Peer physical examination: time to revisit?

Outram, Sue; Nair, Balakrishnan R

doi:10.5694/j.1326-5377.2008.tb02026.x

Cited by 26 publications

(39 citation statements)

References 12 publications

(19 reference statements)

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“…To be able to develop the manual therapy skills to become a registered osteopath in Australia, students undertake carefully scaffolded and supervised practice throughout their course. Students require full information about what is expected of them before they enrol and explanations about the benefits of participating in PPE need to be made clear [ 4 , 30 ]. However, some students may not wish to participate in a particular PPE activity, or may place conditions on their participation [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The University of Queensland Medical School [ 31 ] called for development of such guidelines in medicine. In osteopathy and other health sciences, guidelines for good practice are likely to include: obtaining informed consent from students before they participate in PPE [ 4 , 30 ]; telling students what to expect in practical classes before they commence their courses [ 6 , 30 , 32 ]; facilitating discussions about ethical, cultural and professional issues associated with PPE (e.g. therapeutic touch vs sexual touch; body image; age, gender, cultural influences on willingness to participate in PPE); allowing students to choose who they practise with; and offering alternatives to students who choose not to participate [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…telling students what to expect in practical classes before they commence their courses [ 6 , 30 , 32 ];…”

Section: Discussionmentioning

confidence: 99%

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Perception of peer physical examination in two Australian osteopathy programs

Vaughan

Grace

2016

Chiropr Man Therap

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BackgroundPeer physical examination (PPE) is an efficient and practical educational approach whereby students can practise their examination skills on each other before commencing clinical practice with actual patients. Little is known about the use of PPE in osteopathy education.MethodsStudents in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) completed the Examining Fellow Students and the Peer Physical Examination questionnaires prior to, and at the completion of, their first 12-week teaching session. Descriptive statistics were generated for each questionnaire. The McNemar and sign tests were used to evaluate differences between each questionnaire administration. Logistic regression was used to evaluate the influence of demographics on responses to both questionnaires.ResultsResults showed that students in both programs were generally willing to examine non-sensitive areas both before and after the 12-week teaching session. Students’ were less apprehensive about PPE at the end of the teaching session, and this was reinforced by results for previous exposure to PPE in other courses. Consistent with previous studies, unwillingness to participate in PPE was associated with being female, being born outside Australia, holding religious beliefs, and being older.ConclusionsThis is the first study to explore students’ perceptions of PPE in this cohort and provides a basis for further work, including evaluating longer term changes in student perception of PPE, and whether these perceptions extend to practising manual therapy techniques. This study demonstrates that perceptions about PPE reported in medicine and other disciplines, namely that unwillingness to participate in PPE is associated with being female, being born outside Australia, holding religious beliefs, and being older, also apply to osteopathy. These findings are significant for all manual therapy students who spend a substantial portion of their course developing skills in PPE and practising manual therapy techniques. They highlight the need for curriculum development that acknowledges the importance of good practice in PPE, including discussions about body image, feedback skills training for educators, and providing detailed information to students about what to expect in practical skills classes before they commence their course.Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-016-0102-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Perception of peer physical examination in two Australian osteopathy programs

Vaughan

Grace

2016

Chiropr Man Therap

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“…Some centres have a formal approach to consent and others provide some guiding principles . The practice of PPE is now well established and accepted, but there remains some concerns around the processes employed by individual programmes . The issues that cause concern are around student choice, the responsibilities of the institution, incidental abnormal findings, confidentiality and other aspects of professional behaviour.…”

Section: Introductionmentioning

confidence: 99%

“…Identifying previously unknown abnormalities has been a continuing concern for educators in relation to PPE . Braunack‐Mayer was concerned about novice peers being unable to identify when a finding is abnormal, but this is managed by having good supervision.…”

Section: Introductionmentioning

confidence: 99%

Abnormal findings in peers during skills learning

Wearn

Nakatsuji

Bhoopatkar

2016

The Clinical Teacher

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The low event rate, along with a feasible process for dealing with this issue, goes some way to reassuring those with concerns. We acknowledge that some abnormalities may have been missed, and that some data may have been lost as a result of incorrect process; however, even the highest annual rate is low in absolute terms. We recommend a formal process for managing abnormalities. Ideally this would be part of an overall PPE written policy, communicated to students, enacted by tutors and approved by the local ethics committee.

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Barriers to undergraduate peer-physical examination of the lower limb in the health sciences and strategies to improve inclusion: a review

Hendry

2012

Adv in Health Sci Educ

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Peer-physical examination is a widely adopted and an integral component of the undergraduate curriculum for many health science programs. Unwillingness or perceived inability to participate in peer-physical examination classes may have a negative impact upon students' abilities to competently conduct physical examinations of patients in future as registered health professionals. A literature review on the perceptions and attitudes of peer-physical examination of the lower limb amongst medical and health science students was conducted to identify potential barriers to participation, and to review strategies to improve participation in classes designed to develop clinical examination skills. A pragmatic search strategy of the literature from PubMed and Google Scholar published prior to June 2012 yielded 23 relevant articles. All articles were concerned with the views of medical students' education and there were no articles explicitly addressing the role of peer-physical examination in health science disciplines. Several ethical issues were identified including feelings of coercion, embarrassment, and perceptions of a lack of consideration for cultural and religious beliefs. The available evidence suggests that barriers to participation may be overcome by implementing standard protocols concerned with obtaining informed written consent, adequate choice of peer-examiner, changing facilities and garment advice, and possible alternative learning methods.

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Peer physical examination: time to revisit?

Cited by 26 publications

References 12 publications

Perception of peer physical examination in two Australian osteopathy programs

Perception of peer physical examination in two Australian osteopathy programs

Abnormal findings in peers during skills learning

Barriers to undergraduate peer-physical examination of the lower limb in the health sciences and strategies to improve inclusion: a review

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