Vaginal and speculum examination in medical curricula

Medical students' perception of their own psychomotor skills and attitudes to different methods of teaching the gynaecological examination were studied. Students rated their physical skills poorly, only 7% feeling confident they could detect an abnormality and only 14% considering their ability to perform a Pap smear was good or very good. They rated their doctor/patient skills better, 55% considering they are good at conducting an examination with sensitivity and 67% at explaining to their patient what they were doing and why. Students' first preference for instruction was to examine patients in the Outpatient Clinic under the supervision of a doctor, a method experienced by most students on one occasion. The next preferred method was for students to work with 2 trained gynaecological assistants, acting as patient and instructor, with discussion of feelings and feedback (see Subjects and Methods). The option of student volunteers was a least favoured method but was cited as first preference by 5% of students. Over 25% of the female students considered volunteering for vaginal examination a 'possibility' if they were examined by a student of the same sex. Over 25% of males would 'possibly' volunteer for rectal examination only if the same sex was present. The comments by the students offer help in the future planning of teaching vaginal examination.