Teaching Associates Randomised to Evaluate the Effectiveness of Gynaecological Pelvic Examination Versus Traditional Teaching Using Manikins

NCT01944592 | Completed

• 1 other identifier: TARGET001
• Study Type: interventional
• Target: 492
• Locations: 1 country
• Sites: 1

Brief Summary

Physical examination of the pelvis is an important core skill that medical students need to acquire. However, due to its intimate nature some students are graduating unable to perform competent pelvic examinations. Gynaecological Teaching Associates (GTA's) are women who have been trained to be examined and give valuable feedback to the students. In North America GTA's are quite commonly used in the medical curriculum and they have also been used in Canada, Australia and Scandinavia. In the UK pelvic examination is mainly taught using a combination of clinic patients, pelvic models and patients anaesthetised for surgery. In Birmingham we have already started using GTA's and like other Universities such as Oxford the students have given positive feedback. GTA's are paid professionals and hence introducing this method of teaching has financial implications for Universities. Unless it is proven to be worthwhile it is unlikely that academic institutions will introduce and maintain GTA programs. One UK study did show that those who had been trained with a GTA's and pelvic models were significantly better than those who had been trained with pelvic models alone. However, in this study the GTA training was supplementary to the normal curriculum so the amount of teaching rather than the style of teaching may have acted as a confounding factor. Therefore, a large randomised trial of trainees on the Obstetrics and Gynaecology (O\&G) programme comparing those given an initial teaching session on a pelvic model and those taught by GTA's is needed to assess the effectiveness of GTA's on confidence and competence of the students by the end of the training programme is needed.

Conditions

Female Pelvic Examination

Keywords

Gynaecology Teaching Associate; Pelvic examination; Students

Outcome Measures

Primary Outcomes (1)

• Student confidence

  At the start of the placement in O\&G (during week one), the students will be asked to rate their confidence in gynaecological examination. The assessment tool comprises five questions relating to various communication and practical aspects of the procedure as well as a further global assessment of confidence. A 100mm VAS will be used to measure response. The students will be asked to rate their confidence on the same scales at the end of their placement.

  At the end of placement (week 5)

Secondary Outcomes (3)

• Student competence

  At the end of placement (week 5)

• Number of vaginal examinations performed

  At the end of placement (week 5)

• Student rated usefulness of training session

  At the end of placement (week 5).

Study Arms (2)

Gynaecology Training Associates (GTA's)

EXPERIMENTAL

Final year (Year 5) medical undergraduates embarking upon their O\&G clinical placement trained in pelvic examination with GTA's

Behavioral: Gynaecology Teaching Associates (GTA's)

Manikin training

ACTIVE COMPARATOR

Final year (Year 5) medical undergraduates embarking upon their O\&G clinical placement trained in pelvic examination on manikins.

Behavioral: Manikin (conventional) training

Interventions

Gynaecology Teaching Associates (GTA's) BEHAVIORAL

Two GTA's will conduct the session according to the following structure; Students will receive a short anatomy PowerPoint presentation from the GTA's followed by demonstration of a gynaecological examination on a pelvic manikin. Students will then be taken to the out-patient department where one GTA will demonstrate pelvic examination on the other. Each student will then examine one of the GTAs under supervision by the other. The three non-active students will observe each of their colleagues' examinations. The students will then undergo a role play scenario where they will examine one of the GTAs under supervision of the other and feedback will be given by both GTAs.

Gynaecology Training Associates (GTA's)

Manikin (conventional) training BEHAVIORAL

Clinical Lecturers in Gynaecology (equivalent to Specialist Registrar experience) will conduct the sessions as follows: Students will receive a short anatomy PowerPoint presentation (the same as used in the GTA training). The Clinical Lecturer will then demonstrate pelvic examination on the pelvic manikin. Each student will then perform the pelvic examination twice supervised by the Clinical Lecturer.

Manikin training

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Final year medical students
• Consent

You may not qualify if:

• None

Sponsors & Collaborators

• Birmingham Women's NHS Foundation Trust: lead

Study Sites (1)

Birmingham Womens Hospital

Birmingham, West Midlands, B15 2TG, United Kingdom

Location

Related Publications (8)

• Pickard S, Baraitser P, Rymer J, Piper J. Can gynaecology teaching associates provide high quality effective training for medical students in the United Kingdom? Comparative study. BMJ. 2003 Dec 13;327(7428):1389-92. doi: 10.1136/bmj.327.7428.1389.

  PMID: 14670887 BACKGROUND

• Wanggren K, Fianu Jonassen A, Andersson S, Pettersson G, Gemzell-Danielsson K. Teaching pelvic examination technique using professional patients: a controlled study evaluating students' skills. Acta Obstet Gynecol Scand. 2010 Oct;89(10):1298-303. doi: 10.3109/00016349.2010.501855.

  PMID: 20846063 BACKGROUND

• Wanggren K, Pettersson G, Gemzell-Danielsson K. Medical students learning the pelvic examination: evaluation of a clinical patient model. Acta Obstet Gynecol Scand. 2010 Oct;89(10):1304-9. doi: 10.3109/00016349.2010.513425.

  PMID: 20726831 BACKGROUND

• Robertson K, Hegarty K, O'Connor V, Gunn J. Women teaching women's health: issues in the establishment of a clinical teaching associate program for the well woman check. Women Health. 2003;37(4):49-65. doi: 10.1300/J013v37n04_05.

  PMID: 12956214 BACKGROUND

• Beckmann CR, Barzansky BM, Sharf BF, Meyers K. Training gynaecological teaching associates. Med Educ. 1988 Mar;22(2):124-31. doi: 10.1111/j.1365-2923.1988.tb00422.x.

  PMID: 3374413 BACKGROUND

• Beckmann CR, Sharf BF, Barzansky BM, Spellacy WN. Student response to gynecologic teaching associates. Am J Obstet Gynecol. 1986 Aug;155(2):301-6. doi: 10.1016/0002-9378(86)90814-8.

  PMID: 3740146 BACKGROUND

• Plauche WC, Baugniet-Nebrija W. Students' and physicians' evaluations of gynecologic teaching associate program. J Med Educ. 1985 Nov;60(11):870-5.

  PMID: 4057229 BACKGROUND

• Janjua A, Roberts T, Okeahialam N, Clark TJ. Cost-effective analysis of teaching pelvic examination skills using Gynaecology Teaching Associates (GTAs) compared with manikin models (The CEAT Study). BMJ Open. 2018 Jun 22;8(6):e015823. doi: 10.1136/bmjopen-2017-015823.

  PMID: 29934378 DERIVED

MeSH Terms

Interventions

Manikins; Congresses as Topic

Intervention Hierarchy (Ancestors)

Models, Anatomic; Models, Structural; Audiovisual Aids; Educational Technology; Technology; Technology, Industry, and Agriculture; Organizations; Health Care Economics and Organizations

Study Officials

• Thomas J Clark, MBChB MD(hons)

  Birmingham Women's NHS Foundation Trust

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Consultant Obstetrician and Gynaecologist

Study Record Dates

• First Submitted: September 13, 2013
• First Posted: September 17, 2013
• Study Start: September 1, 2013
• Primary Completion: December 1, 2014
• Study Completion: December 1, 2014
• Last Updated: February 5, 2015

Record last verified: 2015-02

Locations

GB (1)