Learning Pelvic Examination with Professional Patients

B Wijma,K Siwe,K Swahnberg,S Shrestha

doi:10.31729/jnma.141

B Wijma, K Siwe + Show 2 more

Open Access

https://doi.org/10.31729/jnma.141

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Abstract

Performing pelvic examination is a vital skill to learn during gynecological and obstetrical training. It's a difficult maneuver to master as there is very little to see and more to feel and interpret. In addition, learning PE in usual clinical set-up has been found to induce lot of stress and anxiety among both the patients and the students. Students fear of hurting the patients and being judged inept, whereas patients feel embarrassed having to expose their most intimate body parts for learning purpose. This hampers effective learning. Learning PE on sedated women before surgery or on mannequins has been practiced as alternative learning models. But, they have been found to miss out on teaching the communication skills, which are as important as the palpation skills. However, there exists another model of learning PE--the professional patients, who are specially trained to act as patients and also guide the students on how to make a proper PE. They provide stress-free environment for the students to learn PE and at the same time, provide immediate feedback on each of their maneuvers. They form a complete learning model and help students to see patients as partner and not just a person seeking help.

Highlights

Clinical skills are the most valuable asset for a clinician to acquire
Siwe et al compared the skills acquired by two groups of medical students who were trained either with Professional patients (PP) or with clinical patients (CP) in gynecology clinics.[21]
Another study by Kleinman et al showed that PP trained students had better interpersonal skills than the physician-trained students, no difference was found in their technical skills.[22]

Summary

INTRODUCTION

Clinical skills are the most valuable asset for a clinician to acquire. Yet, that is a tricky goal to achieve in medical education. Most of such examinations are performed without the patients informed consent, which in itself is a highly unethical practice.[7,13,15] It silently gives an impression to the students that unethical procedures may be allowed if done undercover. Provide immediate feedback as to what organs the examiner has palpated.[16] But similar to sedated women, these devices are handicapped; as they cant teach students how to approach the patient in such a way that she will feel comfortable and be able to follow instructions like relax her muscles enough to allow the palpation maneuvers. The students start their four weeks of gynecological clinical clerkship, where they try to perform as many PEs as they can, under the supervision of a gynecologist

DISCUSSION

CONCLUSIONS