The use of clinical teaching associates (CTAs) in teaching male intimate examination to medical students: A randomised controlled trial.

Introduction: Genital examinations are challenging for medical students to learn in part due to practice opportunities. In an attempt to address this, we introduced clinical teaching associates (CTAs) who teach third year medical students and allow male intimate examinations to be practiced on themselves.

Materials and methods: A single-blinded parallel-group RCT was conducted, recruiting 96 students. The control group was only given access to the current curriculum (lectures, videos, models) whilst the other group was offered this and a teaching session with CTAs, who are professionally trained, allowing students to examine them. Assessment took the form of a bespoke Objective Structured Clinical Examination (OSCE) and a self-assessment confidence questionnaire before and after the teaching.

Results: Assessed by experienced surgeons, the group receiving the additional CTA teaching scored significantly higher than the control group in the OSCE in 55% (n = 11) of domains. This included, but was not limited to, competence at performing hernial orifice (effect size = 0.985), male genital (effect size = 0.943), penile (effect size = 1.347) and prostate examinations (effect size = 0.578). Assessment by the CTA, acting as the patient, also showed a significant difference in favour of the intervention group in all domains and included whether the patient felt safe (effect size = 0.797) and whether the patient would see the student again (effect size = 1.170).

Discussion: The use of CTAs for teaching male intimate examination results in significantly greater student competence and confidence and their use should be considered in medical schools.