The effectiveness of gynaecology teaching associates in teaching pelvic examination to medical students: a randomised controlled trial

Objectives To assess whether teaching female pelvic examinations using gynaecological teaching associates (GTAs); women who are trained to give instruction and feedback on gynaecological examination technique, improves the competence, confidence and communication skills of medical students compared to conventional teaching. Study design Randomised controlled trial. Setting Ten University of Birmingham (UoB) affiliated teaching hospitals in the UK. Population 492 final year medical students. Methods GTA teaching of gynaecological examination compared with conventional pelvic manikin based teaching at the start of a five week clinical placement in obstetrics and gynaecology (O&G). Main outcome measures Student’s perception of their confidence was measured on a 10 cm visual analogue scale (VAS). Domains of competence were measured by a senior clinical examiner using a standardised assessment tool which utilised 10 cm VAS and by a GTA using a four point Likert scale. Assessors were blinded to the allocated teaching intervention. Results 407/492 (83%) students completed both the intervention and outcome assessment. Self-reported confidence was higher in students taught by GTAs compared with those taught on manikins (median score GTA 6.3; vs. conventional 5.8; p = 0.03). Competence was also higher in those taught by GTAs when assessed by an examiner (median global score GTA 7.1 vs. conventional 6.0; p < 0.001) and by a GTA (p < 0.001). Conclusions GTA teaching of female pelvic examination at the start of undergraduate medical student O&G clinical placements improves their confidence and competence compared with conventional pelvic manikin based teaching. GTAs should be introduced into undergraduate medical curricula to teach pelvic examination.