Medical students' gynecologic examination skills. Evaluation by gynecology teaching associates.

In the past it was assumed that medical students would be able to perform an adequate pelvic examination by the end of the third-year clinical clerkship. At the University of Virginia, students completing the clinical clerkship were evaluated by trained gynecology teaching associates (GTAs), acting as patients and chaperones, who systematically evaluated students' examination and interpersonal skills using both an objective scale including 86 specific items and two 12-point subjective rating scales. Interrater reliability was demonstrated, as was the correlation between the subjective scores and objective ratings. Thirty-two percent of the students were evaluated as having either inadequate or marginal examination skills, and 29% were rated as having interpersonal skills that fell into the same unsatisfactory category. GTAs can be used as evaluators of skills in a competency-based clerkship.