«Gynecological examination» - a teaching video for step-by-step instruction for medical students

Objective In several European countries many students head abroad for an exchange in education during the main gynecology teaching period. The thought is that all students irrespective of exchange or not should have the same skills in gynecology examination when arriving home for the final practical exam. However, for several reasons, this has not been possible for some of the students. Hence, these students need extra teaching in practical skills and ask for extra teaching lessons. Since teaching resources at the medical faculty are scanty, and for wanting to be more up-to-date regarding teaching methods, we found that a step-by-step instruction video specially targeting a Nordic gynecological setting were needed. The aim of this study was therefore to make an instruction video targeting Nordic medical students, and to evaluate the process and the results afterwards. Study design We went through a process of planning: contacting the university´s multimedia center; reading available literature; watching existing instruction videos in gynecological examination technique on the internet or handed over from colleagues at other universities; arranging a meeting of teaching gynecologists to find what is being used at other universities; writing the film manuscript, including details in the procedures and how to exactly perform the examination, panel of instruments and equipment needed, and suitable area for recording; finding possible “actresses”; making an “informed consent letter”; and applying for funding for the project. A medical illustrator agreed to make suitable anatomical sketches, and an ultrasound specialist contribute with ultrasound videos to better depict the internal genitalia. Before recording, the manuscript and plan were accepted by several gynecologists teaching medical students. The recordings were performed by the same cameraman at a gynecological outpatient clinic and at the skills lab for medical students. A total of five movies were made: one showing basic gynecological examination techniques with inspection of the vulva/introital area, vaginal inspection using both the couscous and the sims speculum, how to perform cervical cytology and microbiology tests; the second showing practical urogynecological examination technique, including how to get use of the valsalva maneuver for uterovaginal prolapse and test for urinary stress incontinence; the third showing equipment used, how to perform endometrial biopsy and insertion of intrauterine contraceptive device on plastic models; the forth showing the pelvic floor muscles illustrated; and the fifth step-by-step forensic gynecological examination including the use of colposcopy for inspection of the external genitalia. Final editing and extra English talk together with the cameraman. Results Although there was a lot of preparations, work with the recordings and editing afterwards, the process of making the film was entirely positive, both for the “actresses”, the cameraman and for the teaching gynecologist. Surprisingly, getting access to women willing to participate as models or “actresses” was not as hard as expected. The most important, some of them said, was that their integrity and anonymity was respected. The aim of the project and the importance of medical students getting the best suitable education, was also important reasons to participate as “actress”, another woman said. After publishing the videos the medical students in gynecological term have entirely appreciated the videos. They have found them useful when watching them before practical clinical teaching. They acknowledge that the instructions are shown on a real woman and not a plastic model only. Since, the videos have been demanded by other universities and teaching institutions, including for use in the planned Nordic electronic textbook, we immediately