Medical students' experience of performing female pelvic examinations: Opportunities and barriers

Bhoopatkar, Harsh; Wearn, Andy; Vnuk, Anna

doi:10.1111/ajo.12634

Cited by 20 publications

(12 citation statements)

References 22 publications

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“…The International Society of Ultrasound in Obstetrics and Gynaecology [15] recommend that a minimum of 100 transvaginal scans are required prior to proficiency, which may not be achievable during RANZCOG One such barrier may be trainee confidence, and participants reported poor confidence levels prior to training. The TRUSST programme resulted in improved confidence levels in participants performing a TVUS, and while confidence does not equate to competence, it can be a barrier to performing procedures, especially intimate ones [16]. Table 2 Real patient scanning experience pre-and post-training Although our study demonstrated improvement in scanning skill on the simulator, Tolsgaard et al [17] demonstrated a sustained improvement in scanning abilities on live patients 2 months following simulation training with clinical experience compared to clinical experience alone.…”

Section: Discussionmentioning

confidence: 54%

Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars

2021

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Background Transvaginal ultrasound (TVUS) training opportunities are limited due to its intimate nature; however, TVUS is an important component of early pregnancy assessment. Simulation can bridge this learning gap. Aim To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars. Materials and methods The transvaginal ultrasound simulation training (TRUSST) curriculum consisted of supported practice using virtual reality transvaginal simulators (ScanTrainer, Medaphor) and communication skills training to assist obstetric registrars in obtaining required competencies to accurately and holistically care for women with early pregnancy complications. Trainee experience of live transvaginal scanning was evaluated with a questionnaire. Programme evaluation was by pre-post self-reported confidence level and objective pre-post training assessment using Objective Structured Assessment of Ultrasound Skills (OSAUS) and modified Royal Australian and New Zealand College of Obstetrics and Gynaecology assessment scores. Quantitative data was compared using paired t tests. Results Fifteen obstetric registrars completed the programme. Numbers of performed live transvaginal ultrasound by trainees were low. Participants reported an increase in confidence level in performing a TVUS following training: mean pre score 1.6/5, mean post score 3/5. Objective assessments improved significantly across both OSAUS and RANZCOG scores following training; mean improvement scores 7.6 points (95% CI 6.2–8.9, p < 0.05) and 32.5 (95% CI 26.4–38.6, p < 0.05) respectively. It was noted that scores for a systematic approach and documentation were most improved: 1.9 (95% CI 1.4–2.5, p < 0.05) and 2.1 (95% CI 1.5–2.7, p < 0.05) respectively. Conclusion The implementation of a simulation-based training curriculum resulted in improved confidence and ability in TVUS scanning, especially with regard to a systematic approach and documentation.

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Section: Discussionmentioning

confidence: 54%

Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars

2021

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“…The advantage of the simulation method is the ability to learn how to perform the correct examination before the start of clinical classes. There are papers presenting that 33% of medical graduates have never conducted a gynaecological examination [14]. According to patients, the consent or refusal of a vaginal examination was influenced by factors such as: gender (with a predominance of women), age (for the benefit of older students), less formal behaviour and past gynaecological examination experience [15].…”

Section: Patient Examinationmentioning

confidence: 99%

Application of medical simulation in the education of medical students in the area of gynecology and obstetrics

et al. 2020

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The education of new generations of doctors faces major challenges. The education system should ensure access to modern and effective educational techniques. Medical simulation is a method that is developing very dynamically. Currently, every medical university in Poland has access to the facilities of a Medical Simulation Centre. Many types of simulations can be used. The variety of techniques is considerable. Starting from simple trainers, through advanced patient simulators to hybrid simulation or virtual reality. Thanks to their use, it is possible to teach basic medical procedures in a safe way, without compromising the patient's intimacy. An additional advantage is the possibility to train in an interdisciplinary team. The aim of this work was to present the possibility of using medical simulation as a method of effective and interesting teaching of medical students in the field of gynaecology and obstetrics. The authors described different techniques and levels of simulation sophistication. The basic tasks of the teacher were also described. The paper may be an interesting complement to the knowledge of education for each physician involved in the work with students.

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“…Many medical learners report high levels of discomfort performing genital exams [52–55], though simulation and working with standardized patient volunteers appear to lessen their discomfort. Pelvic exam competencies tend to focus on performing a vaginal and bimanual exam, as well as a pap smears.…”

Section: Myth #4: Clinicians Are Well Trained To Identify the Morpholmentioning

confidence: 99%

The little tissue that couldn’t – dispelling myths about the Hymen’s role in determining sexual history and assault

et al. 2019

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Conclusions about women’s and girls’ sexual history are made in some settings based on assumptions about the hymen, a small membranous tissue with no known biological function, which typically occupies a portion of the external vaginal opening in females. Clinicians, however, continue to refer to changes in the hymen to assess for a history of consensual or nonconsensual sexual intercourse. We reviewed published evidence to dispel commonly held myths about the hymen and its morphology, function, and use as evidence in cases of sexual violence. An examination of the hymen is not an accurate or reliable test of a previous history of sexual activity, including sexual assault. Clinicians tasked with performing forensic sexual assault examinations should avoid descriptions such as “intact hymen” or “broken hymen” in all cases, and describe specific findings using international standards and terminology of morphological features. We call on clinicians to consider the low predictive value of a hymen examination and to: 1) avoid relying solely on the status of the hymen in sexual assault examinations and reporting; 2) help raise awareness of this issue among their peers and counterparts in law enforcement and the judicial system; and 3) promote fact-based discussions about the limitations of hymenal examinations as part of clinical education for all specialties that address the sexual or reproductive health of women and girls. Electronic supplementary material The online version of this article (10.1186/s12978-019-0731-8) contains supplementary material, which is available to authorized users.

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Medical students' experience of performing female pelvic examinations: Opportunities and barriers

Cited by 20 publications

References 22 publications

Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars

Implementing the transvaginal ultrasound simulation training (TRUSST) programme for obstetric registrars

Application of medical simulation in the education of medical students in the area of gynecology and obstetrics

The little tissue that couldn’t – dispelling myths about the Hymen’s role in determining sexual history and assault

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