Table 1 Linking competencies at the abstract and contextualized levels with assessment and learning methods using obstructed labor as an example

Effective Communication

The learner explains different options for accelerating birth to the mother in a calm, clear manner.

Structured practice using simulated patients. Assigned reading on treatment options.

Standardized patient exercise

Basic Clinical Skills

Using physical examination techniques, the learner identifies the presence of a nuchal cord as the etiology behind obstructed labor.

Simulation/Mannequin practice. Physical exam textbook. Supervised clinical experiences.

Structured direct observation and feedback.

Standardized patient examination.

Using Science to Guide Diagnosis, Management, Therapeutics and Prevention

The learner identifies community-based resources to assist in the prenatal management of women at risk for obstructed labor.

Self-guided search. Assigned reading.

Written examination

Moral reasoning and ethical judgment

The learner explains the most important competing issues that weigh in the decision to perform life- saving maternal interventions that may place the fetus at risk in obstructed labor.

Small group discussion of case scenarios.

Oral examination

Programmed reading.

Problem solving

The learner appropriately identifies and refers high- risk cases of obstructed labor that require subspecialty management

Small group discussion with scripted patient management problems. Assigned problem set with feedback.

Chart audit

Professionalism and role recognition

The learner maintains confidentiality in the care of women with obstructed labor.

Lecture.

Supervisor evaluation

Self-directed review of confidentiality policy.