VCOM College Catalog and Student Handbook

Examination of Sensitive Areas In performing the osteopathic palpatory examination, the student may be required to examine or be examined in sensitive areas (areas near the breasts, genitalia, or buttocks). Examples are palpation of the rib cage and axilla, which is near breast tissue and palpation of the buttocks area to identify and treat the coccyx, the ischial tuberosities, PSIS, piriformis, the pubic bone and other areas of the bony structures of the pelvis and hip. Students who perform these examinations must also become aware of how a patient views these same examinations with respect to sensitive areas. Instruction will be given on appropriate methods to examine sensitive areas and the importance of recognizing effective ways to communicate prior to touching such areas, to assure comfort during the examination, and to answer questions a patient might have after the examination. Learning to examine intimate areas is also taught and required of VCOM students; however, this is not taught in the PPC/OMM laboratory and is reserved for observations and examinations performed by faculty in the clinical setting, as well as certain exams in the simulation center using professionally trained patients for the exams. Peer to-peer exams do not involve intimate area exams. Assuring Safety and Comfort Students (as well as faculty) are required to recognize the importance of respect for any patient’s modesty, the cultural and/or gender differences that exist, and to consider other concerns such as a prior history of trauma or disease. It is not possible for all male students to have only male examiners or all female students to have only female examiners. This also does not educate students appropriately for their future practices. Therefore, all instructions to peer students acting as patients (and to patients in OMS 3 and OMS 4) must include the following: • Peer history taking and physical examination, as well as standardized patients, provides the opportunity for the student to practice appropriate medical communication and professional conduct, such as explaining the physical examination, procedure, or treatment and seeking the permission of the patient. In peer-to-peer learning activities, students should practice by informing their fellow students what they plan to do and to seek permission from their fellow students prior to performing any physical examination, procedure, or treatment. o Affirm the patient (in this case the peer student in the role of the patient) understands the reasons for the examination to be performed and what the exam will entail prior to performing the exam. This information is provided in the student lecture and reinforced during laboratory instruction. o Affirm the patient (or fellow student) knows that you are going to start the examination before you start. This can be done by simply stating “I am now going to examine ……” . This will assure the patient, or student is prepared for you to touch them. • If a student is uncomfortable with the examination, procedure, or treatment that is being performed by a peer or by a faculty member, he or she may ask the exam to be stopped at any time without penalty or reprisal if the examination being performed in painful, uncomfortable, or otherwise (religious or culturally) offensive. o Students are always encouraged to provide feedback to other students (or faculty) performing the exam if the examination, procedure, or treatment is painful or caused them to feel uncomfortable in some manner. This provides meaningful education for the peer student and in some cases for the faculty member if they are unaware the student feels uncomfortable. o In the case the student wishes to file a formal complaint, the Discipline Chair will engage Human Resources in this process. o If discomfort with palpation is experienced, the student may:  Ask for a brief interruption to inform the examiner of the discomfort,  Ask questions to provide an opportunity for the student or faculty member to explain why he or she is performing a particular exam or part of an exam,  Ask if the examination can be performed in a different manner that does not cause discomfort,

178