Learning Intimate Exams

[ethics&modesty]

I work as a male urological teaching associate. I use my body to teach students to find all of the physical landmarks to do a complete exam including inguinal lymph nodes, hernia, testicular cancer, STD's, locate the epididymus, vas deferns, femoral pulse and a DRE. The sessions usually have 4 students at a time.

What can I do to make a student's first intimate exam of a male to be less stressful?

What information would be most helpful to have prior to the exam?

Should there be a lecture or a video demonstration prior to the actual exam?

Would it be helpful to have the urogenital teaching associate meet with the class prior to the session to discuss crossing social and religious taboos, ethics and modesty?

Does being in a session with students of the same gender or mixed gender matter?

What questions you would like answered that you might feel embarrassed to ask in public?

[guest82]

I have conducted several sessions as a MUTA over the past six months. It's weird to admit this, but these sessions were so rewarding that I have really enjoyed doing it. As soon as we start a session in earnest, I quickly forget that I am nearly naked and that the students are inspecting and palpating me in the pelvic region. The medical students and the nurse practitioner students have consistently been friendly, respectful and totally engaged. I couldn't feel more comfortable, and they do not appear to feel at all awkward either. At the end of each session, usually with three students, they have never failed to thank me for volunteering for this work. I am looking forward to being invited to conduct more MUTA sessions.

[banterings]

While these sessions focus on the technical aspects of the exam and to a lesser extent patient comfort, the sessions all start out with the ASSUMPTION of consent.

Many times other providers are brought into a room by an attending (such as to cath) and consent is assumed. It is common practice to coerce patients into unpleasant procedures (such as requiring PEs for oral contraceptives).

Reference: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Access-to-Hormonal-Contraception?IsMobileSet=false

Another term that is missing here is "trauma informed care." For those of you not familiar with this term, I suggest that you learn it. This is the new standard for healthcare, failure to do so can cause psychological harm.