VCOM College Catalog and Student Handbook

• Sensitive areas are those areas near the breasts, genitalia, or buttocks.

Intimate areas will not be examined by other students or faculty in the OMM course. Sensitive areas will be examined by peers and faculty in the course and are done in a professional and respectful manner. Examination of sensitive areas are a part of the osteopathic structural examination and osteopathic manipulative medicine treatments and so must be learned for successful completion of the curriculum. Peer student examinations will include examinations that follow the systems learning. These include the musculoskeletal system and extremities, the neurological system and head-eyes-ears-nose and throat, the cardiovascular and pulmonary systems, circulatory and lymphatics, and the gastrointestinal system. These examinations will include palpation and treatment of sensitive areas involving the bony, muscular, and neurological structures, will include the pelvis and buttocks (but not genitalia or rectum), and the ribcage near the breasts (but not the breasts). Students are advised that techniques exist that address various patient complaints/conditions/diagnoses of intimate areas that employ osteopathic manipulation of these anatomic regions; however, these techniques are beyond the osteopathic medical school curriculum and are learned under appropriate supervision in residency and/or advanced training courses. Conduct VCOM students are expected to always exhibit professional conduct including during medical history taking, physical examinations, and during any treatment. The student is expected to participate in the peer-to-peer physical examination process, both in playing the role of the patient and of the physician. This requires the student to be touched and examined by peer students and to examine and touch peer students. 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

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