Perception of peer physical examination in two Australian osteopathy programs

Abstract

BackgroundPeer physical examination (PPE) is an efficient and practical educational approach whereby students can practise their examination skills on each other before commencing clinical practice with actual patients. Little is known about the use of PPE in osteopathy education.MethodsStudents in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) completed the Examining Fellow Students and the Peer Physical Examination questionnaires prior to, and at the completion of, their first 12-week teaching session. Descriptive statistics were generated for each questionnaire. The McNemar and sign tests were used to evaluate differences between each questionnaire administration. Logistic regression was used to evaluate the influence of demographics on responses to both questionnaires.ResultsResults showed that students in both programs were generally willing to examine non-sensitive areas both before and after the 12-week teaching session. Students’ were less apprehensive about PPE at the end of the teaching session, and this was reinforced by results for previous exposure to PPE in other courses. Consistent with previous studies, unwillingness to participate in PPE was associated with being female, being born outside Australia, holding religious beliefs, and being older.ConclusionsThis is the first study to explore students’ perceptions of PPE in this cohort and provides a basis for further work, including evaluating longer term changes in student perception of PPE, and whether these perceptions extend to practising manual therapy techniques. This study demonstrates that perceptions about PPE reported in medicine and other disciplines, namely that unwillingness to participate in PPE is associated with being female, being born outside Australia, holding religious beliefs, and being older, also apply to osteopathy. These findings are significant for all manual therapy students who spend a substantial portion of their course developing skills in PPE and practising manual therapy techniques. They highlight the need for curriculum development that acknowledges the importance of good practice in PPE, including discussions about body image, feedback skills training for educators, and providing detailed information to students about what to expect in practical skills classes before they commence their course.Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-016-0102-2) contains supplementary material, which is available to authorized users.

The use of peer physical examination in undergraduate health professions education: Exploring the perceptions of students and educators in a multicultural, multiracial institution

“…This finding confirms that of similar studies conducted in India and Australia that report students' support of and preference for PPE as a teaching and learning tool in health professions education. [15,16] Participants of this study also reported that PPE is useful because it creates a safe learning environment for students, and prepares them for the clinical aspect of their training (Tables 1 and 3) -this finding is confirmed by the literature. [17,18] This suggests that PPE helps students to achieve learning outcomes by fostering a safe learning environment.…”

A Mokken scale analysis of the peer physical examination questionnaire

“…As with the ‘concern’ subscale, the item ordering value was low suggesting that the ability to discern between different levels of perceived professionalism and education associated with PPE is negligible. This assertion is potentially supported by Vaughan & Grace [ 39 ] who reported no difference in perception of first year osteopathy students in the 4 items of the PPEQ making up this scale over a 12-week period. Evidence is provided for the calculation of a sum score for the subscale.…”

“…The present study sought to evaluate the dimensionality and structure of the PPEQ developed by Consorti et al [ 8 ]. Research by the current authors has previously identified the need to explore the properties of the questionnaire to provide evidence for its ongoing use as a PPE evaluation tool [ 39 ]. Consorti et al [ 8 ] calculated a total score for the PPEQ and used this score as part of their analyses in Italian medical and osteopathy students.…”

“…Items 1 to 4 gauge the students’ perception with regard to performance of PPE and exposure of their body. Students appear to be generally comfortable with participating in PPE [ 12 , 39 ]. Items 8 to 11 specifically address comfort with PPE based on sex.…”

“…‘ Professionalism and education’ are key components in the evaluation of PPE, a position supported by the inclusion of this domain in the study by Chang & Power [ 12 ]. Setting professional behaviour standards [ 12 ], undertaking a formal PPE participation consent process [ 18 ] and creating a positive education environment may contribute to a positive perception of PPE [ 39 ]. This subscale also captures the students perceptions about the need to participate in PPE, a theme consistent with other work [ 6 ].…”