Medical Student's Perception And Preferences About Peer Physical Examination (PPE)

Abstract

There is greater emphasis on clinically oriented teaching and early clinical exposure for medical students. There is limitation to practice and perfect the skills on sick patients. Hence, standardized patients are used for practice of clinical skills. However non-availability of trained standardized patients, high cost of employing them poses a challenge to training medical students. The viable alternative is to use the peers for skill training. It can be a potential area of student discomfort or inappropriate behavior by classmates or tutors. Present study assesses the attitude of students towards Peer Physical Examination (PPE). Fifty three third term medical students (23 males and 30 females) were administered a structured and validated questionnaire with 15 questions to assess elements of comfort, professionalism, appropriateness and value of PPE. Students responded to questions using a five-point Likert scale, where 1 = strongly agree, and 5 = strongly disagree.The pattern of response was similar for male and female students. 81.82% were comfortable with PPE for practice of clinical skills. 32.90% were comfortable examining peers of opposite sex. 18.04% felt it was appropriate to perform breast, genital and rectal examinations on peers. 2.17% agreed to volunteer for such examination.Majority of students preferred PPE to standardized patients for practice of clinical skills. PPE was preferred as it provided valuable feedback, better learning experience, and felt examining classmates was comfortable & appropriate. However they felt inappropriate to volunteer or examine breast, inguinal, genital regions of classmate as a part of PPE.

Practicing Peer Physical Examination by Medical and Allied Health Professions Students: Why the Hesitation and Where are We Now? A Narrative Literature Review

“…Thus, this setting creates a safe controlled environment to acquire essential skills to protect patients from untrained novices. 2 …”

“… 15 , 16 Economically, PPE is organized at a reasonable and affordable cost, competing with other highly-priced alternatives such as standardized patients. 1 , 2 , 12 Finally, in conjunction with the financial side, it can be easily coordinated in terms of organization.…”

“…While performing peer physical examination can provide opportunities for learning and building essential skills in the pre-clinical years, students can face some obstacles which may happen due to the lack of skills or supervision during this practice. 17 These include students’ feelings of discomfort or embarrassment, especially when the examinees are exposed or undressed in front of their classmates during the examination, 2 , 18 and some sort of misbehavior or harm to examinees by some students or instructors. 2 Discovering unexpected abnormal findings during the examination of colleagues is low and approximate an incidence of 1.5% annually, thus, considering it an unimportant issue.…”

“… 17 These include students’ feelings of discomfort or embarrassment, especially when the examinees are exposed or undressed in front of their classmates during the examination, 2 , 18 and some sort of misbehavior or harm to examinees by some students or instructors. 2 Discovering unexpected abnormal findings during the examination of colleagues is low and approximate an incidence of 1.5% annually, thus, considering it an unimportant issue. 19 …”

“… n= 100 Medical students Does medical student willingness to practise peer physical examination translate into action? Consorti et al (2013) 30 Italy Survey (cross-sectional) Convenience sampling n= 241 Medical and osteopathic students Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey Wearn et al (2013) 31 New Zealand Survey (Dual cohort, cross-sectional) n= 128 Nursing students Exploration of the attitudes of nursing students to peer physical examination and physical examination of patients Manjunath et al (2014) 2 India Survey (cross-sectional) n= 53 Medical students Medical Student’s Perception And Preferences About Peer Physical Examination (PPE) Reid et al (2015) 32 Australia Survey n= 243 Medical students Abdomen and chest examinations in peer physical examination: Variation in participation by gender Taylor and Shulruf (2016) 11 Australia Survey n= 130 Medical students Australian medical students have fewer opportunities to do physical examination of peers of the opposite gender Vaughan and Grace (2016) 12 Australia Survey n= 105 Osteopathic students Perception of peer physical examination in two Australian osteopathy programs Burggraf et al (2018) 33 Germany Survey n= 142 Medical students Willingness of medical students to be examined in a physical examination course Ardakani et al (2022) 10 Australia Survey …”