Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey

Fabrizio Consorti, Rosaria Mancuso, Annalisa Piccolo, Giacomo Consorti, Joseph Zurlo, Fabrizio Consorti, Rosaria Mancuso, Annalisa Piccolo, Giacomo Consorti, Joseph Zurlo

Abstract

Background: Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact.As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE.

Methods: A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students).

Results: The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4 ± 6.3 vs. 43.4 ± 8.9; p < 0.01). The only independent variables that were significantly predictive of the score in a linear regression analysis were gender and the condition of medical or osteopathic student. The EFS mean score also showed a significant difference between the osteopathic and medical students (30.76 ± 2.9 vs. 27.85 ± 4.3; p < 0.01).Factor analysis of the new questionnaire identified three factors (appropriateness and usefulness, sexual implications and passive role) accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearson's r coefficient = 0.61). Reliability was expressed in terms of Cronbach's alpha coefficient, which equals 0.86.

Conclusions: These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students' attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional understanding and future interprofessional education.

References

    1. American Association of Colleges of Osteopathic Medicine and the American Osteopathic Association. Osteopathic medical education in the United States: improving the future of medicine. Washington, DC: A report jointly sponsored by the American Association of Colleges of Osteopathic Medicine and the American Osteopathic Association; 2005.
    1. Registro degli Osteopati Italiani [ROI] Code of professional conduct of Italian Osteopath. .
    1. Federazione Nazionale degli Ordini dei Medici, Chirurghi e degli Odontoiatri [FNOMCEO] Code of professional conduct of Italian Medical Doctors. .
    1. Outram S, Nair BR. Peer physical examination: time to revisit? Med J Aust. 2008;189(5):274–276.
    1. Chinnah TI, de Bere SR, Collett T. Students’ views on the impact of peer physical examination and palpation as a pedagogic tool for teaching and learning living human anatomy. Med Teach. 2011;33(1):e27–e36. doi: 10.3109/0142159X.2011.530313.
    1. O’Neill PA, Larcombe C, Duffy K, Dornan TL. Medical students’ willingness and reactions to learning basic skills through examining fellow students. Med Teach. 1998;20:433–437. doi: 10.1080/01421599880526.
    1. Chang EH, Power DV. Are medical students comfortable with practicing physical examinations on each other? Acad Med. 2000;75(4):384–389. doi: 10.1097/00001888-200004000-00020.
    1. Rees CE, Bradley P, McLachlan JC. Exploring medical students’ attitudes towards peer physical examination. Med Teach. 2004;26(1):86–88. doi: 10.1080/01421590310001642984.
    1. Power DV, Center BA. Examining the medical student body: peer physical exams and genital, rectal, or breast exams. Teach Learn Med. 2005;17:337–343. doi: 10.1207/s15328015tlm1704_5.
    1. Braunack-Mayer AJ. Should medical students act as surrogate patients for each other? Med Educ. 2001;35:681–686. doi: 10.1046/j.1365-2923.2001.00970.x.
    1. Rizan CT, Shapcott L, Nicolson AE, Mason JD. PPE: a UK perspective, ‘All for one, NOT one for all’. Med Teach. 2012;34(1):82.
    1. Barnette JJ, Kreiter CD, Schuldt SS. Student attitudes towards same-gender versus mixed-gender partnering in practicing physical examination skills. Eval Health Prof. 2000;23:360–370. doi: 10.1177/01632780022034651.
    1. Rees CE, Bradley P, Collett T, McLachlan JC. “Over my dead body?”: the influence of demographics on students’ willingness to participate in peer physical examination. Med Teach. 2005;27(7):599–605. doi: 10.1080/01421590500237671.
    1. Wearn A, Bhoopatkar H. Evaluation of consent for peer physical examination: students reflect on their clinical skills learning experience. Med Educ. 2006;40(10):957–964. doi: 10.1111/j.1365-2929.2006.02557.x.
    1. Rees CE, Wearn AM, Vnuk AK, Sato TJ. Medical students’ attitudes towards peer physical examination: findings from an international cross-sectional and longitudinal study. Adv Health Sci Educ Theory Pract. 2009;14(1):103–121. doi: 10.1007/s10459-007-9094-y.
    1. Chen JY, Yip AL, Lam CL, Patil NG. Does medical student willingness to practise peer physical examination translate into action? Med Teach. 2011;33(10):e528–e540. doi: 10.3109/0142159X.2011.599893.
    1. Das M, Townsend A, Hasan MY. The views of senior students and young doctors of their training in a skills laboratory. Med Educ. 1998;32(2):143–149. doi: 10.1046/j.1365-2923.1998.00182.x.
    1. Reid KJ, Kgakololo M, Sutherland RM, Elliott SL, Dodds AE. First-year medical students’ willingness to participate in peer physical examination. Teach Learn Med. 2012;24(1):55–62. doi: 10.1080/10401334.2012.641489.
    1. Wearn AM, Bhoopatkar H, Mathew TK, Stewart L. xploration of the attitudes of nursing students to peer physical examination and physical examination of patients. Nurse Educ Today. 2012. S0260-6917(12)00275-4. 10.1016/j.nedt.2012.08.012.
    1. Delany C, Frawley H. A process of informed consent for student learning through peer physical examination in pelvic floor physiotherapy practice. Physiotherapy. 2012;98(1):33–39. doi: 10.1016/j.physio.2011.04.347.
    1. Hendry GJ. Barriers to undergraduate peer-physical examination of the lower limb in the health sciences and strategies to improve inclusion: a review. Adv Health Sci Educ Theory Pract. 2012.
    1. Gale NK. From body-talk to body-stories: body work in complementary and alternative medicine. Sociol Health Iln. 2011;33(2):237–251. doi: 10.1111/j.1467-9566.2010.01291.x.
    1. Young K. Disembodiment: the phenomenology of the body in medical examinations. Semiotica. 1989;1/2:43–66.
    1. Wolkowitz C. Bodies at work. London: Sage; 2006.
    1. Consorti F, Mancuso R, Milazzo F, Notarangelo MG, Piccolo A. Acceptability among Italian medical students of Peer Physical Examination (PPE): validation of tools of measure and first results of a survey. Tutor. 2012;12(1):16–25.
    1. Blue AV, Crandall S, Nowacek G, Luecht R, Chauvin S, Swick H. Assessment of matriculating medical students’ knowledge and attitudes towards professionalism. Med Teach. 2009;31(10):928–932. doi: 10.3109/01421590802574565.
    1. Consorti F, Potasso L, Toscano E. L’idea di professionalità medica degli studenti di Medicina: rilevazione di base per uno studio di coorte [The concept of medical professionalism of medical students: basic assessment for a cohort study] Clin Ter. 2012;163(6):e377–386.
    1. Wearn AM, Rees CE, Bradley P, Vnuk AK. Understanding student concerns about peer physical examination using an activity theory framework. Med Educ. 2008;42(12):1218–1226. doi: 10.1111/j.1365-2923.2008.03175.x.
    1. Rees CE. The influence of gender on student willingness to engage in peer physical examination: the practical implications of feminist theory of body image. Med Educ. 2007;41(8):801–807. doi: 10.1111/j.1365-2923.2007.02779.x.
    1. Italian Institute of Statistics [ISTAT] Italia in cifre 2012 [Italy in figures 2012] : Rome: ISTAT Pub; 2012.
    1. Wilson M. Constructing measures: an item response modeling approach. Mahwah, New Jersey: Lawrence Erlbaum Associates Pub; 2005.
    1. Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported?Critique and recommendations. Res Nurs Health. 2006;29(5):489–497. doi: 10.1002/nur.20147.
    1. McLachlan JC, White P, Donnelly L, Patten D. Student attitudes to peer physical examination: a qualitative study of changes in expressed willingness to participate. Med Teach. 2010;32(2):e101–105. doi: 10.3109/01421590903202504.
    1. Rees CE, Wearn AM, Vnuk AK, Bradley PA. 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. Med Teach. 2009;31(10):921–927. doi: 10.3109/01421590802578244.
    1. Consorti F, Notarangelo M, Potasso L, Toscano E. Developing professionalism in Italian medical students: an educational frame work. Adv Med Educ Practice. 2012;3:55–60.

Source: PubMed

3
Suscribir