Teaching of the sensitive examinations: An international survey

Background: The teaching of the sensitive examinations—i.e. that of the female breast, female pelvis, female and male rectum and male genitalia—is a challenging part of the undergraduate curriculum. There are no studies to date detailing how national and international medical schools teach all of these examinations. Purposes: This research sought to document the teaching strategies used by national and international medical schools regarding the sensitive examinations. Methods: The sensitive examinations surveyed are the: 1) Female breast; 2) Female pelvis; 3) Male genitalia; 4) Female and male rectum. The term “female sensitive examinations” is used to refer to female breast and female pelvis examinations. This was a questionnaire study, which polled national New Zealand medical schools as well as international medical schools. Questions included: a) sensitive examination teaching method; b) stress reduction strategies; c) perceived graduating student confidence. Results: A total of 104 medical schools participated in this survey in 2010. Artificial manikin usage was the most common technique utilized for each sensitive examination (60% of all schools, 95% CI 55%-65%), whether as the sole teaching method or in combination with other methods. The next most common technique was teaching associates (49% of schools, 95% CI 44%-54%). The female breast and pelvis sensitive examinations used the teaching associate program more frequently than the male genital examination and female and male rectal examination. Regardless of teaching method, most schools believed their graduating students were confident. Stress management teaching was used in most schools, in conjunction with teaching associate sessions. Conclusion: Manikins were the most commonly used teaching component of a teaching programme on sensitive examinations. Irrespective of teaching method, most schools believed their students were confident upon graduation.