Pelvic examination skills training with genital teaching associates and a pelvic simulator: does sequence matter?

Introducing the pelvic examination to novice learners has been a challenging task for medical educators. The purpose of this study was to evaluate an educational intervention adding the use of a pelvic examination simulator (SIM) to the use of genital teaching associates (GTAs) in a pelvic examination skills curriculum for second-year medical students.

Each student participated in a session with the pelvic simulator and with the GTA. Students were randomized to the training sequence. Outcome measures include the Fear of Pelvic Examination Scale (F-PEXS), blood pressure measurement, and instructor evaluation of learning performance.

For students who learned with a GTA in the first session, the mean F-PEXS score decreased significantly, and the learning performance score was significantly higher from sessions 1 to 2. There was no significant change in either measure when the pelvic simulator was used first. For both learning sequences, men had a significantly higher F-PEXS score.

When using simulation to teach the pelvic examination to novices, standardized patients seem to be the better initial training experience, reducing student anxiety and improving learner engagement with subsequent mechanical simulation practice of psychomotor skills.