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At least 19 recordsLinked to original sources
PubMed1990

Incorporating endovaginal ultrasonography into the overall gynecologic examination.

Previously endovaginal ultrasonography was considered an adjunct for use in full-service ultrasound facilities by subspecialists only. The technique, however, has tremendous application for use by the clinician in the examination room for patients at bimanual examination. This is because the procedure is meant to be performed with an empty urinary bladder. It requires very little time once the operator is adequately trained. It provides excellent resolution despite high degrees of magnification. This allows for a distinction between a traditional ultrasound examination and this new concept of examining gynecologic patients with vaginal probe ultrasonography as a part of the routine overall gynecologic examination. Methodology and philosophic issues arising from such a concept are discussed.

Female↗
PubMed2002

Medical licensure examination scores: relationship to obstetrics and gynecology examination scores.

OBJECTIVE: We studied the correlations between both Step 1 and Step 2 of the United States Medical Licensure Examination (USMLE) and the National Board of Medical Examiners Obstetrics and Gynecology Examination (NBME-OB/GYN). METHODS: From July 1994 until June 2001, all third-year medical students at Texas Tech University Health Center at Amarillo were studied. The scores from the first attempts for the three examinations were obtained. We investigated for correlations between the examination scores and the score extremes. RESULTS: A total of 258 students were evaluated. The mean USMLE Step 1 score was 203.7; mean score for Step 2 was 205.0. The NBME-OB/GYN final examination was 86.0. We found linear correlations between the NBME-OB/GYN and the USMLE Step 1 (r =.463, P <.001) and USMLE Step 2 (r =.595, P <.001), as well as between the USMLE Steps 1 and 2 (r =.666 P <.001). Students failing the USMLE Step 1 were more likely to fail their USMLE Step 2 (relative risk [RR] 9.3 [95% confidence interval (CI) 2.1, 41.0]) and/or the NBME-OB/GYN (RR 3.3 [95% CI 1.03, 10.8]). Students scoring in the lowest 25th percentile of the NBME-OB/GYN were more likely to fail the USMLE Step 2. CONCLUSION: Both USMLE Steps 1 and 2 correlated with the NBME-OB/GYN scores, as well as with each other. Students failing either the USMLE Step 1 or NBME-OB/GYN were more likely to fail the USMLE Step 2. The use of this information could predict students at risk for low scores on future examinations.

Educational Measurement↗
PubMed1986

Medical students' gynecologic examination skills. Evaluation by gynecology teaching associates.

In the past it was assumed that medical students would be able to perform an adequate pelvic examination by the end of the third-year clinical clerkship. At the University of Virginia, students completing the clinical clerkship were evaluated by trained gynecology teaching associates (GTAs), acting as patients and chaperones, who systematically evaluated students' examination and interpersonal skills using both an objective scale including 86 specific items and two 12-point subjective rating scales. Interrater reliability was demonstrated, as was the correlation between the subjective scores and objective ratings. Thirty-two percent of the students were evaluated as having either inadequate or marginal examination skills, and 29% were rated as having interpersonal skills that fell into the same unsatisfactory category. GTAs can be used as evaluators of skills in a competency-based clerkship.

Breast Diseases↗
PubMed2005

Conscious sedation for the performance of gynecologic examination of individuals with intellectual disability.

OBJECTIVE: Gynecologic examination of some individuals with intellectual disability can be especially problematic. Many of these women reside in a community setting and a widely applicable method for performing these examinations is desirable. METHODS: Intellectually disabled women were referred by their primary care providers for gynecologic examinations under sedation in the emergency room facility of a community hospital. Intravenous conscious sedation was administered under the direction of an emergency room physician. RESULTS: Thirteen adult women underwent 22 examinations over a four-year period. Papanicolau smears, screening for sexually transmitted disease and cervical and endometrial biopsies were obtained without complications. Hospital charges were relatively low and lengths of stay were short. CONCLUSION: In selected individuals with intellectual disability, intravenous conscious sedation in a community hospital emergency room setting provides a safe, effective and relatively inexpensive means for performing gynecologic examinations.

Adult↗
PubMed1997

Patient anxiety during gynecologic examinations. Behavioral indicators.

OBJECTIVE: To identify behaviors that indicate anxiety during a gynecologic examination. STUDY DESIGN: Five hundred twenty-two women visiting a private obstetrician/gynecologist's office completed the A-State scale of the State-Trait Anxiety Inventory and specific questions about their first pelvic examination and experiences with health practitioners performing subsequent gynecologic examinations. In addition, the hand placement a woman exhibited as the speculum was inserted was recorded, as were the reasons for her visit, reports of any symptoms, performance of any special procedures (e.g., colposcopy) and whether the pelvic examination was her first. RESULTS: Five behaviors observed during speculum insertion--holding hands/eyes covered or shut, hands on shoulders, hands covering pelvis, hands on legs, hands holding table--indicated increased anxiety. Together these behaviors were exhibited by one of every four patients and were found to be associated with high levels of anxiety. Greater anxiety was related to colposcopy, a less positive first pelvic examination experience, overall less positive experiences with examiners and performance of the first gynecologic examination at the present visit. CONCLUSION: Easily recognizable behaviors reflecting high anxiety in gynecologic patients were identified. Upon recognizing these behaviors, examiners can take necessary measures to reduce patient anxiety and prevent delays in and avoidance of gynecologic examinations.

Adaptation, Psychological↗
PubMed2002

Gynecological examinations for social and legal reasons in Turkey: hospital data.

AIM: Women in Turkey are subjected to gynecologic examinations not only for legal reasons, such as sexual assault or violence against pregnant women, but also for various social reasons, such as suspicions of premarital intercourse, prostitution, loss of virginity, and pregnancy at the time of entering into a new marriage. The examinations are performed by general practitioners, forensic physicians, and gynecologists. This study presents social reasons for gynecologic examinations of women in Turkey. METHOD: We analyzed the reasons for gynecologic examination of 412 women at the 1st Obstetrics and Gynecology Department, Sisli Etfal Training and Research Hospital, between January 1, 1999 and June 30, 2001. RESULTS: Out of 27,376 women at the Department, 412 (1.5%) underwent gynecologic examination for social or legal reasons: 82 (19.9%) for entering into a new marriage, 41 (10.1%) for violence against pregnant women, 28 (6.7%) for sexual assault, 53 (12.8%) for suspicion of prostitution, and 208 (50.5%) for the determination of virginity. CONCLUSION: Gynecologic examinations for legal or social reasons in Turkey are still rather common. Medicolegal regulation of gynecological examinations should be changed to protect women's human rights.

Adolescent↗
PubMed2003

Women's experiences of the gynecologic examination: factors associated with discomfort.

BACKGROUND: The aim of this study was to evaluate how women experience the gynecologic examination and to assess possible factors associated with experiencing discomfort during the gynecologic examination. METHODS: Consecutive patients visiting the Department of Obstetrics and Gynecology at Glostrup County Hospital, Denmark, were invited to participate in the study, and received a postal questionnaire that included questions about the index visit, obstetric and gynecologic history and sexual abuse history. The response rate was 80% (n = 798). The degree of discomfort during the gynecologic examination was indicated on a scale from 0 to 10. Experiencing discomfort was defined as a score of 6 or more, based on the 75th percentile. RESULTS: Discomfort during the gynecologic examination was strongly associated with a negative emotional contact with the examiner and young age. Additionally, dissatisfaction with present sexual life, a history of sexual abuse and mental health problems such as depression, anxiety and insomnia were significantly associated with discomfort. CONCLUSION: The emotional contact between patient and examiner seemed to have great importance when focusing on discomfort during the gynecologic examination. Furthermore, we found that discomfort was associated with a number of factors that are seldom known to the gynecologists, such as sexual abuse history, mental health problems and patients' sexual life. Gynecologists need to focus on the emotional contact and to reevaluate issues for communication before the examination.

Adult↗
PubMed1997

Field-expedient gynecologic examination table.

In field operational environments, the gynecologic health needs of women may be difficult to provide because of the lack of a small, lightweight, durable, inexpensive gynecologic examination table. Such a table already exists, in pieces, in the inventory of most field-deploying units of battalion aid station size or larger. Because the table's existence is not commonly known, we describe the assembly and use of this field-expedient gynecologic examination table.

Beds↗
PubMed2004

Trust and confirmation in a gynecologic examination situation: a critical incident technique analysis.

BACKGROUND: Gynecologic examination is a common measure in reproductive health care. Many women experience the examination as a more or less negative event, with shortcomings in the examiner's behavior. The aim of the study was to describe, in terms of critical incidences, women's experiences concerning the personnel's behavior in the situation of gynecologic examination. METHODS: The informants were strategically chosen and consisted of 30 Swedish women between the ages of 18-82 years old. The data collection method was qualitative research interviews analyzed by critical incident technique. RESULTS: The result consisted of 30 subcategories, five categories, and two main areas - trust and confirmation. The personnel enabled trust when they promoted participation, created confidence, and were supportive. The opposite behavior contributed to the lack of trust. Confirmation described behavior that confirmed, respectively, did not confirm the women. This was shown through the presence or lack of respect and engagement. CONCLUSION: The personnel's positive behavior enabled trust and confirmed the women as individuals, while negative behavior was decisive in an unfavorable way. A complexity of patterns of knowing in nursing was identified. Participation through information that contributed to trust was important and amounted to one fourth of the incidents in the material. Respect and engagement, which confirmed the women, facilitated a positive caring relationship. The examination situation can be improved through reflection of the personnel's own behavior and further research about women's own experiences.

Adolescent↗
PubMed1996

The effect of sexual experience on the attitudes of medical students to learning gynecological examinations.

The influence of sexual experience and gender on the attitudes of medical students to the methods of teaching the gynecological examination was studied. Data were obtained by questionnaire from students who had completed their obstetric/gynecological and family medicine clinical terms. Two hundred and eighty-six students agreed to participate. Ninety of the male students (53%) and 63 (54%) of the female students had experienced sexual intercourse. Students, male and female, who were sexually experienced felt they were more able to conduct a gynecological examination with sensitivity, put the woman at ease and to explain to the women what was being done and why. Male students who had not experienced sexual intercourse felt less able to perform a speculum examination, to do a Papanicolaou smear or be able to detect an abnormality. There were no gender differences between the preferred methods of learning to conduct a gynecological examination but non-sexually experienced students ranked higher the examination of a woman under anesthesia. The suggestion of student volunteers was more acceptable to sexually experienced women and non-sexually experienced male students. Students varied in their response to being volunteers for students learning to conduct vaginal or rectal (if male) examinations. If only the same sex were present 31% of non-sexually experienced male students would possibly volunteer for rectal examination and 39% of sexually experienced female students for vaginal examination. Sexual experience influences students' choice of methods for learning to conduct a gynecological examination.

Adult↗
PubMed1999

The relationship between characteristics of women with mental retardation and outcomes of the gynecologic examination.

This study examines the relationships among client characteristics and the outcomes of gynecologic examination success, sedation use, and cooperation with the examination in a sample of 99 women with mental retardation who received services from a nurse-managed women's health clinic in a large county medical center. Client characteristics that were associated with a successful gynecologic examination for this population of women were isolated. The findings from this study suggest that the presence of behavioral problems, profound mental retardation, and expressive language difficulties are important signals to providers. Special approaches are necessary when performing gynecologic examinations for women with mental retardation.

Adolescent↗
PubMed1994

The use of transvaginal ultrasonography compared to routine gynecological examination to check the location of an intrauterine contraceptive device.

The objective of this study was to evaluate the use of transvaginal ultrasonography compared with a routine gynecological examination to check the location of an intrauterine contraceptive device (IUCD). Fifty-two women attending the antenatal cure unit at Lundby hospital for contraceptive guidance were included in the study. All women had an IUCD inserted at this visit and were examined bimanually and by speculum. The same examination was repeated and a transvaginal ultrasound scan was carried out at 1 week and then 3 months later. In 51 women, the threads of the device could be identified at the time of the gynecological examination and the IUCD was considered to be correctly positioned. In one woman, the threads could not be seen, but transvaginal ultrasonography confirmed that the position of the device was at the fundus of the uterus. Forty-eight women were judged by ultrasound examination to have the device optimally placed in the uterine cavity. In four women, although the IUCD was apparently correctly located according to the gynecological examination, the device was shown by ultrasonography to be misplaced.We suggest that transvaginal ultrasonography should replace the conventional gynecological examination as the best method of checking the location of an IUCD.

Journal Article↗
PubMed1977

Patients' attitudes toward gynecologic examination and to gynecologists.

A self-administered questionnaire exploring attitudes to gynecologic examination and gynecologists was completed by 409 female patients. Contrary to public statements of some consumer groups, overall results revealed predominantly favorable attitudes to both examination and gynecologists. However, a number of specific criticisms were found. Subjects reported problems with component parts of the gynecologic examination. The traditional lithotomy position and breast examination were the most difficult aspects of the examination emotionally. Speculum insertion was the most uncomfortable part physically. Of the respondents, 10.8 per cent never had had a rectal examination. Many subjects were dissatisfied with gynecologists' understanding of women's psychological and sexual problems. The importance of physicians becoming better informed about female psychology and sexuality, and adapting to women's changing needs is discussed.

Adult↗
PubMedDate not supplied

Women's preferences for gynecological examiners: sex versus role.

Preferences for gynecological examiners are studied in a cervical cancer screening program. Sex appears to be a more important factor in preference than the professional level of the examiner. Female health professionals were preferred by a majority of patients; the distinction between physicians and nurse practitioners was a much less important factor. Female examiners were particularly important to low-income and Mexican-American participants, and to women who were reluctant to participate in screening programs.

Female↗
PubMed1979

Attitudes of women toward the gynecologic examination.

This study was undertaken to determine why patients feel uncomfortable during the gynecologic examination, to assess general knowledge about the procedures, and to find out what would make the patient feel better about the examination. Nine hundred seventy-seven women sampled in 14 different health care facilities in the Salt Lake area in Utah filled out a two-page, self-administered questionnaire while waiting for a medical appointment. Results show that women feel less comfortable during the pelvic examination than they do during the breast examination; physical discomfort of the pelvic examination is the reason most frequently cited. There were 77.1 percent who stated they would feel better about the examination if the physician told them what was going to happen. Over 70 percent wanted to know more about their female organs, normal sexual functions and emotions, and reasons and procedures for the pelvic examination; 68.3 percent felt that knowing more would make them more comfortable. There were 46.5 percent who thought the use of a mirror for the woman to observe the examination was a good idea. Only 28.9 percent knew the rectum was examined. This study shows that women need and want to be educated about the gynecologic examination.

Attitude to Health↗