Advertisement
Featured Article| Volume 12, ISSUE 8, P305-312, August 2016

Success of the First Gynecological Teaching Associate Program in Turkey

      Highlights

      • The first GTA session caused nervousness, anxiety, and embarrassment among students.
      • GTA's encouraging and relaxing approach helped students to overcome their initial embarrassment and hesitation.
      • The students extremely satisfied with the learning experience guided by GTA.

      Abstract

      Background

      Given the sensitive nature of the examination, intimate examination procedures such as breast and genital examination create increased difficulties for students that other noninvasive techniques do not. The purpose of this study was to explore the feasibility and efficacy of an innovative instructional technique, breast examination training via a Gynecological Teaching Associate (GTA), in graduate nursing training in a part of the world where cultural norms dictate a more conservative approach to medical training.

      Method

      A qualitative study design was used, and semistructured interviews were undertaken with four female graduate nursing students.

      Results

      Students expressed feelings of anxiety, embarrassment, and hesitation at the first meeting with the GTA. However, owing to the encouraging and relaxing approach of the GTA, students overcame their initial difficulties, successfully completed the project, and reported both surprise at the unexpected success of the methodology and enthusiasm with the instructional technique.

      Conclusion

      Our study clearly shows that even in cultures where the methodology has never been used before and where a more conservative approach to medical training is used, the effectiveness of this kind of education crosses numerous boundaries and eliminates obstacles to provide excellent clinical examination instruction to all learners.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Simulation In Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Abe K.
        • Fujisaki K.
        • Ban N.
        Perceptions of simulated/standardized patient and SP trainers to have SPs involved in physical examination in the future.
        The Japan Academy for Health Behavioral Science. 2008; 23: 59-73
        • Ahmad F.
        • Cameron J.I.
        • Stewart D.E.
        A tailored intervention to promote breast cancer screening among south Asian immigrant women.
        Social Science and Medicine. 2005; 60: 575-586
        • Ayash C.
        • Axelrod D.
        • Nejmeh-Khoury S.
        • Aziz A.
        • Yusr A.
        • Gany F.M.
        A community intervention: Amber.
        Journal of Immigrant and Minority Health. 2011; 13: 1041-1047
        • Banning M.
        • Hassan M.
        • Faisal S.
        • Hafeez H.
        Cultural interrelationships and the lived experience of Pakistani breast cancer patients.
        European Journal of Oncology Nursing. 2010; 14: 304-309
        • Barrows H.S.
        • Abrahamson S.
        The programmed patient: A technique for appraising student performance in clinical neurology.
        Journal of Medical Education. 1964; 39: 802-805
        • Chang E.H.
        • Power D.V.
        Are medical students comfortable with practicing physical examinations on each other?.
        Academic Medicine. 2000; 75: 384-389
        • Coldicott Y.
        • Pope C.
        • Roberts C.
        The ethics of intimate examinations—Teaching tomorrow's doctors.
        British Medical Journal. 2003; 326: 97-101
        • Deladisma A.M.
        • Gupta M.
        • Kotranza A.
        • Bittner 4th, J.G.
        • Imam T.
        • Swinson D.
        • Lind D.S.
        A pilot study to integrate an immersive virtual patient with a breast complaint and breast examination simulator into a surgery clerkship.
        American Journal of Surgery. 2009; 197: 102-106
        • Donnelly T.T.
        • Al Khater A.
        • Al-Bader S.B.
        • Al Kuwari M.G.
        • Al-Meer N.
        • Malik M.
        • Fung T.
        Beliefs and attitudes about breast cancer and screening practices among Arab women living in Qatar: A cross-sectional study.
        BMC Women's Health. 2013; 13: 2-16
        • Eklöf N.
        • Abdulkarim H.
        • Hupli M.
        • Leino-Kilpi H.
        Somali asylum seekers' perceptions of privacy in healthcare.
        Nursing Ethics. 2015; https://doi.org/10.1177/0969733015574927
        • Fairbank C.
        Effective teaching of pelvic examination.
        The Clinical Teacher. 2009; 6: 101-104
        • Fairbank C.
        • Reid K.
        • Minzenmay K.
        Women's experiences of working as a clinical teaching associate teaching sensitive examinations: A qualitative study.
        Medical Teacher. 2015; 37: 47-52
        • Gibbons S.W.
        • Adams G.
        • Padden D.
        • Ricciardi R.
        • Graziano M.
        • Levine E.
        • Hawkins R.
        Clinical evaluation in advanced practice nursing education: Using standardized patients in health assessment.
        Journal of Nursing Education. 2002; 41: 215-221
        • Harte A.
        Privacy and identity in a changing world.
        Australasian Psychiatry. 2004; 12: 55-57
        • Jain S.
        • Fox K.
        • Van den Berg P.
        • Hill A.
        • Nilsen S.
        • Olson G.
        • Szauter K.
        Simulation training impacts student confidence and knowledge for breast and pelvic examination.
        Medical Science Educator. 2010; 24: 59-64
        • Jha V.
        • Setna Z.
        • Al-Hity A.
        • Quinton N.D.
        • Roberts T.E.
        Patient involvement in teaching and assessing intimate examination skills: A systematic review.
        Medical Education. 2010; 44: 347-357https://doi.org/10.1111/j.1365-2923.2009.03608.x
        • Karbani G.
        • Lim J.
        • Hewison J.
        • Atkin K.
        • Horgan K.
        • Lansdown M.
        • Chu C.
        Culture, attitude and knowledge about breast Cancer and preventive measures: A qualitative study of south Asian breast cancer patients in the UK.
        Asian Pacific Journal of Cancer Prevention. 2011; 12: 1619-1626
        • Kelley F.J.
        • Kopac C.A.
        • Rosselli J.
        Advanced health assessment in nurse practitioner programs: Follow-up study.
        Journal of Professional Nursing. 2007; 23: 137-143
        • Kleinman D.E.
        • Hage M.L.
        • Hoole A.J.
        • Kowlowitz V.
        Pelvic examination instruction and experience: A comparison of laywoman-trained and physician-trained students.
        Academic Medicine. 1996; 71: 1239-1243
        • Kretzschmar R.M.
        Evolution of the gynecology teaching associate: An education specialist.
        American Journal of Obstetrics and Gynecology. 1978; 131: 367-373
        • Luctkar-Flude M.
        • Wilson-Keates B.
        • Larocque M.
        Evaluating high-fidelity human simulators and standardized patients in an undergraduate nursing health assessment course.
        Nurse Education Today. 2012; 32: 448-452https://doi.org/10.1016/j.nedt.2011.04.011
        • Moore S.M.
        • Barling N.R.
        • Hood B.
        Predicting testicular and breast self-examination behaviour: A test of the theory of reasoned action.
        Behaviour Change. 1998; 15: 41-49
        • Nehring W.M.
        • Lashley F.R.
        Nursing simulation: A review of the past 40 years.
        Simulation & Gaming. 2009; 40: 528-552https://doi.org/10.1177/1046878109332282
        • Oh P.J.
        • Jeon K.D.
        • Koh M.S.
        The effects of simulation-based learning using standardized patients in nursing students: A meta-analysis.
        Nurse Education Today. 2015; 35: e6-e15
        • Parrott R.
        • Burgoon J.
        • Burgoon M.
        • LePoire B.
        Privacy between physicians and patients (more than a matter of confidentiality).
        Social Science and Medicine. 1989; 29: 1381-1385
        • Pickard S.
        • Baraitser P.
        • Rymer J.
        • Piper J.
        Can gynaecology teaching associates provide high quality effective training for medical students in the United Kingdom? Comparative study.
        British Medical Journal. 2003; 327: 1389-1392
        • Rees C.E.
        • Wearn A.M.
        • Vnuk A.K.
        • Bradley P.A.
        Don't want to show fellow students my naughty bits: Medical students' anxieties about peer examination of intimate body regions at six schools across UK, Australasia and Far-East Asia.
        Medical Teacher. 2009; 31: 921-927https://doi.org/10.3109/01421590802578244
        • Robertson K.
        • Hegarty K.
        • O'Connor V.
        • Gunn J.
        Women teaching women's health: Issues in the establishment of a clinical teaching associate program for the well woman check.
        Women & Health. 2003; 37: 49-65https://doi.org/10.1300/J013v37n04_05
        • Robinson-Smith G.
        • Bradley P.K.
        • Meakim C.
        Evaluating the use of standardized patients in undergraduate psychiatric nursing experiences.
        Clinical Simulation in Nursing. 2009; 5: e203-e211https://doi.org/10.1016/j.ecns.2009.07.001
        • Ross J.G.
        Simulation and psychomotor skill acquisition: A review of the literature.
        Clinical Simulation in Nursing. 2012; 8: e429-e435https://doi.org/10.1016/j.ecns.2011.04.004
        • Schopp A.
        • Leino-Kilpi H.
        • Välimäki M.
        • Dassen T.
        • Gasull M.
        • Lemonidou C.
        • Kaljonen A.
        Perceptions of privacy in the care of elderly people in five European countries.
        Nursing Ethics. 2003; 10: 39-47
        • Seago B.L.
        • Ketchum J.M.
        • Willett R.M.
        Pelvic examination skills training with genital teaching associates and a pelvic simulator: Does sequence matter?.
        Simulation in Healthcare. 2012; 7: 95-101
        • Sharaa H.B.
        Beliefs and reported practices related to breast self-examination among sample of Egyptian women.
        Academic Journal of Cancer Research. 2013; 6: 99-110
        • Shrestha S.
        • Wijma B.
        • Swahnberg K.
        • Siwe K.
        Learning pelvic examination with professional patients.
        Journal of the Nepal Medical Association. 2010; 49: 68-75
        • Silverman J.
        • Wood D.F.
        New approaches to learning clinical skills.
        Medical Education. 2004; 38: 1021-1023https://doi.org/10.1111/j.1365-2929.2004.01978.x
        • Siwe K.
        • Wijma K.
        • Stjernquist M.
        • Wijma B.
        Medical students learning the pelvic examination: Comparison of outcome in terms of skills between a professional patient and a clinical patient model.
        Patient Education and Counseling. 2007; 68: 211-217
        • Stillman P.L.
        • Ruggill J.S.
        • Rutala P.J.
        • Sabers D.L.
        Patient instructors as teachers and evaluators.
        Academic Medicine. 1980; 55: 186-193
        • Theroux R.
        • Pearce C.
        Graduate students' experiences with standardized patients as adjuncts for teaching pelvic examinations.
        Journal of the American Academy of Nurse Practitioners. 2006; 18: 429-435
        • van Ravesteijn H.
        • Hageraats E.
        • Rethans J.J.
        Training of the gynaecological examination in the Netherlands.
        Medical Teacher. 2007; 29: e93-e99
        • Vessey J.A.
        • Huss K.
        Using standardized patients in advanced practice nursing education.
        Journal of Professional Nursing. 2002; 18: 29-35
        • Wånggren K.
        • Pettersson G.
        • Csemiczky G.
        • Gemzell-Danielsson K.
        Teaching medical students gynaecological examination using professional patients—Evaluation of students' skills and feelings.
        Medical Teacher. 2005; 27: 130-135
        • Westin A.F.
        Privacy and freedom.
        Atheneum, New York1967
        • Ziv A.
        • Wolpe P.R.
        • Small S.D.
        • Glick S.
        Simulation-based medical education: An ethical imperative.
        Academic Medicine. 2003; 78: 783-788