Abstract
ObjectivesWe aimed to explore learning experiences among medical students learning to perform pelvic examinations and to identify factors that facilitate their training. MethodsA mixed-methods study including a web-based survey and focus group discussions (FGDs) was conducted among medical students who had completed their obstetrics and gynaecology (ObGyn) clerkship. The FGDs were recorded, transcribed and analysed using qualitative content analysis with systematic text condensation. Survey factors were compared using the χ2 test or Fisher's exact test. Results160 students (97 female, 61 male, two other) at six universities in Sweden responded to the survey. Two mixed FGDs were conducted. The majority (87%) of the students experienced confidence in performing pelvic examinations, stating that sufficient, repeated training opportunities and support from a clinical tutor were crucial components of the learning experience. Prior to the ObGyn clerkship, negative expectations were more common among male students. The male participants experienced having a disadvantage because of their gender, while female students considered their gender an advantage (p<0.001, N=121, Fisher's Exact Test). The clinical tutor and the use of professional patients (PPs) had a fundamental role in providing learning opportunities by including the student in patient care activities. ConclusionsThe importance of the clinical tutor, as well as the use of PPs, are important factors when planning education in pelvic examinations, and this knowledge could be used when educating other intimate examinations during medical school. In addition, similar investigations on students' experience in training other intimate examinations could be considered.
Highlights
The obstetrics and gynaecology (ObGyn) clerkship has been targeted as critical in terms of recruiting future residents to the speciality.1,4-6Research has shown that male students experience their gender as a barrier in ObGyn training and that this may increase the number of male students who choose not to pursue careers within the field.[6,7]
Missing the opportunity to discuss a case without the patient being present Professional patients: real people in a comfortable setting The introduction: being introduced as a future colleague Being recognised makes a difference
The clinical tutor had a fundamental role in providing learning opportunities by including the student in patient care activities
Summary
Some clinical specialities are more male- or female-dominant than others. In 2018, in the USA, 83% of the residents in obstetrics and gynaecology (ObGyn) were female.[1]. Considering that physicians may choose their speciality based on their medical school experience, the importance of the student clerkship cannot be stressed enough. The feeling of having a disadvantage because of one's male gender may be due to being denied consent to participate in clinical care to a greater degree than female students. Gender bias among faculty members is another identified reason.[4-6] Taken together, these factors may result in male students receiving less training in performing ObGyn examinations and clinical evaluations. All physicians should be confident in when to refer a patient and how to interpret patients' health issues, and be able to understand a Danielsson et al Students learning to perform pelvic examinations written statement by a specialist in ObGyn. it is important that all medical students gain adequate clinical experience and competence in women's health
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