Proposal for the Development of a Sensitive Exam Teaching Module

Rationale:

  • In our curriculum, compared to many Canadian medical schools, students have limited teaching related to performing sensitive examinations (female breast and pelvic, male genitourinary, rectal).
  • It is important that these examinations are optimally taught in order to provide the best possible care to patients, and to increase student and patient comfort
  • Students have requested more rigorous teaching of sensitive examinations through the use of models and Teaching Associates

Overall objectives will include:

  • Students will be able to describe and demonstrate techniques to increase patient comfort during potentially sensitive examinations, including recognizing how past sexual abuse may impact a patient’s response to physical examination (communicator; professional)
  • Students will effectively interview female and male patients regarding their genitourinary/breast, sexual and reproductive history (communicator; medical expert)
  • Students will effectively and sensitively perform female breast examination (medical expert)
  • Students will effectively and sensitively perform a female speculum and bimanual pelvic examination (medical expert)
  • Students will effectively and sensitively perform a male genitourinary and rectal examination (medical expert)
  • Students will reflect on, and debrief about, their own responses to performing sensitive examinations (professional)

Structure:

The module will include pre-session preparation through reading and watching relevant videos, and a 1hr large group orientation. It is anticipated that 3 sessions of 3 hr each will be held. Each session will include: practice interviewing, demonstration and practice on models, demonstration and practice on a live Sensitive Exam Teaching Associate (SETA).

Sessions will be taught by the Sensitive Exam Teaching Associates (in pairs, with one SETA demonstrating and one acting as the “patient”), trained and supervised by the Module Coordinator.

Timing:

The module will occur in Phase A in the first year Professional Skills Course in the second term (Saskatoon). For the 2011-12 and 2012-13 academic years, the module will also be taught in the Phase C Professional Skills III (Clinical Sciences) course (Regina and Saskatoon)

Resources required:

  1. Sensitive Examination Faculty Coordinator:

0.2 FTE from May 1 2011 – Apr 30 2013. It is anticipated at that time that the Coordinator position will go down to 0.1 FTE, as the Module will be established, Teaching Associates will be trained, and the 3rd year double-teaching will be completed. The Faculty Coordinator will be a physician with clinical experience relevant to the content of the module. The Faculty Coordinator will be based in Saskatoon but will travel to Regina as required to assist with training.

Responsibilities will include:

  • Chairing a small working group (consisting of representatives from Obstetrics and Gynecology; Urology; Family Medicine; Regina Curriculum Coordinators; student body) who will provide guidance on module content and structure
  • Develop (and revise as needed) module learning materials for students
  • Develop (and revise as needed) training materials for Teaching Associates
  • Assist with the recruitment of Teaching Associates
  • Train Teaching Associates, supervise their teaching, and provide formative feedback to improve their teaching. (note: Occasionally during the initial start-up of the program when more supervision is required, the Faculty Coordinator may be assisted in supervising by another physician Faculty member)
  • Provide advice to the Administrative Coordinators regarding scheduling and formation of student groups
  • Teach large group introductory sessions
  • Develop student assessment materials, including assignments and OSCE stations
  • Mark assignments and supervise the student assessment process
  • With assistance from the working group, develop and implement an evaluation strategy for the module
  1. Sensitive Examination Administrative Coordinator

0.5 FTE position, which initially will be through the COM but which it is anticipated will be transitioned to become a staff member of the CLRC under the HSc Dean’s Cmt. This position will be based in Saskatoon. In Regina, it is anticipated that support will be provided through relevant position(s) in the COM office.

Responsibilities will include:

  • Providing administrative support to the Working Group
  • Recruit and be responsible for written and verbal communication with Teaching Associates related to their teaching assignments
  • Update learning materials for students as directed by the Faculty Coordinator
  • Update training materials as directed by the Faculty Coordinator
  • Schedule student groups and communicate with students regarding group assignments
  • Post all student learning materials to Course management software (e.g. One45)
  • Book rooms for teaching sessions
  • Communicate with the CLRC Coordinator to ensure teaching materials (models, equipment) are available
  • Prepare assessment materials under the direction of the Faculty Supervisor
  • Collate student assessment results and communicate these to the relevant COM staff members
  • Assist with administration of program evaluation
  1. Sensitive Examination Teaching Associates (SETAs)

Teaching Associates will have relevant previous experience (usually healthcare backgrounds) to provide a foundation for effective teaching of content. It is recommended that Teaching Associates be registered as non-physician Community Faculty and paid through the CF teaching funding. Teaching Associates will be recruited both in Regina and Saskatoon. The number of SETAs enlisted will depend on scheduling of student groups. Anticipated required teaching hours include:

2011-12:

  • Initial Training: 8 hours per Teaching Associate
  • Phase C teaching:
  • Saskatoon Female Teaching Associates - 16 students groups of 4, each requiring 2 x 3hr sessions = 96 hr teaching provided by 2 SETAs = 192 hr
  • Regina Female Teaching Associates – 5 student groups of 4, each requiring 2 x 3hr sessions = 30 hr teaching provided by 2 SETAs = 60 hr
  • Saskatoon Male Teaching Associates - 16 students groups of 4, each requiring 1 x 3hr session = 48 hr teaching provided by 2 SETAs = 96 hr
  • Regina Male Teaching Associates – 5 student groups of 4, each requiring 1 x 3hr session = 15 hr teaching provided by 2 SETAs = 30 hr
  • Phase A Teaching:
  • Saskatoon Female Teaching Associates - 21 students groups of 4, each requiring 2 x 3hr sessions = 126 hr teaching provided by 2 SETAs = 252 hr
  • Saskatoon Male Teaching Associates - 21 students groups of 4, each requiring 1 x 3hr session = 63 hr teaching provided by 2 SETAs = 126 hr

2012-13:

  • Refresher Training: 3 hours per Teaching Associate
  • Phase C teaching:
  • Saskatoon Female Teaching Associates - 16 students groups of 4, each requiring 2 x 3hr sessions = 96 hr teaching provided by 2 SETAs = 192 hr
  • Regina Female Teaching Associates – 5 student groups of 4, each requiring 2 x 3hr sessions = 30 hr teaching provided by 2 SETAs = 60 hr
  • Saskatoon Male Teaching Associates - 16 students groups of 4, each requiring 1 x 3hr session = 48 hr teaching provided by 2 SETAs = 96 hr
  • Regina Male Teaching Associates – 5 student groups of 4, each requiring 1 x 3hr session = 15 hr teaching provided by 2 SETAs = 30 hr
  • Phase A Teaching:
  • Saskatoon Female Teaching Associates - 21 students groups of 4, each requiring 2 x 3hr sessions = 126 hr teaching provided by 2 SETAs = 252 hr
  • Saskatoon Male Teaching Associates - 21 students groups of 4, each requiring 1 x 3hr session = 63 hr teaching provided by 2 SETAs = 126 hr

Subsequent Years:

2012-13:

  • Refresher Training: 3 hours per Teaching Associate
  • Phase A Teaching:
  • Saskatoon Female Teaching Associates - 21 students groups of 4, each requiring 2 x 3hr sessions = 126 hr teaching provided by 2 SETAs = 252 hr
  • Saskatoon Male Teaching Associates - 21 students groups of 4, each requiring 1 x 3hr session = 63 hr teaching provided by 2 SETAs = 126 hr

(note: these hours are estimated based on current class size of 84 students - teaching hours will increase with an increase in student class size)

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Draft Apr 2 2011 Prepared by Meredith McKague for the Clinical Skills and Professional Cmt