Bhoopatkar Harsh, Wearn Andy, Vnuk Anna
Clinical Skills Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Flinders University, Adelaide, South Australia, Australia.
Aust N Z J Obstet Gynaecol. 2017 Oct;57(5):514-519. doi: 10.1111/ajo.12634. Epub 2017 May 10.
Teaching and learning female pelvic examination within the undergraduate medical curriculum offers some potential challenges. One such is the extent to which students are provided practice opportunities with patients in the clinical setting.
To quantify how many pelvic examinations, on real patients, have been performed by medical students at the point of graduation, and to explore opportunities and barriers to performing these examinations.
A retrospective study using a self-completed, anonymous, electronic survey was developed as part of a multi-centre study. Data were collected in the immediate period after graduation from the medical programs at the University of Auckland and Flinders University in 2013. An ordinal set of range categories was used for recording numbers of examinations.
The combined response rate for the survey was 42.9% (134/312). The median range category for the number of pelvic examinations performed in patients who were not in labour was 6-9 and in labour was 2-3. Thirty-three percent of medical students had never performed a pelvic examination in labour. Male medical students performed significantly fewer pelvic examinations compared with female students. Self-reported barriers to performing the pelvic exam include: gender of the student, 'gate-keeping' by other health professionals, lack of confidence and patient factors.
The majority of medical students have performed several pelvic examinations on real patients at graduation. Male gender and access being limited by midwives were the main barriers to performing female pelvic examinations. Medical curricula need to address these issues in the learning environment.
在本科医学课程中教授和学习女性盆腔检查存在一些潜在挑战。其中之一是学生在临床环境中获得与患者进行实践机会的程度。
量化医学生在毕业时对真实患者进行的盆腔检查次数，并探讨进行这些检查的机会和障碍。
作为一项多中心研究的一部分，开展了一项回顾性研究，采用自我填写的匿名电子调查问卷。数据于2013年从奥克兰大学和弗林德斯大学的医学项目毕业之后立即收集。使用一组有序的范围类别来记录检查次数。
调查的综合回复率为42.9%（134/312）。未分娩患者进行盆腔检查次数的中位数范围类别为6 - 9次，分娩患者为2 - 3次。33%的医学生从未在分娩时进行过盆腔检查。与女生相比，男生进行的盆腔检查显著较少。自我报告的进行盆腔检查的障碍包括：学生性别、其他卫生专业人员的“把关”、缺乏信心和患者因素。
大多数医学生在毕业时已对真实患者进行了多次盆腔检查。男性性别以及助产士限制检查机会是进行女性盆腔检查的主要障碍。医学课程需要在学习环境中解决这些问题。
