Purpose: The purpose of this project was to:
Assess baseline student comfort and knowledge regarding EUA
Create a video underscoring potential concerns regarding EUA and highlighting the role of EUA on the OB/GYN clerkship
Provide tools to help students navigate various clinical scenarios
Background: Exam Under Anesthesia (EUA) allows medical students to connect the physical exam to surgical decision making as well as hone exam skills for future independent practice.
Medical students are trained to perform EUAs as part of their OB/GYN clerkship. Patients may be unaware these exams occur. Without informed consent, some patients feel these trainee exams to be a violation of their autonomy. Several medical associations including the AMA, ACOG, and APGO have stated explicit consent is required for trainee EUA.
Methods: Phase 1: Students in the Class of 2020 were surveyed to assess their level of knowledge concerning EUA as well as their comfort in performing EUAs. Professional and lay literature was researched to evaluate both concerns and recommendations regarding EUA.
Phase 2: A video script was written based on current literature, student identified concerns, and recommendations from APGO and ACOG. Actors were hired to play the medical students and patients. Doctors in the scenes were played by actual physicians. Adobe Primer Pro and Adobe Audition editing software were used post-production.
Results: Phase 1: The student survey garnered fifty-five responses and highlighted several issues:
Students were unaware of the controversy regarding EUA and they would be asked to perform EUA
Students were unclear regarding patient awareness of trainee EUA
Students were unclear regarding clinical indications for trainee EUA
Phase 2: A ten-minute video was created and discusses guidance from medical associations, current legislation, and indications/benefits of EUA. It also provides students tools to navigate situations that they may encounter. https://www.youtube.com/watch?v=qoF4RUI1GgU
Discussions: The video seeks to educate students by:
Addressing a potentially controversial topic
Allaying students’ fears about performing sensitive exams during their clerkship
Modeling challenging discussions with attendings
Pelvic examination skills are important and should be taught during medical school. By following the guidance from well-regarded medical associations, both patients and students should feel supported and comfortable regarding performance of EUAs.
Topics: CREOG & APGO Annual Meeting, 2021, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Residency Director, Residency Coordinator, Patient Care, Professionalism, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, Simulation,
Stephanie Scaramella, Resident, USU/ UC Davis; Katerina Shvartsman, MD; Joy Wheat, MD
