Simulating a Real Pelvic Exam

ach year more than 16,000 third-year medical students rotate through the obstetrical gynecological clerkship after only one night of formal training on a live patient during their second year. It’s difficult to find patients who will agree to permit students to perform pelvic exams, so professors hire professional patients for gynecological training.

But this approach doesn’t permit a lot of hands-on or repetitive training.

Recently Miller School of Medicine students had the opportunity to test out an alternative to professional patients, the METI Pelvic ExamSIM.

The Pelvic ExamSIM consists of a female pelvic cavity mannequin with interchangeable internal anatomy, strain gauges, and a laptop computer workstation. Students can practice both pelvic and rectal exams on the mannequin while sensors inside the cavity guide them along. Each unit also comes with commonly occurring anomalies, such as ovarian cysts and fibroids, which a practicing gynecologist would encounter.

Through voluntary faculty Steven Chavoustie, M.D.’s, association with the instrument’s creator, the school was selected as the first in the country to have the simulator on a two-week trial. During that time, 112 medical students, three interns, and four faculty members used and evaluated the simulator. Everyone concurred that this is an effective way to learn the female pelvic exam. “The goal is to get two of these simulators here,” says Chavoustie. Each simulator costs $19,000.

Second-year medical student Nehaten Patel said the simulator allowed her to perform pelvic exams with both hands and to become more adept at finding different organs. “We have an idea of where structures are, but going in at this level is totally different,” Patel says.

“I’m glad that they have this system. When you’re with a real patient and you’re doing your first pelvic exam, you kind of feel like you’re going to hurt the patient.”