Abstract
Objective
This study sought to identify barriers that prevent medical students from performing
pelvic examinations in their obstetrics and gynaecology (Ob/Gyn) clinical clerkship
rotations and to compare the perspectives of faculty, residents, nurses, and students
regarding perceived barriers.
Methods
An electronic survey was distributed to third-year Dalhousie University (Halifax,
NS) medical students on completion of their Ob/Gyn clerkship rotations in the 2015-2016
academic year and to Ob/Gyn nursing staff, faculty, and residents (Canadian Task Force
Classification III).
Results
There were 82 responses, giving an overall response rate of 28%. Students reported
performing an average of 9.2 speculum examinations, 3.8 cervical checks, and 2.8 bimanual
examinations during their 6-week rotations. They reported being declined the opportunity
to perform an examination an average of 7.1 times. Students perceived themselves to
be more competent performing these examinations compared with staff perception of
student competency. Students perceived resident interest in teaching, resident and
staff time constraints, and patient willingness to have a medical student involved
in their examination as frequent barriers. Faculty, residents, and nurses perceived
student gender, patient willingness, difficulty of examination, and resident time
constraints to be significant barriers.
Conclusion
This study is the first to examine multidisciplinary perspectives on perceived barriers
to medical students performing pelvic examinations. Staff and students have different
perceptions of a student's competence performing these examinations. Existing barriers
are likely multifactorial.
Résumé
Objectif
Cette étude visait à définir les obstacles qui empêchent les étudiants en médecine
d'effectuer des examens pelviens durant leurs stages cliniques en obstétrique-gynécologie
et à comparer les points de vue des professeurs, des résidents, des infirmières et
des étudiants quant aux obstacles perçus.
Méthodologie
Au cours de l'année universitaire 2015-2016, un sondage électronique a été distribué
aux étudiants en troisième année de médecine à l'Université Dalhousie d'Halifax (N.-É.)
qui terminaient leurs stages en obstétrique-gynécologie. Il a également été envoyé
aux infirmières, aux professeurs et aux résidents en obstétrique-gynécologie (classification
III du Groupe d'étude canadien).
Résultats
Au total, 82 personnes ont répondu au sondage, ce qui donne un taux de réponse de
28 %. Les étudiants ont déclaré effectuer en moyenne 9,2 examens au spéculum, 3,8
examens du col utérin et 2,8 examens bimanuels au cours de leurs stages de six semaines.
Ils ont également dit s'être fait refuser la possibilité d'effectuer un examen 7,1
fois en moyenne. Les étudiants avaient une meilleure perception de leur aptitude à
réaliser ces examens que le personnel. Parmi les obstacles à la réalisation des examens
fréquemment nommés par les étudiants, notons l'intérêt des résidents quant à l'enseignement,
les contraintes de temps des résidents et du personnel ainsi que l'ouverture des patientes
à l'idée qu'un étudiant effectue l'examen. Selon les professeurs, les résidents et
les infirmières, les obstacles importants étaient le genre des étudiants, l'ouverture
des patientes, les difficultés liées à l'examen et les contraintes de temps des résidents.
Conclusion
Cette étude est la première à s'intéresser aux points de vue multidisciplinaires relatifs
à la perception des obstacles empêchant les étudiants en médecine de réaliser des
examens pelviens. Le personnel et les étudiants ne voient pas du même œil l'aptitude
des étudiants à effectuer ces examens. Les obstacles existants sont probablement multifactoriels.
Key Words
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Article info
Publication history
Published online: February 22, 2019
Accepted:
December 18,
2018
Received:
November 3,
2018
Footnotes
Competing interests: The authors declare that they have no competing interests.
Each author has indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2019 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
