Family Medicine Clerkship

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Menopause

OVERVIEW

Women in midlife frequently see their family physician to discuss menopausal changes in their health. These encounters provide an opportunity for the provider to discuss lifestyle and promote preventive health measures to ensure the continued health of women.

TOPIC LEARNING GOALS AND OBJECTIVES

(Organized by ACGME Competencies)

Patient Care

GOAL: Students will accurately assess signs and symptoms of menopause.

OBJECTIVES: Students will be able to:

• Perform appropriate history to diagnose menopause.

GOAL: Students will appropriately discuss menopause with patients.

OBJECTIVES: Students will be able to:

• Provide education related to normal changes of menopause to patient.
• Discuss management of symptoms of menopause with patient.

GOAL: Students will be sensitive to individual and cultural differences in their development of treatment plans.

OBJECTIVES: Students will be able to:

• Discuss with patients and families the importance of lifestyle changes in the management of menopause.
• Develop a treatment plan in the context of each patient's life and environment.

Medical Knowledge

GOAL: Students will understand the impact of menopause on the health and well-being of women.

OBJECTIVES: Students will be able to:

• Describe the most common symptoms of menopause.
• Describe risks and benefits of hormone replacement therapy for common symptoms of menopause.

GOAL: Students will understand strategies to prevent and treat osteoporosis.

OBJECTIVES: Students will be able to:

• Discuss the methods to prevent and treat osteoporosis.
• Discuss the evidence for the role of lifestyle changes: (exercise, quitting smoking, calcium intake).
• Discuss the side effects and costs of commonly used medications.

Practice-Based Learning and Improvement

GOAL: Students will understand the role of screening for osteoporosis in practice and community settings.

OBJECTIVES: Students will be able to:

• Describe how osteoporosis is monitored in the assigned clerkship site.
• Consider the impact of environment and neighborhood on prevention and treatment of osteoporosis.

GOAL: Students will understand the role of practice-based improvement.

OBJECTIVES: Students will be able to:

• Recognize the importance of practice analysis for a population with osteoporosis.

GOAL: Students will bring up-to-date evidence to the point of clinical care.

OBJECTIVES: Students will be able to:

• Identify gaps in their own knowledge and frame appropriate clinical questions in regard to hormone replacement therapy for the treatment of symptoms of menopause.
• Use the best evidence to answer clinical questions about osteoporosis and hormone replacement therapy.

Interpersonal and Communication Skills

GOAL: Students will understand the importance of effective communication with patients and families in the management of menopausal changes.

OBJECTIVES: Students will be able to:

• Discuss with a menopausal patient the relevant health promotion strategies.
• Use effective listening skills and empathy to improve patient adherence to lifestyle modifications such as diet, exercise, and medications.

Professionalism

GOAL: Students will demonstrate the ability to care for patients with symptoms of menopause from diverse patient backgrounds and at different points in their menopausal changes.

OBJECTIVES: Students will be able to:

• Demonstrate understanding of the relationship of menopause to culture, age, and disabilities.

Systems-Based Practice

GOAL: Students will understand the impact of health care systems and environment on the management of menopause.

OBJECTIVES: Students will be able to:

• Describe cost-effective strategies for identification of osteoporosis risk.
• Analyze barriers to effective integrated treatment of menopause and osteoporosis.
• Consider the role of other disciplines (e.g., pharmacy, nursing, social work, and allied health) in the treatment of menopause.

EDUCATIONAL METHODS AND RESOURCES

Learning Units

• Menopause Core Curriculum Study Guide, North American Menopause Society:
  http://www.menopause.org/edumaterials/
  
• West Suburban College of Nursing Menopause Curriculum:
  http://www.wshmc.org/wshcresidency/optopics/menopause.htm

Published Material

• Anderson GL, Judd HL, Kaunitz AM, Barad DH, Beresford SAA, Pettinger M, Jiu J, McNeeley SG, Lopez AM. Effects of estrogen plus progestin on gynecologic cancers and associated diagnostic procedures: The Women's Health Initiative randomized trial. JAMA. 2003; 290:1739-1748.
  Abstract at PubMed

Web Sites

• NIH Women's Health Initiative:
  http://www.nhlbi.nih.gov/whi/index.html
  
• NIH Facts about Hormonal Treatment of Menopause:
  http://www.nhlbi.nih.gov/health/women/pht_facts.htm

Other

• Patient Education Unit for Latinos- El Paso Collective Health Literacy Project:
  http://www.worlded.org/us/health/docs/elpaso/

ASSESSMENT STRATEGIES

Standardized Patient Cases

• Martinez Case- Perimenopausal Symptoms in a Spanish Speaking Woman- University of Colorado Department of Family Medicine, 2003. [menopause, use of interpreter in a medical encounter]

Lead Author: Ann O'Brien Gonzales, PhD
Clerkship/Post-Clerkship Workgroup members: Ann O'Brien-Gonzales, PhD (Chair), Alexander Chessman, MD (EC Liaison), Caryl Heaton, DO, Janice Nevin, MD, MPH, Lauren Oshman, MD, Deborah McPherson, MD, Mark. E Quirk, EdD, David Schneider, MD, MSPH, William B. Shore, MD, Richard Usatine, MD

Family Medicine Curriculum Resource (FMCR) Project HRSA Contract 240-00-0107.

For questions or comments, please contact Webmaster or Ardis Davis

This page last updated November 6, 2004