Gynaecological examination: a teaching package integrating assessment with learning (693).

A self-directed learning package which includes assessment was developed to allow students to acquire the psychosocial and motor skills needed to conduct a gynaecological examination with sensitivity. The package integrates assessment with learning and uses the Assessment Form as an educational instrument. The introduction, including a video of a vaginal examination and pap smear, is followed by five learning stations for groups of 3 or 4 students to visit. At each station a series of tasks are given which enable the objectives of the station to be fulfilled. The materials necessary to complete the tasks are provided. Gynaecological assistants, themselves trained by participation in the learning sessions, guide the students throughout the session and act as adviser 'patients' to help students acquire the necessary motor skills. In the assessment, students are required to integrate what they have learnt in the learning stations. The students assess themselves and the 'patient' and an observer assesses the student using the same Assessment Form. The form assesses and gives examples of the psychosocial, including legal and motor skills required. The assistants-observers give feedback to the students about their performance and make suggestions for future improvement. Of the 232 medical students completing their clinical terms in Obstetrics and Gynaecology in 1995, those students receiving the learning package rated their practical experience as significantly better. They rate the learning method, content, enjoyment and package overall very highly (median 4, 5 point scale 1-5). Open-ended comments by students confirmed these findings.