How do gloves affect cutaneous sensibility in medical practice? Two new applied tests.

In order to quantify the effect of medical gloves on tactile performance, two new Simulated Medical Examination Tactile Tests (SMETT) have been developed to replicate the tactile and haptic ability required in medical examinations: the 'Bumps' test and the 'Princess and the Pea' (P&P) test. A pilot study was carried out using 30-40 subjects for each test in order to investigate the suitability of the tests for medical glove evaluation. Tests were performed with latex and nitrile examination gloves and without gloves. Following the tests, small-scale studies were carried out to investigate the effect of various design parameters, such as material stiffness and tactile exploration method. In the 'Bumps' test, subjects performed significantly better in the ungloved condition, and there were 'almost significant' differences between the gloves, with the thinner latex gloves performing better than the thicker nitrile gloves. Both finger orientation and surface lubrication were found to have a significant effect on results, indicating that these need to be clearly defined in the test procedure. In the 'P&P' test, no significant effect of hand condition was found, suggesting that haptic sensing is less affected by medical gloves than cutaneous sensibility. Other factors such as material stiffness, technique and test orientation had a more significant effect. The SMETT 'Bumps' test has potential as a clinical manual performance evaluation tool and may be used to evaluate the relative effects of different gloves. The SMETT 'P&P' test is a valid measure of haptic or tactile performance, but should not be used in glove evaluation. Both tests could have further applications, such as in the assessment of neurological impairment or aptitude testing for potential surgeons.