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Frontier Clinical Bound

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I am thinking about going to Frontier for nurse midwifery next year but am concerned about the clinical bound portion of the program. I read on Frontier's website that students give and receive pelvic exams. I am assuming that this means you will give and receive these during clinical bound. Can any Frontier students or previous graduates tell me your experience with this. It's not that I mind getting a pelvic exam, but it's a little unnerving around your peers.

Thanks for any feedback

THis does happen at Frontier but not at Frontier Bound. Frontier Bound is the orientation session that lasts 4 days. Then you do course work for 12-18 months (depending if you are full-time or part-time) and then you come to campus for an 8 day skills session with a smaller group before you start clinical. Here students do physical exams including pelvic exams on each other, not really as bad as you think and anyone who really opposes this does not have to have one done on themselves (although they do have to do one before starting clinical). The philosophy is that you can leanr alot both ways (having one done and doing one).

I hear that students have to practice pelvic exams on each other in every program, not just Frontier.

I hear that students have to practice pelvic exams on each other in every program, not just Frontier.

I think it's true for most program although I think a few hire women to a t as models.

I know Columbia does this for sure but was unsure about Frontier. Midwyf what do you mean students have to do one before they can start clinical? Does it have to be on a mannequin or another student? My main concern for this practice is student who have a history of sexual abuse or a sexually transmitted disease. I realize midwifery student are primarily women, but what about male students? I have also never heard of medical students or ob residents practicing on each other and I think this would be considered sexist if they "forced" female students to participate. I don't think the philosophy applies to this situation, because most women have had pelvic exams in the past and know what a pelvic feels like. (Same thing with shots, iv sticks, etc) That's what the Sim man is for. Let's not forget that these are still our bodies and we are practicing medical procedures that are medically uneccessary. I think most midwife students go through with this because they are too afraid to stand up for themselves. In my opinion this practice is outdated and completely unethical. We pay enough for school that they should be able to hire "models" or gynecological teaching assistants.

If you don't go into midwifery with a compassionate attitude to begin with than you shouldn't be in the profession. No one can make you compassionate and caring to patients if you are not compassionate and caring:angryfire.

zahryia, LPN

Specializes in L&D, QI, Public Health.

I know Columbia does this for sure but was unsure about Frontier. Midwyf what do you mean students have to do one before they can start clinical? Does it have to be on a mannequin or another student? My main concern for this practice is student who have a history of sexual abuse or a sexually transmitted disease. I realize midwifery student are primarily women, but what about male students? I have also never heard of medical students or ob residents practicing on each other and I think this would be considered sexist if they "forced" female students to participate. I don't think the philosophy applies to this situation, because most women have had pelvic exams in the past and know what a pelvic feels like. (Same thing with shots, iv sticks, etc) That's what the Sim man is for. Let's not forget that these are still our bodies and we are practicing medical procedures that are medically uneccessary. I think most midwife students go through with this because they are too afraid to stand up for themselves. In my opinion this practice is outdated and completely unethical. We pay enough for school that they should be able to hire "models" or gynecological teaching assistants.

If you don't go into midwifery with a compassionate attitude to begin with than you shouldn't be in the profession. No one can make you compassionate and caring to patients if you are not compassionate and caring:angryfire.

I hope this is not your main concern-as you stated several reasons- for not wanting to do this, because your population will certainly comprise of women with histories of sexual abuse/assault and/or STDs. I don't care if your practicing in the 'heartland' (can't stand that term), upscale areas or the hood. It happens everywhere.

Having said that, I happen to relate to your angst about this process. I'm not crazy about it. I don't like people 'practicing' on my vagina. As it is, I'm not crazy about pelvic exams with experienced providers; much less students.

Reminds me of when I was in cliinical and I refused to get a fingerstick from other students, but I was more than happy to do them on my classmates. My instructor wasn't happy with me, but oh well.

I understand that the population of women will consist of women with stds or sexual abuse which are extremely vulnerable. I do not agree with causing these women more trauma then what they have already experienced. Making them go through a pelvic exam without the privacy of their trusted healthcare provider (not fellow students) when it is medically uneccessary is not acceptable to me. This causing more harm then good in my opinion. I also do not think it is fair to women (from a feminist standpoint) because men would never have to do these type of procedures on each other.

I understand that the population of women will consist of women with stds or sexual abuse which are extremely vulnerable. I do not agree with causing these women more trauma then what they have already experienced. Making them go through a pelvic exam without the privacy of their trusted healthcare provider (not fellow students) when it is medically uneccessary is not acceptable to me. This causing more harm then good in my opinion. I also do not think it is fair to women (from a feminist standpoint) because men would never have to do these type of procedures on each other.

I have been having trouble understanding your posts and what your point is. Are you referring to other students with whom one must practice pelvic exams as the"population of women will consist of women with stds or sexual abuse which are extremely vulnerable"? Do you personally have a history of STIs or sexual abuse and do not want to have other students perform an exam on you? Any STI should be treated, anyway, unless one has herpes that can flare up, say, unpredictably under stress. I would think any student with active herpes has an absolute right to refuse an exam and would not have to go into detail with the instructor.

When I was at Clinical Bound (CB) there were a few students who did not have exams done on them. Several women had had hysterectomies and had no cervix, so they were excused. If a student had a real objection to being examined, one could refuse. I refused a physical exam at the checkoff because I have other physical issues I did not want exposed to my classmates for potential ridicule, but the pelvic did not bother me so much, so I volunteered for an extra one.

What do men have to do with this? There were no male students at my CB. Are you referring to the fact that if there are male students they get to perform exams on their female classmates, but they do not likewise have to have an exam from the women in the class?

We discussed this at CB and tended to agree it is not fair. I might have refused to let a male examine me, but it did not come up. It is true Frontier does not pay gyne teaching associates and I feel they should.

I agree that if you are not comfortable with doing this that you should not be forced to do it, but it does sound like they are understanding of those who choose not to have it done. Personally I do not have a problem with it and welcome the learning experience. I think it is a great learning opportunity for me and my classmate. I can give feedback to her and have an open dialog of what is happening and visa versa. I don't think anyone should make this the determining point as to what school you attend since it can be refused. Choose a school who's mission and philosophy's mesh best with yours, knowing that there may be some things that you feel differently on. Good luck in choosing your path.

Sorry, let me clarify a little. I just feel like students with a history of an STD or sexual abuse should have the right to refuse just because the experience itself might be traumatizing for them emotionally. Frontier's handbook made it sound like it was a mandatory thing before begining clinicals. If it is strictly optional than I think that is fine and would be a great learning experience. My post was based strictly upon REQUIRED pelvic exams. I have heard some schools like Columbia require this. Here is the forum on allnurses that talks about male student going to the hospital and females being required to practice on each other.

https://allnurses.com/forums/f223/columbia-university-etp-2008-a-257838-36.html

There is also a documentary call At Your Cervix, that identifies this as an issue in colleges. The documentary also talks about medical students doing exams on anesthesized women which is completely unethical. http://www.atyourcervixmovie.com

I just think that women should have the right to choose whether or not they participate in this experience and I wanted to get feedback on others who have done this while attending Clinical Bound.

As far as male students, I was just stating that it wouldn't be fair to require female students to practice on each other, while male students go to the hospital, etc.

Another point I was trying to make was that if it was required than I would reevaluate what schools I want to go to.

Thanks for all the feedback. I am glad to hear that the process is voluntary.

Baby Catcher, CNM

Specializes in OB/GYN. Has 15 years experience.

This is how it works at Frontier. You and a partner of your choice go into an exam room with an instructor. You each do a pelvic exam on each other. No big deal. If you don't want to let someone do an exam on you, don't, but then you may not find someone to let you practice on them which is a requirement to pass clinical bound. To a mature adult female it's no big deal. If this is such an issue, you may not be ready for midwife school.

I don't think it is a question of maturity or not. I think it has to do with being the one in charge of your own body and not accepting less. I will not exploit my body for teaching purposes. I am actually shocked at how many women would just lay down and do this without any objections. I guess this just proves that women really are still considered the weaker sex and sexist practices are still being used. As i said before this would never be accepted in medical schools or schools with more men. Men would not agree to practice catheters or prostate exams on each other. If you can't speak up for yourself on issues like this then how can you ever advocate for your patients who are extremely vulnerable. How will you (as a midwife) ever sympathize with women like me who find pelvic exams to be humiliating and traumatic. Midwifery should be about empowering women not continuing to support the belief that the "norm" in our society should be passive, voiceless women.

... As i said before this would never be accepted in medical schools or schools with more men. Men would not agree to practice catheters or prostate exams on each other. If you can't speak up for yourself on issues like this then how can you ever advocate for your patients who are extremely vulnerable. ... .

You have an excellent point here. Medicine has more prestige because it is male-dominated, and midwifery, which is classified as advanced practice nursing in the USA, has less prestige being a female-dominated profession, and associated closely with nursing. I was a gyne teaching associate a long time ago and taught med students how to do pelvics on me (before I went into health care). The female med students might have practiced on each other -- I never heard of it. Probably not but maybe they do sometimes, to improve their technique. If so, it is voluntary and private, not mandated by the school.

I think most midwifery schools do hire gyne teaching associates. They certainly teach much more thoroughly than what we got at Frontier. They are able to critique your technique as you perform an exam on them. This doesn't happen with two students practicing on each other.

The only reason why I can guess Frontier does not hire them is because they don't want to spend the money, or possibly they can't find any to travel to Hyden, KY.

I did not like the fact that at least one faculty member saw my body without clothes. I wouldn't mind practicing with students so much, but the faculty watching crossed too many boundaries for me. Thankfully it was over in one afternoon, and I did volunteer more than once, despite my feelings.

I think any of us with sensitivity and compassion can advocate for our pts and help those with traumatic histories, just as you don't have to have had a baby to be a midwife or OB, or have had a chronic illness or surgery or tragedy to empathize with those who suffer. But those women who have been sexually traumatized can tell the rest of us what helps and what hinders performing such exams, and how can we do them in such a way to cause as little trauma as possible?

Penny Simkins has a book out about caring for women in childbirth with a history of sexual abuse. Have you read that? There are articles about it, too, although they are no with me right now so I can't give you information. Maybe you could offer to give a short talk at clinic bound at Frontier about how to approach a woman with a history of trauma, instead of letting someone examine you.

Selke thanks for your post. I am glad at least one person can understand my feelings. I just don't think it is acceptable for midwifery schools to require this. Sure we can all get through this, but it is really necessary. Gynecological Teaching Assistants seem so much more effective because these women are trained like you said to teach the skill effectively and critique students. I can't see how much could be learned on the opposite spectrum when both students practicing in front of an instructor are already embarressed and uncomfortable. It's not ok for Frontier not to use GTA's just because they don't want to spend the money. Students pay a lot for tuition.

I will have to read the book you suggested. It seems very informative for those of us study to become midwives. Something like 1 in 3 women have suffered sexual abuse so this would be very helpful.

Journey_On, BSN, RN

Specializes in Occupational Health. Has 11 years experience.

It has been interesting to read both sides of this issue - both are very logical.

I found the book by Penny Simkins. It is called When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on Childbearing Women. Thank you for mentioning it, Selke. I think it is an important thing to consider when working with women, considering the statistics.

Yes Jamie, at Frontier anyone has the right to refuse to have a pelvic done on them. There are students with issues and everyone is told at the beginning that if they object and do not want to participate, they should tell the instructor.

Dr. Tammy, FNP/GNP-C

Specializes in ER; CCT.

I think most midwife students go through with this because they are too afraid to stand up for themselves. In my opinion this practice is outdated and completely unethical. We pay enough for school that they should be able to hire "models" or gynecological teaching assistants.

If you don't go into midwifery with a compassionate attitude to begin with than you shouldn't be in the profession. No one can make you compassionate and caring to patients if you are not compassionate and caring:angryfire.

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I just returned from clinical bound, and I know this topic was from a few months ago, but if anyone is still reading and considering Frontier, this may help you out. The pelvic exam portion is completely non-confrontational, there is a video playing, the lights are dimmed, there are exam rooms, part of the class is practicing pap smears on a model, part is practicing the pelvic exam on a model. By the time the course is over, no one knows who has had a pelvic done on them, and who has done one; this makes it almost completely anonymous except for you and your partner. I chose not to have the pelvic done on me, yet I had a classmate that offered to let me do one on her. Take my advice as someone who has been a victim of sexual abuse, it is a completely stress free environment. You are not made to say "I don't want to do this," there is no singling out.

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