The effect of practitioner characteristics on patient pain and embarrassment during ED internal examinations

The objective was to determine if practitioner characteristics influence patients' pain and embarrassment during an emergency department (ED) internal pelvic examination (IPE). This prospective, comparative study was performed in an urban, university teaching hospital ED with an annual census of 64,000. The study population consisted of a convenience sample of patients who required an IPE as part of her ED evaluation. Information gathered included patient age and final diagnosis, as well as examiner gender and level of training (LOT). Immediately after IPE, the patient was asked to rate both pain and embarrassment of the examination using a previously validated 100-mm visual analog scale (VAS). Finally, each subject was asked to indicate her practitioner gender preference for IPE. The influence of examiner gender and LOT on patient pain and embarrassment was assessed using a t-test or ANOVA with significance defined as P <.05. A total of 278 subjects completed the study (mean age 27.7 +/- 10.5 years, range 13 to 70 years). The mean pain and embarrassment scores were 29.7 and 17.5 respectively. Examiner gender, examiner LOT and patient age did not predict pain and embarrassment scores. Overall, 173 (62%) patients had no practitioner gender preference, whereas 93 (34%) preferred women and 11 (4%) preferred men.

Examiner characteristics do not influence either the pain or the embarrassment associated with IPE in the ED.