Improving student learning of pelvic examinations through the Clinical Teaching Associate tutorial

Abstract

Background: Medical training usually provides limited opportunities to learn to perform pelvic examination, and students frequently cite a lack of confidence in performing this examination. Learning the technical and communication skills involved in performing a pelvic examination is complex; therefore, there is a need to explore the impact of specialised approaches to teaching pelvic examination during medical training. In this study, we examined the immediate and long-term impact of a professional patient tutorial in teaching medical students to perform pelvic examination. Method: Students ( n = 215) learned pelvic examination by watching an interactive CD, practising on a manikin and participating in the Clinical Teaching Associate (CTA) tutorial. Students completed questionnaires before and after the tutorial and at the end of the course. These questionnaires assessed experience with and attitudes towards performing pelvic examination and self-rated technical and communication skills. Results: After the tutorial, students were more confident, less anxious and embarrassed, and less worried about hurting the patient during a pelvic examination (all p < 0.001). Students rated their communication and technical skills higher at the end of the CTA tutorial. From the end of the CTA tutorial to the end of the course, communication skills ratings remained stable, but student ratings of technical skill decreased. Conclusion: The CTA tutorial provides individualised instruction and feedback in pelvic examination to medical students, with immediate and long-term benefits to students’ self-reported skills. Medical students have limited opportunities for learning pelvic examination in clinical contexts. Demonstrating that alternative training methods have long-lasting benefits on students’ capacity to competently perform these examinations is important.