Genital and rectal examinations are challenging intimate examinations for medical students to learn. This is often related to a lack of content in the curriculum, poor training or difficulty in gaining access to practice these skills in a comfortable environment for both student and patient. The aim of this study is to identify studies that utilised different educational tools for teaching intimate examinations and assess their efficacy in terms of student competence and confidence following the intervention.

PubMed, Embase and Cochrane Library were searched for English language published articles which evaluated teaching tools for rectal, gynaecological and testicular examinations to medical students. Risk of bias was assessed according to Cochrane Risk of Bias Tool and ROBINS-I. The GRADE tool was used to determine a level of effectiveness for each teaching modality.

In total, 5619 articles were screened and 26 were ultimately eligible for inclusion in the study, enrolling 2456 students. All (n = 21) of the studies looking at the use of teaching associates saw an increase in student competence. Following teaching with a teaching associate, 93% (n = 14) saw an increase in student confidence. One study assessed the effect of real patients on student competence and one study on confidence. There was an increase in student competence and confidence respectively. One study showed an increase in student confidence following teaching with real patients. When comparisons were made between teaching with teaching associates and models 80% (n = 4) showed a significant superiority in favour of teaching associates regarding student competence and 100% (n = 3) regarding student confidence. Two studies (67%) comparing teaching associates with the use of real patients saw a significant increase in student competence. One study (33%) comparing teaching associates with real patients saw a significant increase in student confidence; the remaining studies showed no significant difference. One study (50%) comparing the use of models with use of lectures saw a significant increase in student competence. The other showed the reverse; a significant increase in student competence in favour of lecture-based teaching. With regards to student competence when comparing model and lecture-based teaching, 100% (n = 1) saw no significant difference.

Intimate genital examination education should be adopted into the medical school curriculum. Several educational tools have been developed. In the studies eligible for inclusion, it appears that the use of teaching associates is the most effective teaching method.

Whilst the use of Teaching Associates appears to be the most effective teaching method for genital examinations, further trials directly comparing teaching methods need to be conducted.

Continence 2S2 (2022) 100424
DOI: 10.1016/j.cont.2022.100424