A Qualitive Study of the Impact and Acceptability of Gynaecological Teaching Associates

Aisha Janjua,Lucy Burgess,T Justin Clark

doi:10.15694/mep.2016.000128

Abstract

This article was migrated. The article was marked as recommended. ObjectivesDeclining clinical exposure in female pelvic examination, increasing student numbers and the intimate nature of the examination poses challenges for medical student training. This study explores the experience and acceptability of all stakeholders involved in a novel method of pelvic examination teaching with the use of expert patients called 'Gynaecological Teaching Associates' (GTAs). An additional aim was to ascertain the motivation of lay women to become GTAs.MethodsA qualitative study was conducted with participants including medical students, teaching and non-teaching faculty members and GTAs. Data was collected through semi-structured interviews, a group interview with a supplemental interview, and non-participant observation (NPO). Twenty students, eight faculty staff, and four GTAs were interviewed, and NPO was accomplished during teaching sessions.AnalysisSequential thematic analysis was conducted on all transcripts. Data from both field notes and interview transcripts was triangulated to establish the validity of findings.ResultsMedical students found GTA teaching acceptable and reported an increased confidence in undertaking female pelvic examinations. They reported a lack of opportunities for male medical students to obtain exposure to, and experience of, gynaecological examination prior to the introduction of the GTA teaching. Other themes included overcoming the intimate nature of the examination, comparing manikin to GTA teaching, and the positive impact on clinical practice. Potential drawbacks included the perception of this "abnormal" teaching method amongst the general public. Lay women volunteered due to the rewarding nature of teaching and the benefit provided to the students.ConclusionGTA teaching has been described as a positive experience by all stakeholders. Acceptability has been established with positive outcomes noted for students. GTA motivation was noted to be altruistic. There are some concerns documented, especially the ability to recruit and monitor an effective GTA teaching programme, as well as to ensure the safety of the GTAs themselves.

Highlights

Medical students require proficiency in female pelvic examination to pass both their Obstetrics and Gynaecology (O&G) placements and graduate medical school
This study explores the experience and acceptability of all stakeholders involved in a novel method of pelvic examination teaching with the use of expert patients called ‘Gynaecological Teaching Associates’ (GTAs)
Medical students found Gynaecology Teaching Associates (GTAs) teaching acceptable and reported an increased confidence in undertaking female pelvic examinations. They reported a lack of opportunities for male medical students to obtain exposure to, and experience of, gynaecological examination prior to the introduction of the GTA teaching

Summary

Introduction

Medical students require proficiency in female pelvic examination to pass both their Obstetrics and Gynaecology (O&G) placements and graduate medical school. Iyengar et al (2012) have stated that some students complete their training without the opportunity to perform a female pelvic examination on a patient who is awake. Male students report feeling that their gender negatively impacted their undergraduate pelvic examination experience, with a greater degree of embarrassment or higher rate of patient refusal (Akkad et al, 2008; Chang et al, 2010). Gynaecology Teaching Associates (GTAs) are women trained to teach pelvic examination skills. The undergraduate teaching faculty at the Birmingham Women’s Hospital (BWH) recruited and trained a GTA faculty to provide independent teaching of clinical gynaecological examination to include instruction in technical aspects, psychological aspects and communication skills. GTA teaching has been incorporated into the O&G block at BWH for the past four years

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