Administrative Checklist

This list contains all items that each student is required to complete during the course of their OB/GYN Clerkship.

OB/GYN CLERKSHIP ADMINISTRATIVE CHECKLIST

All items listed below are required by students from ALL sites and must be completed on the due date (indicated beside each item) in order to receive full credit, or a 4, for the Administration portion (5%) of your final grade. Also, if your particular site has any other items that need to be returned and/or completed before the end of your clerkship, those items will need to be done as well in order to earn a 4 towards your Administration grade.  Failure to complete ALL items will result in a value of “0” for the Administrative portion (5%) of your final grade.

 

You can also access a pdf version of the checklist here.

 

 

 OB/GYN Clerkship Tasks

Due Date/Time

 

ALL SITES (except Asheville)

 

X

Orientation Attestation Form submitted (may appear as self-eval in your to-do list)

First day of rotation after orientation

X

OB Task Card

Day of Shelf Exam

X

Clinical Log (completed in One45)

8AM, Monday after Shelf Exam

X

Passed Complementary and Alternative Medicine Quiz

8AM, Monday after Shelf Exam

X

Attend Critical Incident Session

Day of OBGYN OSCE

X

Complete and Email Narrative Essay to Sara Tinkham

1 week before OBGYN OSCE

 

CHAPEL HILL

 

X

Any borrowed resources and  surgical skills kit with ALL instruments and knot tying board

11:30 AM, Day of Shelf Exam to Sara Tinkham’s office (3020 Old Clinic)

X

At least ONE evaluation of Resident

7 days after Shelf Exam

X

At least ONE evaluation of Faculty/Fellow

7 days after Shelf Exam

X

Submitted Clerkship Clinical Performance Evaluation-Self Assessment form for Mid rotation Feedback

8AM, Monday before Mid rotation feedback with

 Dr. Chuang/Evers

 

WAKE

 

X

Surgical skills kit with ALL instruments and knot tying board

11:30 AM, Day of Shelf Exam to Sara Tinkham’s office (3020 Old Clinic)

X

ID badge

Last day at Wake

X

Pager

Last day at Wake

X

Any borrowed textbooks or resources

Last day at Wake

X

Gestation Wheel

Last day at Wake

X

Common Phone Numbers “Laminated Card”

Last day at Wake

X

Return combination lock

Last day at Wake

 

Midrotation review requirements

 

X

-           Submitted Clerkship Clinical Performance Evaluation-Self Assessment form  for Mid rotation Feedback

Before mid-rotation review w/ Dr. Gantt

X

-           Clinical log up-to-date

Before mid-rotation review w/ Dr. Gantt

X

-           Bring copy of H&P from first 3 weeks

At mid-rotation review w/ Dr. Gantt

 

CHARLOTTE

 

X

CANOPY modules completed & certificates sent to Gina Davis

Prior to first day

X

Fit testing forms returned to Gina Davis via email

Prior to first day

 

Complete Student Information Questionnaire

Prior to first day

X

Midrotation review requirements

 

X

-           Evaluations distributed/returned for first 3 weeks

Before mid-rotation review w/ Dr. Bliss

X

-           Submitted Clerkship Clinical Performance Evaluation-Self Assessment form  for Mid rotation Feedback

Before mid-rotation review w/ Dr. Bliss

X

-           Clinical log up-to-date

Before mid-rotation review w/ Dr. Bliss

X

-           Bring copy of H&P from first 3 weeks

At mid-rotation review w/ Dr. Bliss

 

-           Oral presentation topic discussed

At mid-rotation review w/ Dr. Bliss

X

Complete CMC required forms on ONE45

 

X

-           APGO Excellence in Teaching (for faculty nominee)

Last day of rotation

X

-           Resident Excellence in Teaching

Last day of rotation

X

-           Evaluations of each rotation

Last day of rotation

X

-           Evaluations of Residents/Faculty

Last day of rotation

X

Beeper returned

Last day at Charlotte

X

Any borrowed textbooks or resources

Last day at Charlotte

X

ID badge/needle stick policy hangtag returned

Last day at Charlotte

X

Message Center cleared in Canopy/Medical Records Clearance form signed

Last day of rotation

X

Teacher-Learner contracts returned signed

Last day of rotation

X

LARC Study survey f/u

Last day of rotation

X

Educational module survey returned

Last day of rotation

 

WILMINGTON

 

X

ID badge

Last day at Wilmington

X

Pager

Last day at Wilmington

X

Any borrowed textbook or resources

Last day at Wilmington

 

ASHEVILLE (Longitudinal Students)

 

X

Orientation attestation Form submitted on One 45

July 31, 2015

X

OB Task Card Completed and Submitted to Gaye Colvin

Day of SHELF exam

 

Clinical Log (all OB/GYN items as outlined in orientation packet) completed and submitted on Longitudinal computer log

Monday after SHELF Exam

X

Passed Complementary and Alternative Medicine Quiz (https://sakai.unc.edu/samigo-app/servlet/Login?id=9c3df002-0b4b-4bf9-be74-3bd03852653b1403705515127)

Monday after SHELF EXAM

X

Submitted Clerkship Clinical Performance Evaluation-Self Assessment form for Mid Rotation Feedback (please comment on status of clinical log and task card)

Before mid rotation review with preceptor

X

Select evaluators for first L&D inpatient week

Wednesday following completion of L&D week

X

Select evaluators for GYN/ONC inpatient week

Wednesday following completion of GYN/ONC week

X

Select evaluators for L&D inpatient week #2

Wednesday following completion of L&D #2 week

X

Select attending who was present for oral presentation (given during L&D week #2)

Wednesday following completion of  L&D  #2 week

X

Any borrowed textbooks or resources

Last day of rotation