Anna Vnuk

Medical students’ attitudes towards peer physical examination: findings from an international cross-sectional and longitudinal study

Although studies have begun to shed light on medical students’ attitudes towards peer physical examination (PPE), they have been conducted at single sites, and have generally not examined changes in medical students’ attitudes over time. Employing both cross-sectional and longitudinal designs, the current study examines medical students’ attitudes towards PPE at schools from different geographical and cultural regions and assess changes in their attitudes over their first year of medical study. Students at six schools (Peninsula, UK; Durham, UK; Auckland, New Zealand; Flinders, Australia; Sapporo, Japan and Li Ka Shing, Hong Kong) completed the Examining Fellow Students (EFS) questionnaire near the start of their academic year (T1), and students at four schools (Peninsula, Durham, Auckland and Flinders) completed the EFS for a second time, around the end of their academic year (T2). Univariate and multivariate analyses revealed a high level of acceptance for PPE of non-intimate body regions amongst medical students from all schools (greater than 83%, hips, at T1 and 94.5%, hips and upper body, at T2). At T1 and T2, students’ willingness to engage in PPE was associated with their gender, ethnicity, religiosity and school. Typically, students least comfortable with PPE at T1 and T2 were female, non-white, religious and studying at Auckland. Although students’ attitudes towards PPE were reasonably stable over their first year of study, and after exposure to PPE, we did find some statistically significant differences in attitudes between T1 and T2. Interestingly, attitude changes were consistently predicted by gender, even when controlling for school. While male students’ attitudes towards PPE were relatively stable over time, females’ attitudes were changeable. In this paper, we discuss our findings in light of existing research and theory, and discuss their implications for educational practice and further research.

Assessing proficiency in adult basic life support: student and expert assessment and the impact of video recording

Self-assessment is an important aspect in the development of lifelong learning skills for medical students, crucial to maintaining a high level of competence in practice. Basic Life Support (BLS) is a skill that all health professionals must acquire and maintain competence in. This paper reports data from a study of 95 first-year graduate entry medical students at Flinders University in Australia, determining how well the students could assess their own BLS performance. These students were videotaped performing a short CPR scenario using a Resusci®Anne with SkillReporter™ (Laerdal, Norway). Using a six-point descriptive ratings scale, students graded themselves twice: once immediately after completing the task, and again after viewing a video of their performance. A single expert assessor viewed all the video recordings and, based on International Liaison Committee on Resuscitation (ILCOR) Guidelines, graded the students using the same scale. The hypothesis was that the intervention of viewing their performance on video would improve the correlation of their ratings with the expert assessor. The results showed that the students’ assessments did not agree with the expert assessor either before (weighted κ = 0.03) or after seeing the video (weighted κ = 0.002). Possible reasons, including student attitudes and lack of benchmarking, are discussed. Self-assessment skills of students warrant further attention.

Understanding student concerns about peer physical examination using an activity theory framework

Context  Peer physical examination (PPE) has been employed for several decades as part of the formal curriculum for learning clinical skills. Most of the existing studies exploring students’ attitudes towards PPE are single‐site and use quantitative methods. Currently, there is a lack of theoretical underpinning to PPE as a learning method.

Don't want to show fellow students my naughty bits: Medical students' anxieties about peer examination of intimate body regions at six schools across UK, Australasia and Far-East Asia

Background: Although recent quantitative research suggests that medical students are reluctant to engage in peer physical examination (PPE) of intimate body regions, we do not know why. Aim: This article explores first-year medical students’ anxieties about PPE of intimate body regions at six schools. Methods: Using the Examining Fellow Students (EFS) questionnaire, we collected qualitative data from students in five countries (UK; Australia; New Zealand; Japan; Hong Kong) between 2005 and 2007. Results: Our framework analysis of 617 (78.7%) students’ qualitative comments yielded three themes: present and future benefits of PPE; possible barriers to PPE; and student stipulations for successful PPE. This article focuses on several sub-themes relating to students’ anxieties about PPE of intimate body regions and their associated sexual, gender, cultural and religious concerns. By exploring students’ euphemisms about intimate areas, our findings reveal further insights into the relationship between students’ anxieties, gender and culture. Conclusion: First-year students are anxious about examining intimate body regions, so a staged approach starting with manikins is recommended. Further qualitative research is needed employing interviews to explore in depth students’ anxieties about examinations of intimate body regions and how their views are shaped by interactions with peers, patients and doctors.

Medical students' experience of performing female pelvic examinations: Opportunities and barriers

Teaching and learning female pelvic examination within the undergraduate medical curriculum offers some potential challenges. One such is the extent to which students are provided practice opportunities with patients in the clinical setting.

The influence of students’ gender on equity in Peer Physical Examination: a qualitative study

Abstract Peer Physical Examination (PPE) is an educational tool used globally for learning early clinical skills and anatomy. In quantitative research, there are differences in students’ preferences and actual participation in PPE by gender. This novel study qualitatively explores the effect that gender has on medical students’ experiences of learning physical examination through PPE. We employ an interpretative approach to uncover the PPE experiences of students from a European, graduate-entry medical school. Volunteers participated in either individual or group interviews. The data were transcribed, de-identified and analysed using thematic analysis. There was evidence of gender inequity in PPE, with students describing significant imbalances in participation. Male students adopted roles that generated significant personal discomfort and led to fewer experiences as examiners. Assumptions were made by tutors and students about gender roles: male students’ ready acceptance of exposure to be examined and female students’ need to be protected from particular examinations. In contrast with the first assumption, male students did feel coerced or obliged to be examined. Students described their experiences of taking action to break down the gender barrier. Importantly, students reported that tutors played a role in perpetuating inequities. These findings, whilst relating to one university, have implications for all settings where PPE is used. Educators should be vigilant about gender issues and the effect that they may have on students’ participation in PPE to ensure that students are not disadvantaged in their learning.

E-learning for self-management support: introducing blended learning for graduate students – a cohort study

BackgroundE-learning allows delivery of education in many diverse settings and researchers have demonstrated it can be as effective as learning conducted in traditional face-to-face settings. However, there are particular practices and skills needed in the area of providing patient self-management support (SMS), that may not be achievable online. The aim of this study was to compare three approaches in the training of university students regarding the preparation of a Chronic Condition Self-Management Care Plan: 1) traditional face-to-face delivery of SMS training, 2) an e-learning approach and 3) a blended approach (combining e-learning and face-to-face teaching).MethodsGraduate entry physiotherapy students and medical students at Flinders University were recruited. Depending on the cohort, students were either exposed to traditional face-to-face training, e-learning or a blended model. Outcomes were compared between the three groups. We measured adherence to care plan processes in the preparation of an assessment piece using the Flinders Program Chronic Care Self Management tools. A total of 183 care plans were included (102 traditional, 52 blended, 29 e-learning,). All students submitted the Flinders Program Chronic Care Plan for university assessment and these were later assessed for quality by researchers. The submission was also assigned a consumer engagement score and a global competence score as these are integral to successful delivery of SMS and represent the patient perspective.ResultsThe blended group performed significantly better than the traditional group in quality use of the Flinders Program tools: Problem and Goals (P < 0.0001). They also performed significantly better in the total care plan score (P < 0.0001) and engagement score (P < 0.0001). There was no significant difference between the groups for the Partners in Health tool.ConclusionsIn this pilot study, the blended learning model was a more effective method for teaching self-management skills than the traditional group, as assessed in the development of a chronic condition self-management care plan. We anticipate that future research with identical groups of students would yield similar results but in the meantime, academics can have confidence that blended learning is at least as effective as traditional learning methods.