Dr. Crippen talks rectal exams

He remembers his first time and opines:

Medical students have to learn. Simulators are available, but they are not as good as the real thing. It is a difficult area. From what I hear from medical students, they get much less opportunity to do personal examinations than I did.

I do not know what happens nowadays to patients under anaesthetic. But the next time you are having an operation, perhaps you should ask if there is a queue of medical students waiting to explore your orifices.

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  • Gasman

    Simulation will not replace the real thing for some time. In any event, no matter how high of fidelity the simulation is, and how trained the student is, there is always a first time with a human. A student is not proficient in physican examination until he has done dozens, perhaps hundreds of the same so that he appreciates the range of normal from which he is supposed to differentiate abnormal.

    Simulation does have an substantially underutilized role today. Too much of my early patient interaction was spent trying to learn humane and respectful ways to deal with humans under stressful situations. Low stress repetition of the dialog and physicial interaction needs to be done with medical school peers and coached actors. The emphasis needs to be not so much on high fidelity, highly realistic settings, actors, and faculty critique out the wazoo, but low stakes and low stress repetition to allow each student time to find their groove. The high fidelity (expensive) low repetition method encourages stiff scripted behaviors for trainees. The cheap, low fidelity, high repetition practice allows trainees to finnd their own manner, and allows them to review and adjust their performance.

    Unfortunately educational systems and educators are enamored with the high tech systems.

  • ipanema

    I’m wary about what they do when one is on the operating table. When I went for a follow-up in the doctor’s clinic, the naughty doctor’s secretary assisted my orthopaedic surgeon remove stitches after my operation. I was lying face down and she purposely pulled my trousers way below. I could feel cold air fanning my butt…lol. My male doctor shooed her away.

    I experienced being examined when I went labour for my first born. I think there were 3 of them! The resident, a nurse and my doctor. I feel awful. I ended delivering thru CS operation. After that, I don’t like going to my OB/GYN. The last vaginal examination I had was when I went for my first and last paps smear.

    Apart from my OB/GYN and paediatrician of my children all my other doctors are male. I didn’t choose, it’s by referral.

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