Semester 9 IMU Family Medicine Posting

Dated from: 27.2.18

Title: Unwanted pregnancies, Emergency Contraception, STI and Abortion

Prerequisites
Students are to revise their learning on menstrual cycle, pregnancy and STI from Phase 1;
contraception from Phase 1 and Semester 8 in Phase 2 and to read up (from Phase 1) and update on
abortion laws and age of consent in Malaysia

Learning Outcomes:

By the end of this 2‐hour session, you should be able to:

i. Manage emergency contraception using current best evidence (15 mins) Discussion 15 mins
ii. Discuss on the medico-legal, ethical, social and community issues of unwanted pregnancies
rape, abortion and patient safety (15 mins) Discussion 15 mins
iii. Role Play: Emergency contraception (EC), “rape” based on the short scenario below and
perform in a role play (not more than 15 minutes) Discussion 15 mins
iv. Discuss and manage common STI

Learning Activities
Presentation and Role Play

1. ALL students have to read up on the references provided below (before the lesson)
2. Divide into 4 groups to deal with the four outcomes
3. Each group have to search for further reference materials relevant to their tasks (before the
lesson). Search the Penal Code for the latest on rape and abortion
4. The first two groups have to prepare, submit and deliver a short, concise PowerPoint presentation
(10 minutes with 15 minutes each for discussion by the whole class
5. The 3rd group has to write a complete role play (10 minutes) based on the storyline below for
Learning Outcome (iii)
6. The 4th group has to write a complete role play (10 minutes) for Learning Outcome (iv). Write up a
role play for managing a patient with an STI-(gonorrhoea or syphilis or genital warts). Include a
practical procedure on how to teach patients how to use a condom. (The latest guideline for STI
management from Malaysia is provided.)
7. Group leader is to collate and submit to me all the data from the 4 groups

Learning outcome iii: Storyline:

May is a 17-year-old student who had unprotected sexual intercourse with her a man she met on
WeChat three months ago. You are her family doctor. She comes to see you today as she does not
want to become pregnant.

Instructions for role play script:

Expand on the storyline above. Write the notes and script for the simulated patient. Identify and
train the ‘patient’ from your group. The ‘doctor’ will be randomly selected from students in the first
2 groups.
INSTRUCTIONS TO CANDIDATE: (for first role play)

1. Address May’s request for emergency contraception.

2. Provide appropriate advice and management.

An assessment will be carried out later to evaluate whether learning has taken place

References:

Must read:
1. Malaysian guidelines in the treatment of sexually transmitted infections. 4th ed. 2015,
Ministry of Health of Malaysia and Dermatological Society of Malaysia.
2. Raymond EG, Cleland K. Emergency contraception. N Engl J Med. 2015;372:1342-8.
3. Faculty of Sexual & Reproductive Healthcare March 2017 (FSRH) Guideline: Emergency
Contraception.

Other references:

1. Jessica Shaw. Abortion in Canada as a Social Justice Issue in Contemporary Canada.

Critical Social Work 2013; 14(2): . Abortion in Canada as a Social Justice Issue in
Contemporary Canada (accessed 10 September 2015).
2. Lachlan J de Crespigny, Dominic J Wilkinson, Thomas Douglas, Mark Textor, Julian
Savulescu. Australian attitudes to early and late abortion. The Medical Journal of
Australia 2010; 193(1): . https://www.mja.com.au/journal/2010/193/1/australian-
attitudes-early-and-late-abortion (accessed 10 September 2015).
3. Wu S, Godfrey EM, Wojdyla D et al. Copper T380A intrauterine device for emergency
contraception: a prospective, multicentre, cohort clinical trial. British Journal of
Obstetrics and Gynaecology 2010; 117: 1205–1210.

Prepared by
Professor Dr Kwa Siew Kim
Dated on 27 Feb 2018