Best Practices for Peer Physical Examination in PA Education: A Trauma-informed, Culturally Sensitive Approach

Peer physical examination (PPE) is a foundational component of physician assistant (PA) education, providing students with opportunities to develop essential clinical, communication, and professional skills through hands-on practice. However, PPE may present challenges for students whose participation is influenced by cultural or religious modesty, gender dynamics, or prior traumatic experiences. Programs often lack practical guidance for addressing these concerns while maintaining educational standards.This paper presents a trauma-informed, culturally responsive framework for implementing PPE in PA education. The proposed approach emphasizes proactive communication, clear expectations regarding attire, draping, and examination procedures, and the use of an optional preactivity questionnaire that allows students to indicate preferences, such as same-sex pairings or accommodation requests, without requiring disclosure or justification. Faculty review responses confidentially and implement accommodations discreetly to promote psychological safety, preserve student privacy, and minimize stigma while maintaining equitable educational experiences.Integrating trauma-informed and culturally responsive practices into PPE offers PA educators practical guidance for fostering an inclusive learning environment without compromising clinical skill development. This framework supports student well-being while reinforcing patient-centered values essential to compassionate, ethical, and culturally responsive clinical practice.By adopting these recommendations, PA programs can create more inclusive and psychologically safe learning environments while preserving the educational value of PPE. Future research should evaluate the impact of these strategies on student comfort, psychological safety, and learning outcomes using preimplementation and postimplementation assessments.