Simulators for intimate examination training in the developing world

Abstract

IntroductionExamination of the female genitalia is the most intimate and potentially embarrassing element of a clinical consultation. Women in both developed and developing countries often find the experience of gynaecological examination offputting and unpleasant and this has important implications for the utilisation of gynaecological and family planning services. Apprehension and anticipation may be worse than the actual experience: Norwegian women reported that the experience was 'not so bad after all'. 1 The Royal College of Obstetricians and Gynaecologists published standards for intimate examination in 1997 which emphasised the provision of adequate privacy, the presence of a chaperone, the maintenance of verbal communication for reassurance, and allowing women to dress and be seated in the consulting room for any discussion of the results of the examination or future proposed treatment. Further aspects, especially relating to training, were highlighted in the recently updated document. 2 This aspect of quality of care has received little attention in developing countries, with no published assessments of the training needs of medical and paramedical staff in intimate examination. In the present study we evaluated the use of a pelvic simulator for training of medical and nonmedical staff in a family planning setting, and for enhancing reproductive education for women.

Dyspareunia and Urinary Sensory Symptoms in India: Population-Based Study

“…It is not clear whether these differences reflect understanding of and attitudes to bodily functions and symptoms among women from different educational backgrounds. Certainly, there are substantial deficits in knowledge of normal anatomy and function that have been the focus of health education in the context of family planning provision [9]. Perhaps because of a lack of interspousal communication and a desire to maintain personal privacy, many women in India seem to bear silently the pain and the symptoms without seeking medical advice or treatment [10].…”