Intimate examination teaching with volunteers: Implementation and assessment at the University of Antwerp Kristin Hendrickx a, * , Benedicte Y. De Winter a , Jean-Jacques Wyndaele c , Wiebren A.A. Tjalma b , Luc Debaene a , Bert Selleslags a , Frieda Mast a , Philippe Buytaert b , Leo Bossaert a a Skillslaboratory, University Hospital of Antwerp & University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium b Department of Gynaecology, University Hospital of Antwerp & University of Antwerp, Belgium c Department of Urology, University Hospital of Antwerp & University of Antwerp, Belgium Received 23 March 2005; received in revised form 20 August 2005; accepted 22 August 2005 Abstract Objectives: Teaching intimate physical examinations in medical schools generates practical, didactical and ethical problems. At the University of Antwerp, a unique program with intimate examination assistants (IEA) was implemented for fifth year’s undergraduate students. They learn gynaecological and urological skills in healthy volunteers. Technical, communicative and attitude aspects are taken into account. Methods: Description of the implementation of the project. Assessment of the project by questionnaires, written reflections and round table conferences. Results: The results provide detailed information about the student’s perceptions of each component of the program as well as the perceptions of the IEA’s and the teachers. Conclusion: The multilevel evaluation of the program supports the surplus value of working with IEA’s in medical education. The eye- catcher in this program is the integration of clinical skills with communicative skills and attention for students’ attitude. Practice implications: Working with IEA’s for intimate examinations represents a benefit in medical education by lowering the student’s threshold to perform the intimate physical examination on both men and women during their fulltime clerkships. # 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Intimate investigations; Patient simulation; Gynaecology; Urology; Training; Education; Undergraduate; Teaching associates 1. Introduction Teaching gynaecological, urogenital and rectal examina- tions in medical schools encounters practical, didactical and ethical problems [1–4]. It is estimated that one-fourth of the gynaecological examinations during medical school are performed on patients under anaesthesia or sedation without informed consent [2]. If pelvic examinations are carried out ‘‘solely for educational purposes’’ by students who are not actual members of the operating team, such actions are not appropriate unless specific permission has been obtained from the patient by the surgeon in charge of the case [4]. In the past, some faculties implemented solutions such as use of chaperones, use of manikins, examination of patients with explicit permission or examination of trained women [1–8]. Since the eighties, programs with Gynaecological Teaching Associates are implemented in the training of future physicians in several universities in the USA, Canada and the Netherlands [5,6,9,10]. The use of teaching associates for the urogenital and rectal examination of the man is less common [11]. Evaluations of these programs have included mostly faculty impressions of effectiveness and measure- ment of student retention of skills. Subjective students’ responses have indicated overall satisfaction with such programs. Students have generally not been asked to evaluate specific program components or to provide judgements about how they have benefited [5,6,9]. In the Antwerp curriculum, a teaching strategy for intimate examinations has been implemented for the first time in 2002, during the fifth-year undergraduate medical school. www.elsevier.com/locate/pateducou Patient Education and Counseling 63 (2006) 47–54 * Corresponding author. Tel.: +32 3 8202518; fax: +32 3 8202526. E-mail addresses: kristin.hendrickx@telenet.be, kristin.hendrickx@pandora.be (K. Hendrickx). 0738-3991/$ – see front matter # 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.pec.2005.08.009