Janjua Aisha, Smith Paul, Clark T Justin
a Birmingham Heartlands Hospital , Bordesley Green , UK.
b Birmingham Women's Hospital , Mindelsohn Way , UK.
J Obstet Gynaecol. 2018 May;38(4):521-525. doi: 10.1080/01443615.2017.1363726. Epub 2018 Feb 1.
Gynaecological teaching associates (GTAs) appear to be effective in aiding medical students to acquire core skills in female pelvic examination (FPE). The aim was to explore the current provision for teaching and assessment of FPE in Obstetric and Gynaecological (O&G) placements across UK medical schools and in particular, the use of GTAs. An online survey was sent to undergraduate academic leads for O&G, representing 29 of the 30 UK medical schools. The response rate was 21/29 (72%). The average placement was 6.7 weeks and teaching of FPE varied including training on manikins (20/21, 95%), instruction in outpatient clinics (17/21, 81%) and instruction on anaesthetised patients (17/21, 81%). The survey revealed that anatomic pelvic models are combined with supervised instruction in outpatient clinics and operating theatres. GTAs are used by less than a third of medical schools, and where used are thought to enhance teaching in this core skill in contrast to those universities not using GTAs. Short placements, a reluctance to use GTAs and a lack of formal assessment may adversely impact upon the competency of newly qualifying medical students in FPE. Impact statement What is already known on this subject: Experience of female pelvic examination intimate is limited. Expert patients, known as Gynaecological Teaching Associates (GTAs), have been suggested as a potential solution to improve teaching of gynaecological examination, but the last survey of medical schools in the United Kingdom (UK) conducted in 1989 reported that only two were using GTAs in an average clinical placement length of 11.5 weeks. What the results of this study add: Twenty-five years after the last survey, Obstetrics and Gynaecology (O&G) clinical placements have been reduced to an average of 6 weeks with one-third requiring only an informal impression of competence in female pelvic examination. Despite published evidence since 1989 supporting the effectiveness of GTAs, just six medical schools are using GTAs for teaching and assessment with all believing them to be effective. What the implications are of these findings for clinical practice and/or further research: A combination of short placements, an apparent reluctance to use GTAs and a lack of uniform formal assessment may mean that the competency of newly qualifying medical students in basic gynaecological examination is compromised.
妇科教学助理（GTAs）似乎有助于医学生掌握女性盆腔检查（FPE）的核心技能。本研究旨在探讨英国各医学院校妇产科实习中FPE教学与评估的现状，尤其是GTAs的使用情况。向代表英国30所医学院校中29所的妇产科本科教学负责人发送了在线调查问卷。回复率为21/29（72%）。平均实习时长为6.7周，FPE教学方式多样，包括在人体模型上培训（20/21，95%）、门诊指导（17/21，81%）以及对麻醉患者的指导（17/21，81%）。调查显示，解剖盆腔模型与门诊及手术室的督导指导相结合。不到三分之一的医学院校使用GTAs，与未使用GTAs的大学相比，使用GTAs的学校认为其能提升这项核心技能的教学效果。实习时间短、不愿使用GTAs以及缺乏正式评估可能会对新毕业医学生在FPE方面的能力产生不利影响。影响声明关于该主题已有的了解：女性盆腔检查的亲身体验有限。专家患者，即妇科教学助理（GTAs），被认为是改善妇科检查教学的潜在解决方案，但1989年对英国医学院校进行的上一次调查显示，平均临床实习时长为11.5周的情况下，只有两所学校使用GTAs。本研究结果补充了什么：在上次调查25年后，妇产科临床实习平均时长已减至6周，三分之一的学校仅要求对女性盆腔检查能力有非正式的评估。尽管自1989年以来已有证据支持GTAs的有效性，但只有六所医学院校将GTAs用于教学和评估，且所有学校都认为其有效。这些发现对临床实践和/或进一步研究有何影响：实习时间短、明显不愿使用GTAs以及缺乏统一的正式评估，可能意味着新毕业医学生在基本妇科检查方面的能力受到影响。
