Assessment of the Effect of Various Teaching Strategies on Medical Students' Skills, Attitudes, and Comfort During Gynecological Examinations: A Randomized Controlled Trial.

Abstract

Introduction: Few studies have evaluated the stress-related factors experienced by medical students during gynecological examination training or the effectiveness of different teaching strategies involving real patients. This study aims to assess the impact of 3 distinct instructional approaches, each incorporating a commercially available pelvic examination simulator, on medical students' clinical skills, attitudes, and comfort levels when performing gynecological examinations.

Methods: A total of 138 clerkship students received a commercially available pelvic examination simulator and were randomly assigned to the following interventions: reading a handout (reading), watching a video of pelvic examination on a pelvic model (model video), or watching a video of patient experience with pelvic examinations (testimonial video). Skill performance, measures of fear/anxiety/comfort, and overall satisfaction were assessed during both simulated and real patient encounters to evaluate the impact of each teaching modality.

Results: Mixed analysis of variance revealed statistically significant differences in all dependent variables for time (all P < 0.001) and for the time × group interaction on the Fear of Pelvic Examination Scale (F-PEXS) for discomfort ( P = 0.038). Post hoc analyses between subjects in the real-life environment revealed higher total F-PEXS ( P = 0.034) and F-PEXS discomfort ( P = 0.009) scores for the model video compared with reading and higher scores for the testimonial video compared with reading on the pelvic examination checklist ( P = 0.034).

Conclusions: Despite good acquisition of skills, the model video group demonstrated greater fear of performing pelvic examinations. By contrast, the reading group exhibited the lowest acquisition of skills, but lower levels of fear. The testimonial video group exhibited good acquisition of skills and low fear levels. These findings support the ongoing discussion and potential implementation of brief, targeted educational strategies for teaching pelvic examination techniques.