Communication Skills Of Medical Students Research Articles

Simulated Paging Curriculum to Assess and Improve Communication Skills

PURPOSE: To examine the impact of a simulated paging curriculum for senior medical students on physician-nurse communication skills. BACKGROUND: New residents are expected to triage and address a high volume of clinical pages yet medical students receive little training in this important skill. Previous studies have evaluated the impact of simulated paging curricula on clinical decision making and student confidence but have not examined the effect on communication skills. METHODS: Two trained Registered Nurses (RNs) administered specialty-specific pages to 76 fourth-year medical students enrolled in 4-week residency preparation electives. For each case, RNs evaluated students’ performances on seven communication domains using previously validated 5-point semantic-differentiation scales (1=worst, 5=best) in precision, instruction, assertiveness, direction, organization, engagement, and ability to solicit information. Immediate feedback was provided to the students. RESULTS: A total of 351 pages were administered: 144 in week 1, 73 (week 2), 97 (week 3), and 37 (week 4). Students from all specialties improved communication scores throughout the four weeks. Mean communication scores increased from 4.02 to 4.26 from week 1 to week 2 (<0.0001). Improvement was most pronounced for the students going into internal medicine (3.82 to 4.25) and pediatrics (3.95 to 4.38) and less pronounced for the procedural specialties of surgery (4.26 to 4.22) and ob/gyn (4.07 to 4.18). Communication skills continued to improve in weeks 3 and 4 but with inadequate number of pages to power this comparison. DISCUSSION: Our data demonstrates that a simulated paging curriculum is a promising platform for teaching and improving physician-nurse communication skills for senior medical students.

Assessing the empathy of medical students during medical interview training in Japan by using mixed-methods surveys of simulated patients.

This article was migrated. The article was marked as recommended. Background: Medical interviews are performed during objective structured clinical examinations, to assess the communication skills of medical students. In particular, medical students are assessed regarding whether they demonstrate empathy during these staged interviews. However, no studies to date have analyzed the validity of the methods to evaluate empathy during objective structured clinical examinations. Aim: Here we sought to identify factors affecting whether simulated (standardized) patients (SPs) felt that the medical students had treated them empathetically during medical interview training. Methods: The training involved the participation of SPs during the bedside learning of fifth-year medical students in Japan. After the students completed medical interview training, we conducted a questionnaire-based survey. We developed the list of questionnaire items through semi-structured interviews asking SPs to describe when the student had been empathetic. Results: The item "I felt that the student was empathic throughout the interview" was significantly correlated with "I was given enough time to talk at the beginning of the interview," "The student made good eye contact," "The student's attitude was appropriate," "I was able to say enough of what I wanted to talk about," and "The student used phrases that expressed empathy." Multiple regression analysis revealed that "The student used phrases that expressed empathy" was the only independent predictor of "I felt that the student was empathic throughout the interview." Conclusions: The factor that correlated most strongly with the SP feeling that the student was empathic during a medical interview was "The student used phrases that expressed empathy." However, correlations also occurred with open-ended questions and the student's level of attention at the beginning of the interview and with the student's attitude. Together, these findings indicate that several types of both verbal and nonverbal communication determined whether SPs felt that medical students showed empathy during staged medical interviews.

Can a Multi-modal Communication Program Enhance Empathy and Doctor-Patient Social Interactions?; Results of a Pilot Training Study of Russian Medical Students

Communication is a vital element of basic professional competency within medicine. However, some medical schools may not typically offer structured developmental skills training to medical students. A multi-modal doctor communications enhancement-training program was therefore organized at a medical university in Russia. A total of 83 students ages 18-19 participated. Pre-course communication ability levels were measured at 21.7% low, 69.8% medium, and 7% high level. Post course outcome measurements demonstrated 1.2% low, 51.8% medium, and 47% high communication levels.&#x0D; Outcome: It was concluded in this pilot study that a formalized multi-modal communications development program in conjunction with performance feedback, could significantly enhance essential patient communication skills in Russian medical students.

Comparison of Medical Student Communication Skills Measured by Standardized Patients During an OSCE and by Faculty During an In-Hospital Encounter.

At our institution, learner communication skills during an objective structured clinical examination (OSCE) are measured by standardized patients (SPs) using the New Mexico Clinical Communication Scale (NM-CCS). Faculty physicians also conduct a direct observation of a clinical encounter (DOCE) to observe students' interactions with real hospitalized patients. The objective of this study was to determine whether students have similar communication skills scores with real patients as compared with SPs. The NM-CCS was modified to fit a hospital encounter (mNM-CCS). Student NM-CCS scores for an OSCE were compared with their matched mNM-CCS scores obtained during their DOCE. Matched scores were compared for 83 students. The mean total percentage scores on the DOCE and OSCE were both 60%. There was no correlation between individual student communication scores. The difference between mean total scores mNM-CCS scores for the faculty preceptors was not statistically significant (P = 0.1985). We found no correlation between student communication scores measured by faculty during the DOCE compared with communication skills measured by SPs during an OSCE. The discordant results of some students on the OSCE compared with the DOCE suggests that the OSCE may not identify students who may benefit from additional communication skills training.

The formation of speech competence in medical students in classes of “The Ukrainian Language (for Specific Purposes)”

In the article, we investigate the formation of speech competence in medical students in classes of the Ukrainian Language for Specific Purposes. We have substantiated the appropriateness of complex formation of linguistic and speech competence in the students of medical educational institutions. We have emphasized that the professional communication of future medical workers should be formed as a result of thorough training aimed at professional expertise. The professional activity can be exercised only by persons with a high professional level of culture, intercultural communication and ability to improve professionally. In the article, we have stressed the importance of formation of the professional communicative competence in future workers of the health industry. There have been defined the characteristic features of the communicative culture of the medical employee. We have elaborated on the methodology of the formation of communicative competence in future medical workers. We have proved that successful formation of professional communication skills in medical students depends on active enrichment of their vocabulary with terminology based on profession-oriented texts and dictionaries, work on stable skills of communicative self-control and self-analysis, the formation of critical thinking, desire to work independently, compliance with the rules of linguistic courtesy. Communicative competence of students is effectively formed with the aid of the technology of critical thinking development as it gives a possibility to create ambiguous situations and consider one problem from the different viewpoints. We propose to use debates in class as a form of communicative strategy that facilitates the process of new topics acquisition, induces the students to search for new information and extends their knowledge, develops not only communicative, but also intellectual capacities of medical students, and educates morally conscientious professionals.

Critical Thinking and Scientific Writing Skills of Non-Anglophone Medical Students: a Model of Training Course.

There are currently very limited reports on the strengths and weaknesses of Japanese medical students in processing (i.e., searching, reading, synthesizing, writing, editing, refining) and presenting medical content based on scholarly journal articles. We developed and offered a 3-week group independent research course in English as a summer elective named “Improving Medical English Skills and Creating English Medical Content (PPT and video) Based on Medical Journal Articles” to our fourth-year Japanese medical students who follow a 6-year medical curriculum as the target audience. Herein, we describe the specific strengths and weaknesses of 6 students who chose and completed the course. Thereafter, we assessed the possible reasons underlying these weaknesses, pondered on the potential implications of such weaknesses on the critical thinking, logical reasoning, and communication skills of Japanese medical students, and suggested approaches to further enhance these skills. The assessments, implications, and suggestions given may provide medical educators new insights on how to newly organize educational and clinical programs to address such weaknesses, improve searching, reading, writing, editing, and presentation skills, enhance critical thinking and logical reasoning abilities, and gain in-depth knowledge essential for effectively appraising and communicating medical content.

Public forum by undergraduate medical students during clinical postings: A way to improve the communication skill

Introduction: Excellent communication skills are essential to the practice of medicine as good doctor–patient communication is necessary to elicit information from the patient to arrive at an accurate diagnosis. Aim: The aim of this study was to assess the improvement in the communication skills of undergraduate medical students using public forum as a tool. Methodology: A total of 80 students of 5th-semester MBBS were invited to participate in public forum on the topic of “contraception.” Their communication skills were assessed using the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) assessment of communication skills tool. Each student performed four public forums over 2 months, one every fortnight. Each student delivered 15 min talk once in 2 weeks in front of a group of patients regarding the different contraceptive methods. The assessment of communication skill was done twice, i.e., they were assessed at the first and after the fourth public forum. Paired t-test was applied to assess the improvement in communication skill. Results: The mean score on RANZCOG assessment at the first public forum was 11.92 ± 3.89 and after the fourth public forum was 19.75 ± 6.13 (P

Differences in expectations of passing standards in communication skills for pre-clinical and clinical medical students

ObjectiveCommunication and interpersonal skills (CIS) are essential elements of competency-based education. We examined defensible CIS passing levels for medical students completing basic sciences (second-year students) and clinical training (fourth-year students), using five standard setting methods. MethodsA 14-item CIS scale was used. Data from second-year (n = 190) and fourth-year (n = 170) students were analyzed using descriptive statistics and generalizability studies. Fifteen judges defined borderline CIS performance. Cut scores and fail rates from five standard setting methods (Angoff, Borderline-Group, Borderline-Regression, Contrasting-Groups, and Normative methods) were examined. ResultsCIS performance was similar during second-year (Mean = 74%, SD = 6%) and fourth-year (Mean = 72%, SD = 5%) students. Judges using the Angoff method expected greater competence at the fourth-year level, as reflected in the Angoff cut scores (second-year = 53% with 0% fail, fourth-year = 66% with 10% fail). Cut scores from the remaining methods did not differentiate between training levels. We found evidence of case specificity. ConclusionPerformance on CIS may be case specific. Passing standards for communication skills may require employing approaches such as the Angoff method that are sensitive to expectations of learner performance for different levels of training, competencies, and milestone levels. Practice implicationsInstitutions that want to encourage continued growth in CIS should apply appropriate standard setting methods.

Motivational interviewing training for medical students: A pilot pre-post feasibility study

ObjectiveTo evaluate the impact of brief training in motivational interviewing (MI) from a non-specialist professional for medical students. MethodsStudents (n = 20) received three four-hour sessions of MI training over one week. They interviewed caregivers acting as patients in two standardised medical situations, six weeks before and three weeks after training. Global scores from the MITI-3.1.1 code, including “MI- Spirit”, were attributed to the audiotaped interviews by two independent coders, blind the pre- or post-training status of the interview. Secondary outcomes were: caregivers’ perception of students’ empathy (CARE questionnaire), students’ evaluation of self-efficacy to engage in a patient-centred relationship (SEPCQ score), and students’ satisfaction with their own performance (analogue scale). ResultsMI-Spirit score increased significantly after training (p < 0.0001, effect size 1.5). Limited improvements in CARE score (p = 0.034, effect size 0.5) and one of the SEPCQ dimensions (sharing information and power with the patient; p = 0.047, effect size 0.5) were also noted. Students’ satisfaction score was unaffected (p = 0.69). ConclusionThese findings suggest that brief MI training can improve communication skills in medical students. Practice implicationsSuch an intervention is feasible and could be generalised during medical studies.

Effect of In-Class vs Online Education on Sexual Health Communication Skills in First-Year Medical Students: a Pilot Study.

Online education is effective for knowledge acquisition, but its effect on clinical skill development is not well characterized. We aimed to compare communication skills of 50 first-year medical students who learned to assess and treat patients through an online learning module vs an in-class lecture. Twenty-six students were randomized to learn about antidepressant-induced sexual dysfunction in class and 24 learned the same content through an online module. Students were individually observed conducting an interview with a standardized patient with antidepressant-induced sexual dysfunction. Students were assessed by faculty raters blinded to the student's learning mode. Standardized patients were asked about their willingness to have the student as their physician. More students who learned in class vs online demonstrated appropriate verbal empathy (18 [69%] vs 8 [33%]; P = 0.01), defined as completing each task in the "verbal empathy" assessment domain, as measured by a faculty rater. Other assessed variables were not significantly different. Standardized patients' willingness (vs unwillingness; P = 0.01) to have the student as their physician was associated with the demonstration (by faculty appraisal) of a number of basic skills: using open-ended questions, asking one question at a time, using gender-neutral terminology when asking about the patient's relationship, and using appropriate sexual-health terminology. This study, although limited by a single-site design and the small number of participants, offers preliminary evidence that, if confirmed, may suggest that in-class learning from a psychiatrist (vs from an online module) is associated with greater verbal empathy in the assessment of SSRI-related sexual dysfunction.

The effect of multitasking on the communication skill and clinical skills of medical students

BackgroundMental workload is an abstract concept that perceives cognition as the brain having a small and finite capacity to process information, with high levels of workload associated with poor performance and error. While an individual may be able to complete two different tasks individually, a combination of tasks may lead to cognitive overload and poor performance. In many high-risk industries, it is common to measure mental workload and then to redesign tasks until cognitive overload is avoided. This study aimed to measure the effect of multitasking on the mental workload and performance of medical students completing single and combined clinical tasks.MethodsMedical students who had completed basic clinical skills training in a single undergraduate Medical School completed four standardised tasks for a total of four minutes each, consisting of: inactivity, listening, venepuncture and a combination of listening and venepuncture. Task performance was measured using standard binary checklists and with mental workload measured using a secondary task method.ResultsThe tasks were successfully completed by 40 subjects and as expected, mental workload increased with task complexity. Combining the two tasks showed no difference in the associated mental workload and performance at venepuncture (p = 0.082) However, during the combined task, listening appeared to deteriorate (p < 0.001).ConclusionsIf staff are expected to simultaneously complete multiple tasks then they may preferentially shed communication tasks in order to maintain their performance of physical tasks, leading to the appearance of poor communication skills. Although this is a small-scale study in medical students it suggests that the active assessment and management of clinician workload in busy clinical settings may be an effective strategy to improve doctor-patient communication.

Interpersonal Skills Among Fourth- and Fifth-Year Medical Students

The aim of this study was to validate a French version of the standardized patient satisfaction questionnaire (SPSQ), an interpersonal skills assessment form, originally published in English, destined to be completed by SPs and used as a validated tool for the evaluation of communication skills of French medical students, during ambulatory care consultations. During the academic year, fourth- and fifth-year medical students participated in mock ambulatory care consultations. The French SPSQ was completed by 16 SPs who performed scenarios written by professors of medicine. Validity evidence for test content, response process, internal structure, and relation to other variables was determined by calculating the Cronbach α coefficient, the Loevinger H index (response coherence), intraclass coefficients, the differences between fourth- and fifth-year students and by using item correlations as well as the correlation with an independent validated assessment form. G theory was used to identify the sources of variations in the mean of SPSQ. Four hundred thirty-three students were evaluated for a period of 2 months and participated in a total of 1703 mock consultations. The Cronbach α coefficient (0.94) was superior to that of the English SPSQ. The Loevinger H index was good ranging from 0.65 to 0.70. The reproducibility among external observers (intraclass correlation coefficient = 0.67) and between external observers and the SPs (intraclass correlation coefficient = 0.79 and 0.78, respectively) was satisfactory. Results of the French SPSQ were positively and significantly correlated to the scores obtained via an independent, validated, questionnaire (R = 0.72) and showed a significant difference between fourth- and fifth-year students' scores (P < 0.0001). G coefficients were estimated at 0.64 and 0.52 for year 4 and year 5, respectively. Validity evidence supports the use of French-version SPSQ scores to screen for students experiencing difficulty with communication.

Evaluation of clinical communication skills in medical students with simulated patients

Background: Communication skills are not learnt innately. It is therefore necessary to both train and evaluate medical students in this area. Aim: To evaluate communication skills of fourth-year medical students with the use of a simulated patient (SP). Material and Methods: Four clinical scenarios (CS) for clinical interviews with simulated patients were designed: chronic and acute diseases, difficult and functional patients. Each student performed the four CS, and his communication skills were evaluated using our own questionnaire as agreed with the SP. The questionnaire included items on verbal and nonverbal communication, warmth, respect, specificity, assertiveness and empathy (rated from 0 to 10). The response variable was the arithmetic mean of the scores on each item. All students received a detailed evaluation report. Results: Sixty one students (32 men) performing 244 interviews, were evaluated. The overall mean score was 7.87 (4.62 to 9.03). The highest scores were for respect and specificity (7.57 and 7.15 respectively). The lowest were for empathy and nonverbal communication (6.44 and 6.84 respectively). The CS evaluations were 7.87 (chronic disease), 7.02 (difficult patient), 6.46 (acute disease) and 6.14 (functional pathology). Women had higher overall scores compared to men (7.26 and 6.51 respectively; p <0.01) and a significantly higher score in all communication variables (p <0.01). Conclusions: The overall assessment in clinical communication with SP is satisfactory although there is room for improvement, especially in empathy and nonverbal communication. Women had significantly higher scores than men.

Hybrid simulation training: An effective teaching and learning modality for intrauterine contraceptive device insertion.

Hybrid simulation training (HST) is a teaching modality that combines patient interaction using simulated patient (SP) with pelvic model. This provides realism to learners, lacking in manikins alone. This study was designed to compare knowledge, procedural, and communication skills of medical students regarding intrauterine contraceptive device (IUCD) insertion before and after introducing HST and to assess learner satisfaction with this methodology. This quasi-experimental mixed-method study was conducted at Aga Khan University Hospital, Karachi, from October 2016 to September 2017, for third-year medical students (n = 90). IUCD insertion was introduced to students through interactive session and provision of literature/video clip on IUCD insertion. Students were pretested on objectively structured clinical examination -station (IUCD insertion) using SP and manikin simultaneously. This was followed by practice on manikin and subsequent posttest on same OSCE-station. Learner evaluation of activity was through validated pro forma with both, Likert scale and open-ended questions. Out of the 90 students, 73 completed pre/posttest and evaluation survey. There was significant increase in pre- and post-simulation mean scores for all clinical skills; history taking (5.1 pretest, 8.8 posttest, P ≤ 0.0005), counseling (40.11 pretest, 57.85 posttest, P ≤ 0.0005), procedural (15.16 pretest, 49.09 posttest, P ≤ 0.0005) and total scores (60 pretest, 115.6 posttest, P ≤ 0.0005), when compared using two-sided Wilcoxon signed rank sum test. Overall, activity was assessed as "very good" to "excellent" by 83.5% participants. Themes generated from open-ended questions of evaluation forms were "Process-descriptors," "Teaching-utility," "Pedagogic-efficacy" and "Way-forward." HST is an effective teaching strategy with potential to improve competency of medical students. Students acknowledged it, as innovative learning strategy that increased their satisfaction and confidence in performing IUCD insertion.

A novel approach to suicide prevention - Educating when it matters.

Background:Looking at the burden of suicide, there is a dire need for medical schools to incorporate suicide prevention training. Effective communication helps in early detection and management of suicidal behavior. Medical students can act as a GATEKEEPER if they receive adequate training.Methodology:This was an educational intervention study done at tertiary care teaching hospital to assess the knowledge and attitude of medical students toward depression and suicide and to impart and assess communication skills for suicide prevention in one of the four batches of students in 4th semester. Pretest was conducted to assess knowledge and attitude toward depression and suicide, followed by training using interactive lectures, demonstration of interview, and hands-on training with patients and role-plays. The posttest and objective structured clinical examination (OSCE) were administered for skill assessment. Feedback was taken regarding this intervention.Results:The mean marks of the pre- and post-test were 8.96 (8.3–9.6) and 14.58 (13.8–15.3), respectively, out of 25. The difference was statistically significant (t = 13.24, P ≤ 0.0001) which suggests improvement in knowledge. We found mixed responses in attitude statements showing limited change. Mean obtained marks on OSCE examination out of 66 was 42.7. Among various components of OSCE, students scored high on rapport building. The most useful components of trainings were role-play, OSCE, and interaction with patients as per their feedback.Conclusion:The intervention was found effective in increasing knowledge, changing attitude, and enhancing communication skills of medical students toward suicide prevention. Training of communication skills for suicide prevention in depressed person should be given to every medical student as suggested by feedback.

Electronic-clinical evaluation exercise (e-CEX): A new patient-centered EHR use tool

IntroductionElectronic Health Record (EHR) use can enhance or weaken patient-provider communication. Despite EHR adoption, no validated tool exists to assess EHR communication skills. We aimed to develop and validate such a tool. MethodsElectronic-Clinical Evaluation Exercise (e-CEX) is a 10-item-tool based on systematic literature review and pilot-testing. Second-year (MS2s) students participated in an EHR-use lecture and structured Clinical Examination (OSCE). Untrained third-year students (MS3s) participated in the same OSCE. OSCEs were scored with e-CEX compared to a standardized patient (SP) tool. Internal consistency, discriminant validity, and concurrent validity were analyzed. ResultsThree investigators used e-CEX to rate 70 videos (20 MS2, 50 MS3). Reliability testing indicated high internal consistency (Cronbach’s alpha=0.89). MS2s scored significantly higher than untrained MS3s on e-CEX [e-CEX 55(10.7) vs. 44.9 (12.7), P=0.003], providing evidence of discriminant validity. e-CEX and SP score correlation was high (Pearson correlation=0.74, P<0.001), providing concurrent validity evidence. Item reduction suggested a three-item tool had similar explanatory power (R-squared=0.85 vs 0.86). Conclusione-CEX is a reliable, valid tool to assess medical student patient-centered EHR communication skills. Practice implicationsWhile validation is needed with other healthcare providers, e-CEX may help improve provider behaviors and enhance patients’ overall experience of EHR use in their care.

Association of Communication Skills of Medical Students with their Quality of Life and Depressive Mood

Association of Communication Skills of Medical Students with their Quality of Life and Depressive Mood

Communication skills of medical students during the OSCE: Gender-specific differences in a longitudinal trend study

BackgroundCommunication skills are essential in a patient-centred health service and therefore in medical teaching. Although significant differences in communication behaviour of male and female students are known, gender differences in the performance of students are still under-reported. The aim of this study was to analyse gender differences in communication skills of medical students in the context of an OSCE exam (OSCE = Objective Structured Clinical Examination).MethodsIn a longitudinal trend study based on seven semester-cohorts, it was analysed if there are gender differences in medical students’ communication skills. The students (self-perception) and standardized patients (SP) (external perception) were asked to rate the communication skills using uniform questionnaires. Statistical analysis was performed by using frequency analyses and t-tests in SPSS 21.ResultsAcross all ratings in the self- and the external perception, there was a significant gender difference in favour of female students performing better in the dimensions of empathy, structure, verbal expression and non-verbal expression. The results of male students deteriorated across all dimensions in the external perception between 2011 and 2014.Discussion & conclusionIt is important to consider if gender-specific teaching should be developed, considering the reported differences between female and male students.

Characteristics and Gender Differences in the Medical Interview Skills of Japanese Medical Students.

Objective To examine the characteristics of the communication skills of medical students, we observed their performance during introductory medical interview training with simulated patients (SPs). Methods The subjects of the present study included fifth-year medical students (male, n=180, female, n=99) who were undergoing clinical training in Japan from 2012 to 2014. Each student was assigned to one of four 10-minute clinical scenarios, which was conducted with an SP. Three or four teachers observed and assessed the performance of each of the students. The overall performance was rated on a 10-point scale, and nine basic communication skills that were common to each of the scenarios were rated using a four-point scale. The students also assessed their own performance on these items. The SPs assessed the students' performance from a patient's perspective on four items. Results There were significant correlations between the teacher and student scores. However, the students tended to score themselves significantly lower than the teachers. The female students were rated significantly higher by the teachers on the following four items; ‘eye contact and appropriate attitude,’ ‘nodding and back-channeling,’ ‘giving empathic verbal responses,’ and ‘acquisition of patient's psychosocial information.’ However, the self-assessments of the female students were only significantly higher than the male students in one item, ‘acquisition of patient's psychosocial information.’ In contrast, self-assessments of the male students were significantly higher in two items; none of their items was scored higher by the teachers. There was no significant gender difference in the assessments made by the SPs. Conclusion There were significant gender differences in the communication skills of the medical students during introductory training, suggesting the possibility that there were gender-specific traits and gender-based differences in the students' degrees of readiness.

The effectiveness of gynaecology teaching associates in teaching pelvic examination to medical students: a randomised controlled trial

ObjectivesTo assess whether teaching female pelvic examinations using gynaecological teaching associates (GTAs); women who are trained to give instruction and feedback on gynaecological examination technique, improves the competence, confidence and communication skills of medical students compared to conventional teaching. Study designRandomised controlled trial. SettingTen University of Birmingham (UoB) affiliated teaching hospitals in the UK. Population492 final year medical students. MethodsGTA teaching of gynaecological examination compared with conventional pelvic manikin based teaching at the start of a five week clinical placement in obstetrics and gynaecology (O&G). Main outcome measuresStudent’s perception of their confidence was measured on a 10cm visual analogue scale (VAS). Domains of competence were measured by a senior clinical examiner using a standardised assessment tool which utilised 10cm VAS and by a GTA using a four point Likert scale. Assessors were blinded to the allocated teaching intervention. Results407/492 (83%) students completed both the intervention and outcome assessment. Self-reported confidence was higher in students taught by GTAs compared with those taught on manikins (median score GTA 6.3; vs. conventional 5.8; p=0.03). Competence was also higher in those taught by GTAs when assessed by an examiner (median global score GTA 7.1 vs. conventional 6.0; p<0.001) and by a GTA (p<0.001). ConclusionsGTA teaching of female pelvic examination at the start of undergraduate medical student O&G clinical placements improves their confidence and competence compared with conventional pelvic manikin based teaching. GTAs should be introduced into undergraduate medical curricula to teach pelvic examination.