Syrian medical students’ acceptance of peer physical examination and its associating factors: a cross-sectional study

Abstract

Background This study aimed to evaluate the acceptance of Peer Physical Examination (PPE) in middle Eastern society with its associate factors, and PPE acceptance during Covid-19 pandemic. The acceptance of PPE is considered high in multiple studies carried out in the west, but there were nearly no studies investigating the acceptance of PPE in the middle east or low-income countries. Methods A questionnaire was shared through social media with students with focus on clinical-year students. A total number of 657 medical students were collected with a 74.5% response rate. The questionnaire gathered demographic information and recorded previous experience of PPE. A 5-point-likert scale was used to assess acceptance of PPE, factors affecting it, and the influence of COVID-19 pandemic. It also considered body’s areas students would accept to be examined. Associations between participants’ demographic and other details were tested using independent-samples T Test and other tests, and a p-value of < 0.05 was considered significant. Results Eighty percent of medical students accepted PPE, while 3% did not, and 17% were neutral. Males had statistically significantly higher acceptance rates of PPE (M = 3.94 out of 5). Also, females had lower acceptance of being examined by other gender than males but did not mind examining other gender. Furthermore, the groin area (thigh) was the most rejected area for examination (20% only accept it), followed by the breast (23%). There was no statistically significant difference between different Universities groups or between different academic performance groups, finally there was statistically significant effect of religion and society on acceptance of PPE and religion has affected females more than males (p- value = 0.002). 70.8% of students supported PPE during the COVID-19 pandemic, while 6.8% did not, and 22.4% were neutral. There was not a significant difference in acceptance and supporting of PPE during the COVID-19 pandemic between males and females. Conclusions With an 80% acceptance rate, PPE represents an effective alternative to the absent life models in Syrian universities. The application of PPE is less likely to go without difficulties, but authors suggest the presence of a supervisor and single-gender groups with friends paired together if possible.

Practicing Peer Physical Examination by Medical and Allied Health Professions Students: Why the Hesitation and Where are We Now? A Narrative Literature Review

“…In the last decade, the bulk of the available literature has focused on PPE in the medical college program. Some of these studies were conducted in different countries such as Australia, 11 , 32 Hong Kong, 17 Syria, 18 and other regions in an attempt to help identify different trends in practicing PPE in such extremely different areas.…”

“… 11 This is congruent with the research, which showed that same-sex pairing of students in examination sessions is preferable to matching students of different genders. 8 , 10 , 18 According to the authors, the outlook is a student self-estimation related to personal attitudes and beliefs, including consideration for religion and culture. The outlook of the respondents was divided into three categories: conservative, liberal, and average (the majority).…”

“…A Syrian study by Soqia et al 18 shed light on the acceptance of PPE and its related factors during COVID-19 at a wide range of universities, 12 in total. The study’s large sample can be considered a representative one with an acceptable response rate of 74.5%.…”

“…While performing peer physical examination can provide opportunities for learning and building essential skills in the pre-clinical years, students can face some obstacles which may happen due to the lack of skills or supervision during this practice. 17 These include students’ feelings of discomfort or embarrassment, especially when the examinees are exposed or undressed in front of their classmates during the examination, 2 , 18 and some sort of misbehavior or harm to examinees by some students or instructors. 2 Discovering unexpected abnormal findings during the examination of colleagues is low and approximate an incidence of 1.5% annually, thus, considering it an unimportant issue.…”

“…In general, these can include psychological barriers such as feelings of embarrassment, anxiety, and even sexual arousal by both genders, ethical issues related to privacy invasion, cultural norms among peers of different cultural backgrounds, religious considerations, body regions to be examined, and preconceptions about PPE. 10 , 17 , 18 , 23 , 24 …”