Two years ago, Robert Reid realized he gave the same tutorial to every medical student at each gynaecology clinic he conducted. Was there a way, he wondered, to transform this tutorial into an educational film for medical students?
Along with medical student Bryden Magee, Dr. Reid, a Queen's University professor in Obstetrics and Gynaecology, and Chair of the Division of Reproductive Endocrinology and Infertility at Kingston General Hospital, began working with volunteers to film demonstrations of pelvic and bimanual exam techniques.
"Bimanual exams are the type of pelvic exam that medical students watch but often have no idea what's really going on," explains Dr. Reid, whose own tutorial was included in the final 17-minute DVD.
The team also hired professional artist Kathy Piercy to produce anatomical renderings that demonstrate the internal examination techniques used by doctors during a pelvic exam.
To test the ability of the DVD to convey information and instill confidence among inexperienced medical students the team tested students before and after viewing key segments of the DVD. The students' knowledge and confidence in conducting a first pelvic examination was vastly improved after they watched the DVD.
Additionally, a follow-up research study found that inexperienced medical students who watched the DVD all scored highly on a practical pelvic-exam assessment without additional coaching. Fifty-three per cent of these students received an honours grade of 80 per cent or higher.
Pelvic exams are usually taught through a combination of lectures, plastic models or simulators, or with the assistance of volunteer female Gynaecological Teaching Associates (GTA) who are available for repeat pelvic examinations at a cost of $200 per medical student.
"The cost to the medical schools of hiring GTAs for a large cohort of medical students can amount to thousands of dollars per year," says Dr. Reid. "Due to scheduling challenges students may receive their hands-on training from the GTAs months before their first clinic experience and essential steps may be forgotten. Better alternatives are needed."
The Academic Professionals in Obstetrics and Gynaecology (APOG) has already endorsed the video as an education tool for universities across Canada. Dr. Ruth Ronn, a resident now working with Dr. Reid, will present the latest research on the effectiveness of the DVD at a national conference of the American Association of Professors of Obstetrics and Gynaecology in San Antonio, Texas, in March.