Australian medical students have fewer opportunities to do physical examination of peers of the opposite gender.

Silas Taylor,Boaz Shulruf

doi:10.3352/jeehp.2016.13.42

Silas Taylor, Boaz Shulruf

Open Access

https://doi.org/10.3352/jeehp.2016.13.42

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Abstract

PurposePeer physical examination (PPE), by which junior medical students learn physical examination skills before practicing on patients, is a widely implemented and accepted part of medical curricula. However, the ethical implications of PPE have been debated, since issues including student gender impact on its acceptability. Research has previously demonstrated the phenomenon of ‘attitude-behavior inconsistency’ showing that students’ predictions about their participation in PPE differ from what they actually do in practice. This study asks whether gender and student self-ratings of outlook affect engagement in PPE.MethodsThis study gathered data from students who had completed PPE with the objective of determining what factors have the greatest impact on the actual practice of PPE by students. Data were used to derive the number of opportunities students had to examine a peer, for various body parts. Respondent gender and self-ratings of outlook were recorded.ResultsResponses from 130 students were analysed: 74 female (57%) and 56 male (43%). Students have fewer opportunities to examine peers of the opposite gender; this is statistically significant for all body parts when male students examine female peers.ConclusionGender is the factor of overriding importance on whether these peer interactions actually occur, such that students have fewer opportunities to examine peers of the opposite gender, particularly male students examining female peers. Student outlook has little impact. We speculate that the more acceptable PPE is to participants, paradoxically, the more complicated these interactions become, possibly with implications for future practice.

Highlights

Peer physical examination (PPE) is a learning activity whereby medical students examine each other to learn physical examination skills [1] and PPE is a common part of medical curricula [2,3] and other health science programs [4]. This has occurred as large student cohorts have created pressure on health systems, and patients in hospital are less willing or able to assist junior medical students in practicing examination skills [5]
It is an activity which may challenge student beliefs and two broad factors documented in the literature which impact on student engagement with PPE are gender and what we describe here as student outlook [2,3,6,8]
Whilst the overall acceptability of non-intimate PPE is high, often above 90% [9,10], gender has a strong effect on acceptability of PPE, with male medical students being more comfortable with PPE than their female counterparts [2]

Summary

Introduction

Peer physical examination (PPE) is a learning activity whereby medical students examine each other to learn physical examination skills [1] and PPE is a common part of medical curricula [2,3] and other health science programs [4]. It seems reasonable to question whether overall student outlook and actual student action during specific examinations may be at variance In this regard, fewer students (of either gender) performed PPE despite claiming to be willing to do so for all body regions, on both genders, whether examining or being examined by a peer: authors termed this phenomenon ‘attitude-behaviour inconsistency’ [2]. Fewer students (of either gender) performed PPE despite claiming to be willing to do so for all body regions, on both genders, whether examining or being examined by a peer: authors termed this phenomenon ‘attitude-behaviour inconsistency’ [2] In light of this data, this study focuses on what impacts on the actual practice of PPE by students. We ask whether gender affects engagement in PPE? And second, do student self-ratings of outlook affect engagement in PPE?

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Discussion