67. HIPPOCRATES APPRENTICES ON EARTH: MEDICAL STUDENTS EXPERIENCES AND CONSENT FOR VAGINAL EXAMINATIONS OF ANAESTHETISED PATIENTS

Abstract

Vaginal examinations (VEs) are an essential sexual health examination skill. Reports of students having difficulties getting experience with VEs are matched by reports of patients being examined without consent. This study prospectively aimed to find out what was happening when medical students sought consent for VEs of anaesthetised patients.

All 66 2005 5^th year medical students at OU, WSM & HS were asked to prospectively complete a 14 item questionnaire about their experience at gynaecology operating sessions. Chi-squared test determined result significance.

Student response rate was 78%. 141/184 patients were asked if the student could attend the operation. Students asked 101 patients. Consultants were more likely ask on the student's behalf for males than females. p > 0.0010.

All male students sought consent within 2 hours of operations. Some female students sought consent 5 or more hours beforehand; a significant gender difference (p > 0.0001).

Five patients declined student attendance at their operation.

When asked 96 patients (86.6%/-3.4%) agreed and 16 (13.3% +/-3.4%) declined permission for the student conducting a VE under anaesthesia; with no statistical gender difference in refusal rate.

VEs were done on 82 patients; including 2 without consent. In 19 instances a student had consent but no examination was done. Eleven students (3 male, 6 female) did no examinations.

The value of the examination for student learning was rated 4/5 by 73% students; with no statistical difference by gender or age.

The implications of these findings for teaching sexual health skills to medical students are discussed.