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Beyond technical skills: women's expectations regarding the relational dimensions prior to gynecologic examinations
Julie Zenou1, Clémentine Jouffray2, Rodrigo Lisboa2
1Maternité, Centre Hospitalier du Haut-Anjou, Château-Gontier, France.
Introduction:
Gynecologic examinations expose women to particular vulnerability, making relational and ethical aspects essential beyond technical skills. While professional societies outline recommended behaviors, the importance women attribute to these non-technical elements remains insufficiently characterized. This study aimed to assess how women value key relational components of gynecologic examinations.
Methods:
In this exploratory cross-sectional study, a questionnaire was developed from gynecologic and ethical guidelines, and distributed via QR codes in outpatient gynecology and general practice settings. Eleven items (Q1-Q11) were rated on a numeric scale (0-10). Principal component analysis (PCA) assessed internal coherence and identified thematic dimensions. Descriptive and comparative analyses were conducted, including stratification by age and prior gynecologic examination.
Results:
A total of 540 women participated (mean age 37 ± 10 years). PCA identified three dimensions: consent (Q1, Q5, Q9-Q11), privacy (Q6-Q8), and feelings/experience (Q2-Q4). Consent-related items received the highest scores (all >9/10 except Q1). Privacy items showed greater variability, with lower importance assigned by women over 50 to partial undressing (p = 0.006) and draping (p = 0.007), while women undergoing their first examination assigned greater importance to undressing out of the provider's sight (p = 0.01). Feelings-related items were more heterogeneous, although attention to patients' feelings during the examination was highly rated (9.7 ± 0.8).
Conclusion:
Women consistently prioritized explicit and ongoing consent and sustained attention to their feelings. Privacy was also important, though more variable. These findings support the integration and structured assessment of non-technical competencies in training related to gynecologic examinations.
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