Undressing for clinical skills lab

[edgesofsanity]

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yOU Should feel lucky that they are not letting your classmates practice breast and rectal exams on each other.

Yeah, but the OP should feel unlucky that they're still doing clinical skill practice on their classmates 2.5 years after they started.

 

[wiryMD]

I dont understand what the big deal is.

All you have to do is take off your shirt (guys) or wear sports bra (women). You dont have to do any pelvic, rectal, or genital exams, so you wont have to get into your underwear at all.

I thought the only thing you did in these labs were:

1) listen to heart
2) listen to lungs
3) maybe palpate abdomen
4) look at ears
5) look at eyes
6) look at throat/mouth

What else do you do besides those things? Taking off your shirt is no big deal and I have yet to hear of a school that makes YOU do the pelvic exams on each other instead of using a paid volunteer.

I dont see why even the women would be sensitive about this. They're not grabbing breasts or practicing mammograms they're just putting the stethoscope on your chest.

I'm with ya, it's a little ackward at first, putting on the sports bra that that is....... 😉 No reason to fret, the only pelvic exams ever done involved whiskey and an infectious disease final exam. Get used to touching other people, your gonna be doin it for a while.

 

[wiryMD]

This whole thread is really quite surprising. I have friends at a number of top-ranked MD schools and none of them have examined one another in their clinical skills classes. My school does not do this either. To those saying it is not a big deal -- I think that would be a minority opinion. Not only is it very UNprofessional to be undressing in front of your future colleagues, but it is completely unnecessary. We may need to get used to various states of undress in our patients, but not in our colleagues. This must be a pretty new phenomenon at those few schools represented in these posts. I am sure that physicians who are now practicing did not learn this way -- especially in coed groups.

At my school, we were chastised for wearing bikinis to our beach parties. There is no way they want us to be interacting on that level in a school environment. This is coming from a very liberal school in a liberal state where scant clothing is the norm.

praying4MD -- very good point. I am sure there are many more people like this, who would suffer from such an ordeal. I am glad that most schools have more sense than to parade their doctors and students around in their underwear.

I must disagree here, I go to a catholic institution (conservative 😀 ) and we did exams on each other week 1. I think it would be nice if more schools did such things. We had small groups of 3 people, and would proceed to do simple exams on them, one part of a standard physical each week. I don't see how you get proficient at it without practice. And why not practice on people that you are comfortable with, who probably are having the same problems you are. And in fact it is not a new phenomena, ask an older physician, and they'll probably tell you some odd story about having to palpate their friends liver..... It's better to make a mistake when doing an exam on your classmate than to do so on a patient.

 

[ddmo]

As future physicians I think everyone needs to rise above their insecurities. Your patients will feel the same way when you do it to them, so put yourself in their shoes a couple times.

 

[Bigsheed920]

I think to rationlize the whole process of undressing by saying it will help you feel what the patient feels is total bull. I mean you probably have enough of that expreience with your own doctor as a patient. Not everyone is comfortable with their body and for many their religion and culture does not allow them to show their body. To undress in front of people you will be good friends with is not the best idea in the world. There should always be options for everyone though. The students who want to practice on one another should be allowed to. For others, the medical schools should have paid people ready. Just my 2 Cents.

 

[UTCobra]

My school as far as I know does not do anything like this. We always use standardized patients.

BUT, we are tested over our clinical skills while only seeing a standardized patient for each type of exam once. SO, many of my classmates got in small groups of a few guys and a few girls (usually good friends) and practiced the clinical exams in someones apartment. Guys usually just went shirtless for practice. As for the females in the groups depending on what was being examined, it would be under shirt over bra, shirtless w/ bra, or topless but draped with a towel. No who-has or wee-wees for anyody though 😉

Just have to be mature about it.

Also concerning the "Hooking up with classmates thread," Doing a practice physical exam on a classmate is alot easier is you have already seen her breasteseses. Less likely to be distracted if you've already seen them.

 

[nabeya]

That sounds hot. 😍 At my school they bring in "trained" patients in once a week so that we can practice on them.

My school as far as I know does not do anything like this. We always use standardized patients.

BUT, we are tested over our clinical skills while only seeing a standardized patient for each type of exam once. SO, many of my classmates got in small groups of a few guys and a few girls (usually good friends) and practiced the clinical exams in someones apartment. Guys usually just went shirtless for practice. As for the females in the groups depending on what was being examined, it would be under shirt over bra, shirtless w/ bra, or topless but draped with a towel. No who-has or wee-wees for anyody though 😉

Just have to be mature about it.

Also concerning the "Hooking up with classmates thread," Doing a practice physical exam on a classmate is alot easier is you have already seen her breasteseses. Less likely to be distracted if you've already seen them.

 

[stinkycheese]

As future physicians I think everyone needs to rise above their insecurities. Your patients will feel the same way when you do it to them, so put yourself in their shoes a couple times.

I disagree with this viewpoint. When I go to my doctor, I may be slightly embarrassed to disrobe, but she's my doctor, and that's the nature of our relationship. However, it is entirely different when these are your colleagues. I want to have a professional relationship with my classmates, and that doesn't include wearing a bikini in front of them, which I would be completely uncomfortable with. If my school has these types of "practice on each other" classes, I will probably not participate in any sort of undressing required. I find it wholly unprofessional and inappropriate.

 

[Slippery Pete]

If my school has these types of "practice on each other" classes, I will probably not participate in any sort of undressing required. I find it wholly unprofessional and inappropriate.

i dont think ur gonna have a choice dude

its either participate or fail...

i could be wrong though

 

[8744]

I have not read the whole thread so pardon me if this has been said:

The requirement to do pelvics, DREs and other invasive exams on classmates is an urban myth. You will not have to stick a speculum or your finger in anybody in your class, period.

To learn how to do a pelvic, for example, on your OB-Gyn rotation you will probably observe your resident do a few at which time he will let you try your hand. Believe it or not it is a rare patient at a teaching hospital who will object to even this.

As for Digitial Rectal Exams, when you do surgery or medicine your resident will just tell you to go do one. The first one you do will fell kind of akward but after a few it will be nothing, just another skill.

It is true that you may do a few "surface anatomy" exercises with your classmates but you will not touch anybody's breasts, genitals or any other spot which would make anybody uncomfortable.

We did practice drawing blood once from each other but that was it. Occasionally the professor will ask for a volunteer to demonstrate some exam skill but this is voluntary. If you don't want to be touched by your professor or classmates this is perfectly acceptable.

Because you are expected not to be squeamish about other people's bodies does not mean you are expected to discard your own modesty. When you examine a naked patient you do not strip nude yourself to make him feel more comfortable.

Jeez, folks, stop scaring the new people.

 

[8744]

I must disagree here, I go to a catholic institution (conservative 😀 ) and we did exams on each other week 1. I think it would be nice if more schools did such things. We had small groups of 3 people, and would proceed to do simple exams on them, one part of a standard physical each week. I don't see how you get proficient at it without practice. And why not practice on people that you are comfortable with, who probably are having the same problems you are. And in fact it is not a new phenomena, ask an older physician, and they'll probably tell you some odd story about having to palpate their friends liver..... It's better to make a mistake when doing an exam on your classmate than to do so on a patient.

I'm not going to dispute you, but believe me, you will have plenty of opportunity to get proficient at physical exam skills during third year on real patients.

 

[stinkycheese]

i dont think ur gonna have a choice dude

its either participate or fail...

i could be wrong though

I doubt it. If a medical school used threats of failing someone if they didn't undress, that could actually be considered a form of sexual harassment. (Male or female students, doesn't matter.) To force someone to strip to their underwear and be examined by their peer could, in some cases, be construed as sexual or physical assault. Remember, surgeons get permission from their patients to do what is technically, mutilation and assault of the body. Even though it is in the name of progress and healing, we must never forget as clinicians that we don't have the right to touch anyone against their will. The same goes for our own freedom to refuse being touched or to refuse being semi-nude in front of classmates. Forcing a student to act as a patient violates their rights as that patient, even when just pretending, and there are even potential HIPAA issues here if a peer found an abnormality on exam.

I doubt any MD school in the country would threaten a student with failure if they did not want to participate in these activities. I trust in the fairness of the LCME and the individual schools.

 

[musiclink213]

i think my problem might not be one of being in a sports bra (frankly, i'm personally not that modest, especially after having lived in france for some time) but i think i would be more ticklish if anyone touched me. if anyone so much as comes near me with their fingers, i start to feel ticklish before they'd even touch me. even when i was in the ER for an appendectomy (sp?) i kept laughing every time they tried to feel my stomach. i think i may have been a "difficult" patient because of that.

 

[Kimmer]

After practicing physical exams on both patients and my classmates I think it is much weirder to work on classmates. Patients are a little more ticked if you screw up but you generally don't have outside history or drama with a patient percolating through your head as you prod him or her. Of course ideally we would not have drama with any of our classmates (this is a v. bad idea) but who doesn't have someone in their class they would rather not be partnered with for such exercises? I had some poor luck with my first random assignment for practice on the heart. I was bright red and shaking. Not professional at all. I find it less weird to be practiced on actually. Sports bra and all.
I am not the only one either. I have seen a few people sweat like a mad fiend when examining specific people. It is good in general though. I learn a lot from the physician who oversees the class and in the last few months we have learned to suck it up and be grown – ups. As for hiring standardized patients to come in all the time, I think my tuition is expensive enough without that. They get paid a lot from what I hear.

 

[Madhatter]

does anyone know if UF makes its students undress for these sessions???

 

[Samoa]

I think this is more an issue of teaching variability than of professionalism. If you plan to practice in a small town, you're going to have history and external dealings with your patients, so I don't think that argument really holds any water. What I think does matter is that students are taught in a reproducible manner, so that they each get the same quality of teaching, and are held to the same standard of performance of that skill. Any class where you learn on each other is not going to provide that.

My school uses standardized patients for the whole first two years. We never practice on each other, and frankly I prefer that. Not because of any discomfort I might feel in examining a classmate, but rather because the standardized patient knows exactly what I'm supposed to be doing, and will tell me if I don't do something quite right.

That particular thing was a big selling point for me when I came to interview. My PharmD program had a physical assessment course where we practiced on each other, and my biggest gripe about it was that there was no way my classmate would know if I did something completely wrong. Yes, we had supervision, but they were trying to supervise 15 people at once, and they could easily miss something. The way my med school does it, I feel confident that I've learned all the exam maneuvers correctly.

 

[lotanna]

I dont understand what the big deal is.

All you have to do is take off your shirt (guys) or wear sports bra (women). You dont have to do any pelvic, rectal, or genital exams, so you wont have to get into your underwear at all.

I thought the only thing you did in these labs were:

1) listen to heart
2) listen to lungs
3) maybe palpate abdomen
4) look at ears
5) look at eyes
6) look at throat/mouth

What else do you do besides those things? Taking off your shirt is no big deal and I have yet to hear of a school that makes YOU do the pelvic exams on each other instead of using a paid volunteer.

I dont see why even the women would be sensitive about this. They're not grabbing breasts or practicing mammograms they're just putting the stethoscope on your chest.

you do have to move the breast over somewhat to do a good cardiac/lung exam
we are in small groups and we pair off, seems like they sort of divided our groups into people that would feel comfortable with each other like I was in a group with like 2 of my closest med schl buddies, and other friends

 

[bulldogs]

Oh this class (when I did show up) was a joke. Might as well be balls-azz naked. Its just an opportunity for the good lookin ladies to strut their stuff while the class hags looked for a place to hide.

 

[OhFace]

Since I used to take women's clothes off as part of my job, I'm quite the professional at doing it.

The only problem I've run into is that the girls in my class are in such awe of my manhood that clinical skills runs a little over the scheduled block time, if you know what I mean.

I am looking at our timetable and in a few weeks time we start clinical skills lab. It looks like we will be in groups of about 8 and we practise examining various systems on each other, and also some procedures such as EKG. The handbook suggests wearing swimsuit tops for us females.

I find the concept a little uncomfortable and I'm just wanting to hear from fellow med students who have been through it all.

How do you try and maintain 'professionalism' while examining their classmates? Do you really learn a lot from examining 'normal' people?

 

[OhFace]

Tru dat on the hags. Most med school women, if not all, are pretty much hags anyways. I would rate a few of them 6, maybe 7 on a real world scale. Funny thing too is that they become less attractive to men as they get further along in their education: on call doughnuts and the cynicism of not having kids til they are in their 30's begins to hit.

Oh this class (when I did show up) was a joke. Might as well be balls-azz naked. Its just an opportunity for the good lookin ladies to strut their stuff while the class hags looked for a place to hide.

 

[Obedeli]

Hey Holden Caufield (aka bulldog - better yet bull***t)

Hasn't the taxi picked you up yet or are you taking the midnight train?

 

[bulldogs]

Hey Holden Caufield (aka bulldog - better yet bull***t)

Hasn't the taxi picked you up yet or are you taking the midnight train?

Hey big boozehound, Im somber today, no booze left and my head hurts. The cab cost us $18 each way last night for a $36 cab fair total. But hey at least its alot cheaper than a DUI. 👍