The effectiveness of gynaecological teaching associates in teaching pelvic examination: a systematic review and meta-analysis

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The effectiveness of gynaecological teaching associates in teaching pelvic examination : a systematic review and meta-analysis. / Smith, Paul P; Choudhury, Shelina; Clark, T Justin.

In: Medical Education, Vol. 49, No. 12, 12.2015, p. 1197-1206.

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@article{aecf49142424423f80249ebf7c1b6ec9,
title = "The effectiveness of gynaecological teaching associates in teaching pelvic examination: a systematic review and meta-analysis",
abstract = "CONTEXT: An increasing number of graduating students are unable to competently and confidently perform a pelvic examination. Gynaecology teaching associates (GTAs) teach technical and communication skills and offer immediate feedback. The objective was to perform a systematic literature review to assess whether teaching pelvic examinations using real women who are trained to give instructions on technique and feedback improves the competence, confidence and communication skills of trainees when compared with traditional teaching methods.METHODS: MEDLINE, EMBASE, the Cochrane Library, CINAHL and the ISRCTN Register of Clinical Trials were searched using selected terminology. No language restrictions were applied. The selection criteria were randomised clinical trials (RCTs) and controlled studies that investigated the use of GTAs to teach students or health-related professionals the pelvic examination. Data evaluating study outcomes, along with methodological details, were extracted in duplicate. The outcomes measured were: self-reported confidence, assessed competence and assessed communication skills. The standard mean difference (SMD) was derived for each study where possible and heterogeneity across studies was quantified using the I(2) statistic. In the presence of substantial variation, the data were pooled using a random effects model.RESULTS: Eleven studies with 856 participants were included: five RCTs and six observational studies. GTA training improved competence compared with other teaching methods and the finding of enhanced competence was consistent when the pooled analysis was restricted to RCTs. Communication skills were also improved with GTA teaching, but to a lesser degree, whereas no effect on student confidence was observed. Statistical heterogeneity was present for all outcomes when data were pooled.CONCLUSION: Our findings suggest that GTA-based teaching of pelvic examination is associated with improvement in the competence and communication skills of trainees. However, further larger-scale studies with standardised relevant educational outcomes are needed to confirm these findings.",
keywords = "Adult, Clinical Competence, Education, Medical, Undergraduate, Female, Gynecological Examination, Gynecology, Humans, Outcome Assessment (Health Care), Patient Simulation, Journal Article, Meta-Analysis, Review",
author = "Smith, {Paul P} and Shelina Choudhury and Clark, {T Justin}",
note = "{\textcopyright} 2015 John Wiley & Sons Ltd.",
year = "2015",
month = dec,
doi = "10.1111/medu.12816",
language = "English",
volume = "49",
pages = "1197--1206",
journal = "Medical Education",
issn = "0308-0110",
publisher = "Wiley",
number = "12",

}

RIS

TY - JOUR

T1 - The effectiveness of gynaecological teaching associates in teaching pelvic examination

T2 - a systematic review and meta-analysis

AU - Smith, Paul P

AU - Choudhury, Shelina

AU - Clark, T Justin

N1 - © 2015 John Wiley & Sons Ltd.

PY - 2015/12

Y1 - 2015/12

N2 - CONTEXT: An increasing number of graduating students are unable to competently and confidently perform a pelvic examination. Gynaecology teaching associates (GTAs) teach technical and communication skills and offer immediate feedback. The objective was to perform a systematic literature review to assess whether teaching pelvic examinations using real women who are trained to give instructions on technique and feedback improves the competence, confidence and communication skills of trainees when compared with traditional teaching methods.METHODS: MEDLINE, EMBASE, the Cochrane Library, CINAHL and the ISRCTN Register of Clinical Trials were searched using selected terminology. No language restrictions were applied. The selection criteria were randomised clinical trials (RCTs) and controlled studies that investigated the use of GTAs to teach students or health-related professionals the pelvic examination. Data evaluating study outcomes, along with methodological details, were extracted in duplicate. The outcomes measured were: self-reported confidence, assessed competence and assessed communication skills. The standard mean difference (SMD) was derived for each study where possible and heterogeneity across studies was quantified using the I(2) statistic. In the presence of substantial variation, the data were pooled using a random effects model.RESULTS: Eleven studies with 856 participants were included: five RCTs and six observational studies. GTA training improved competence compared with other teaching methods and the finding of enhanced competence was consistent when the pooled analysis was restricted to RCTs. Communication skills were also improved with GTA teaching, but to a lesser degree, whereas no effect on student confidence was observed. Statistical heterogeneity was present for all outcomes when data were pooled.CONCLUSION: Our findings suggest that GTA-based teaching of pelvic examination is associated with improvement in the competence and communication skills of trainees. However, further larger-scale studies with standardised relevant educational outcomes are needed to confirm these findings.

AB - CONTEXT: An increasing number of graduating students are unable to competently and confidently perform a pelvic examination. Gynaecology teaching associates (GTAs) teach technical and communication skills and offer immediate feedback. The objective was to perform a systematic literature review to assess whether teaching pelvic examinations using real women who are trained to give instructions on technique and feedback improves the competence, confidence and communication skills of trainees when compared with traditional teaching methods.METHODS: MEDLINE, EMBASE, the Cochrane Library, CINAHL and the ISRCTN Register of Clinical Trials were searched using selected terminology. No language restrictions were applied. The selection criteria were randomised clinical trials (RCTs) and controlled studies that investigated the use of GTAs to teach students or health-related professionals the pelvic examination. Data evaluating study outcomes, along with methodological details, were extracted in duplicate. The outcomes measured were: self-reported confidence, assessed competence and assessed communication skills. The standard mean difference (SMD) was derived for each study where possible and heterogeneity across studies was quantified using the I(2) statistic. In the presence of substantial variation, the data were pooled using a random effects model.RESULTS: Eleven studies with 856 participants were included: five RCTs and six observational studies. GTA training improved competence compared with other teaching methods and the finding of enhanced competence was consistent when the pooled analysis was restricted to RCTs. Communication skills were also improved with GTA teaching, but to a lesser degree, whereas no effect on student confidence was observed. Statistical heterogeneity was present for all outcomes when data were pooled.CONCLUSION: Our findings suggest that GTA-based teaching of pelvic examination is associated with improvement in the competence and communication skills of trainees. However, further larger-scale studies with standardised relevant educational outcomes are needed to confirm these findings.

KW - Adult

KW - Clinical Competence

KW - Education, Medical, Undergraduate

KW - Female

KW - Gynecological Examination

KW - Gynecology

KW - Humans

KW - Outcome Assessment (Health Care)

KW - Patient Simulation

KW - Journal Article

KW - Meta-Analysis

KW - Review

U2 - 10.1111/medu.12816

DO - 10.1111/medu.12816

M3 - Article

C2 - 26611185

VL - 49

SP - 1197

EP - 1206

JO - Medical Education

JF - Medical Education

SN - 0308-0110

IS - 12

ER -