Intimate examinations on volunteers during medical school: a challenge at the University of Antwerp,
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The ethics of intimate examinations—teaching tomorrow's doctorsCommentary: Respecting the patient's integrity is the keyCommentary: Teaching pelvic examination—putting the patient first
Intimate examinations on volunteers during medical school: a challenge at the University of Antwerp,
Coldicott et al. highlights concerns regarding the use of patients in
training clinical skills. Our current program for training fifth-year’s
undergraduates could serve as a model for dealing with these legitimate
problems. Our aim was to create a “safe” environment to learn intimate
examinations. The project was approved by our ethical committee.
Twenty healthy volunteers were recruited as Intimate Examination
Assistants (IEA’s) and were screened for their characteristics and
motivation. Each IEA signed informed consent. They received an
introduction in anatomy, technical examinations, doctor-patient
interactions and feedback training: in our setting the IEA served both as
patient and as teacher. Medical staff was trained in supervising and
coordinating the feedback sessions. Before, students were informed on the
scenario, and technical skills were teached on manikins. A comprehensive
training manual was produced.
Students performed three training sessions (urogenital-rectal,
gynaecological, breast examination) Each setting consisted of two students
(performer – observer), one IEA and one medical doctor. The students,
IEA’s and supervisor had sufficient opportunity for feedback to
contribute and ventilate their feelings and concerns. The attention was
mainly focused on personal attitude, technical and communication skills of
the students.
The program was evaluated at 3 levels (students, IEA, supervising
staff) by structured questionnaires, personal reflections of the students
and round-table conferences. Preliminary data showed a positive
appreciation of the training by students and IEA’s. Both stated that the
feedback moment was of utmost importance for the mutual understanding and
appreciation. The students were grateful to work with IEA’s.
Trust and respect were positive outcomes of our setting of combined
training of technical and communication skills. As the students reported
themselves: “It will certainly help us in our future careers, we feel more
secure while performing intimate examinations, and having more attention
for the patients, their feelings, integrity and privacy.”
K. Hendrickx[1], B.Y. De Winter[1], J.J. Wyndaele[2], F. Mast[1], B. Selleslags[1], L.Debaene[1], W.A.A. Tjalma[3], Ph. Buytaert[3], L. Bossaert[1]
[1]Skillslab, [2] Dep. of Urology and [3] Dep. of Gynaecology, University of Antwerp, Belgium
Coldicott Y. et al The ethics of intimate examinations – teaching
tomorrow’s doctors. BMJ 2003;326:97-101 (11 January)
Competing interests:
None declared
Competing interests:
No competing interests
25 January 2003
Kristin Hendrickx
medical doctor, assistant dpt of medecine, university of Antwerp
B.Y. De Winter, J.J. Wyndaele, F. Mast, B. Selleslags, L. Debaene, W.A.A. Tjalma, Ph. Buytaert, L. Bossaert
University of Antwerp, Skills lab, Universiteitsplein 1, 2610 WILRIJK, BELGIUM
Rapid Response:
Intimate examinations on volunteers during medical school: a challenge at the University of Antwerp,
Coldicott et al. highlights concerns regarding the use of patients in
training clinical skills. Our current program for training fifth-year’s
undergraduates could serve as a model for dealing with these legitimate
problems. Our aim was to create a “safe” environment to learn intimate
examinations. The project was approved by our ethical committee.
Twenty healthy volunteers were recruited as Intimate Examination
Assistants (IEA’s) and were screened for their characteristics and
motivation. Each IEA signed informed consent. They received an
introduction in anatomy, technical examinations, doctor-patient
interactions and feedback training: in our setting the IEA served both as
patient and as teacher. Medical staff was trained in supervising and
coordinating the feedback sessions. Before, students were informed on the
scenario, and technical skills were teached on manikins. A comprehensive
training manual was produced.
Students performed three training sessions (urogenital-rectal,
gynaecological, breast examination) Each setting consisted of two students
(performer – observer), one IEA and one medical doctor. The students,
IEA’s and supervisor had sufficient opportunity for feedback to
contribute and ventilate their feelings and concerns. The attention was
mainly focused on personal attitude, technical and communication skills of
the students.
The program was evaluated at 3 levels (students, IEA, supervising
staff) by structured questionnaires, personal reflections of the students
and round-table conferences. Preliminary data showed a positive
appreciation of the training by students and IEA’s. Both stated that the
feedback moment was of utmost importance for the mutual understanding and
appreciation. The students were grateful to work with IEA’s.
Trust and respect were positive outcomes of our setting of combined
training of technical and communication skills. As the students reported
themselves: “It will certainly help us in our future careers, we feel more
secure while performing intimate examinations, and having more attention
for the patients, their feelings, integrity and privacy.”
K. Hendrickx[1], B.Y. De Winter[1], J.J. Wyndaele[2], F. Mast[1], B. Selleslags[1], L.Debaene[1], W.A.A. Tjalma[3], Ph. Buytaert[3], L. Bossaert[1]
[1]Skillslab, [2] Dep. of Urology and [3] Dep. of Gynaecology, University of Antwerp, Belgium
Coldicott Y. et al The ethics of intimate examinations – teaching
tomorrow’s doctors. BMJ 2003;326:97-101 (11 January)
Competing interests:
None declared
Competing interests: No competing interests