The Journal of the American Osteopathic Association, 2009/01, 109(1):59-60. doi: 10.7556/jaoa.2009.109.1.40, type of study: ,ppt,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2009.109.1.40/html)

Keywords:

clinical competence [227]
diagnosis [412]
medical students [693]
osteopathic medicine [2108]
pelvis [56]
perception [146]
pretest posttest design [240]
USA [1751]

Abstract:

Purpose: We tested the hypothesis that practice pelvic examinations on standardized patients within the second year osteopathic medical school curriculum improves students' perceptions of competency and preparedness for clinical rotations. Methods: After IRB approval, 260 second year medical students at Kansas City University of Medicine and Biosciences—College of Osteopathic Medicine (KCUMB-COM) were asked, both verbally and via e-mail, to complete two electronic surveys. The pre/posttest surveys were voluntary and anonymous, and included questions about demographics and pelvic exam experience. The pre-test survey consisted of 18 questions and the post-test contained 41 questions. Results: Of the 260 students solicited, 88 (34%) completed the pre-test survey (36 male, 51 female), and 71 (27%) completed the post-test survey (32 male, 34 female). In the pre-test, 76 students (90%) indicated they never had performed a pelvic exam. Before the activity, 39 (45%) students did not know how to use a speculum; 57 (67%) could not bi-manually locate the cervix; 69 (81%) could not bi-manually locate the uterus; 72 (85%) could not bi-manually locate the ovaries; 74 (87%) could not assess pubococcygeus muscle tone; and 31 (36%) students were not familiar with the appearance of a cervix. Following the experience, 71 (100%) students knew how to use a speculum; 70 (99%) could bimanually locate the cervix; 66 (93%) could bimanually locate the uterus; 57 (80%) could bimanually locate the ovaries; 44 (62%) could assess pubococcygeus muscle tone; and 70 (99%) students knew what a cervix looked like. Students indicated that the practice pelvic exam improved their perception of preparedness (n=70, 99%) and confidence (n=64, 90%) for performing the pelvic exam in a clinical situation. In addition, 64 (90%) students reported that the experience helped reduce their anxiety about performing pelvic exams. Conclusions: The practice pelvic exam activity at KCUMB-COM provides second year students with an effective learning environment to ask questions, develop skills, receive feedback, and improve confidence during potentially uncomfortable clinical situations. The practice pelvic exam considerably improved students' self-perceived competency and preparedness for clinical rotations, which may help their performance. The utility of this experience during the third and fourth years of medical education warrants further investigation.