG Part 2

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How to Study Green-Top Guidelines?

This blog post is very basic advice regarding your preparation for the MRCOG exam. I am going to share a few tips to cover the GTGs which might be helpful in retaining the enormous information. I have added ALL GTGs Algorithms at the end of the post.

As we all know that green top guidelines are one of the backbones of the MRCOG exam. They are regarded as the ‘Bible’ for any topic. You have to know these words by word and by heart. If one goes and sits for the exam without GTGs, it's like he/she is on a suicide mission. I think I can not emphasise more on its importance.

The most important tip to understand and memorise GTGs is “to revise it as many times as you can or at least 3 times”

Steps to cover GTGs

• First of all, visit the RCOG website and search for all the guidelines. I have compiled all the green top guidelines in one of the blog posts. You will get one-click downloadable links to all GTGs. 
• To access the post: Click Here
• Make sure to have the latest version of the guideline
• Decide whether you want to use soft copy or a printed form

GTG # 26 Assisted Vaginal Birth

This post is the summary of GTG #26 Assisted Vaginal Birth which was released in April 2020. This guideline has been update in detail with few recommendations which are different from previous version.

In this post, important points from the guideline (which could be tested in exam) are extracted. It is strongly recommended to read the original document to develop deep understanding of this guideline.

I hope this summary is helpful. 
Your feedback and suggestions to improve future posts are welcome. 

Thanks 

To download the guideline : Click Here

ASSISTED VAGINAL BIRTH

Introduction

• Incidence of Assisted Vaginal Birth (AVB) in UK → 10-15%
• 1:3 Nulliparous deliver by vacuum or forceps

Preparation for assisted vaginal birth (AVB)

Avoiding AVB

Factors which can reduce the need

• Continuous support during labour specially when carer is not a staff member 
• If not using epidural → adopt upright or lateral position in 2nd stage of labour
• With low-dose epidural→ 6% absolute ↑ in chance of spontaneous vaginal birth if lying down vs upright in 2nd stage 
• Delayed pushing for 1-2 hrs recommended in nulliparous with epidural (↓ rotational/ mid pelvic AVB)

Factors which can increase the need

• Epidural analgesia although less likely with newer techniques

No effect

• Epidural either in latent phase or active phase
• Discontinuing epidural analgesia during pushing → No ↓ incidence of AVB, but ↑ woman's pain  (22% vs 6%)

Insufficient evidence to recommend for reducing incidence of AVB

• Any particular regional analgesia technique
• Routine oxytocin augmentation for women with epidural
• Routine prophylactic manual rotation of fetal malposition in 2nd stage of labour
• Different studies:

• Manual rotation→ 90% success rate with ↓ in operative birth. Also ↓ duration of 2nd stage 
• If corrected fetal malposition by manual rotation in early 2nd stage→ no difference in rate of AVB
• Larger RCTs are needed

Defining AVB

• Use standard classification system Table 1 and perform systematic abdominal & vaginal examination