Gaynor Heading

Medical students' experiences learning intimate physical examination skills: a qualitative study.

BackgroundIntimate physical examination skills are essential skills for any medical graduate to have mastered to an appropriate level for the safety of his or her future patients. Medical schools are entrusted with the complex task of teaching and assessing these skills for their students. The objectives of this study were to explore a range of medical students’ experiences of learning intimate physical examination skills and to explore their perceptions of factors which impede or promote the learning of these skills.MethodsIndividual semi-structured interviews (N = 16) were conducted with medical students in years two to five from the University of Newcastle, as part of a larger research project investigating how medical students develop their attitudes to gender and health. This was a self-selected sample of the entire cohort who were all invited to participate. A thematic analysis of the transcribed data was performed.ResultsStudents reported differing levels of discomfort with their learning experiences in the area of intimate physical examination and differing beliefs about the helpfulness of these experiences. The factors associated with levels of discomfort and the helpfulness of the experience for learning were: satisfaction with teaching techniques, dealing with an uncomfortable situation and perceived individual characteristics in both the patients and the students. The examination causing the greatest reported discomfort was the female pelvic examination by male students.ConclusionsStudent discomfort with the experience of learning intimate physical examination skills may be common and has ongoing repercussions for students and patients. Recommendations are made of ways to modify teaching technique to more closely match students’ perceived needs.

Using problem-based learning in public health service based training

OBJECTIVES This study explored the suitability and benefits of problem-based learning (PBL) in competency-based postgraduate public health training. The PBL was delivered within a rural retreat and included site visits. METHODS Qualitative semistructured interviews with trainee public health officers and key informants. RESULTS The learning approach (retreat-PBL combination with site visits) was valuable and relevant. Trainees reported a high learning impact with increased knowledge about the problems examined and rural public health practice. They also expressed an openness to work rurally. CONCLUSION Collaboratively developed and delivered, experiential rural public health PBL provides a positive learning experience for trainees undertaking competency-based training in public health and could play an important workforce role. PBL appears to be suitable in rural and non-rural public health training settings.

Mobilising a rural community to lose weight: Impact evaluation of the WellingTonne Challenge

OBJECTIVE To evaluate the impact of the WellingTonne Challenge. DESIGN Before-after study. SETTING The National Action Agenda for the prevention and control of obesity in Australia identified community action and development as a key theme. The WellingTonne Challenge was a whole-of-community project designed to support a small rural community to lose weight and reduce their risk of chronic disease. PARTICIPANTS Adult residents of the Wellington Local Government Area who were overweight or obese. RESULTS The project successfully engaged the community with around 10% of the target group formally participating in the Challenge. Participants achieved a weight reduction of around 3 kg each, as well as positive changes in diet and physical activity. A total of 59% of those who signed up for the Challenge achieved an accumulated loss of 687 kg at the end of the 12-week program--less than the community goal of 1000 kg. CONCLUSION The WellingTonne Challenge is a promising intervention. Wider implementation of this approach in other small rural communities might make a significant contribution to the national effort. The opportunity should be taken to undertake a more rigorous evaluation to determine whether this approach benefits communities in the longer term.