Thursday, May 14, 2009

Inside and Out

Yesterday I ticked off a med student first: I learned how to do a pelvic exam. I think many of us head into this with some apprehension - fear of causing pain, fear of making a mistake, and the pressure to do it right right off the bat. Fortunately, we have a great program here - GTAs (gynecologic teaching associates). GTAs are trained patients who, in pairs, teach us (also in pairs) how to do this exam. These women are incredibly knowledgeable about their bodies, and provide us with an idespensible first-time experience. What better way to learn than on a real person, in a relaxed enviromnent, where you can take your time, ask questions, and receive live feedback?

In the past, (and present for some schools), students were required to learn the pelvic exam on rubber models or anesthetised patients. Or, they may be required to perform an exam for the first time on a random patient in clinic who is just about as scared as they are. The GTA program was developed in the 1970's by the Boston Women's Health Collective. This group worked to bring women's reproductive health issues out into the open, and made it a misson to educate women about their bodies so that they could be advocates for their own health care. The GTA program teaches us how to do "educational pelvics", which I had only read about in the Boston Women's Health Collective's seminal book, Our Bodies Ourselves. I've never seen anyone do an educational pelvic in practice. With an educational pelvic, the examination table head is raised so that the woman can make eye contact with the examiner, and observe the exam with a mirror, hopefully building a sense of participation and empowerment with respect to the exam and her health.

The whole session was wonderful, and got me ruminating over the idea of an educational pelvic. Arguably, most of us never get to see our cervix. Perhaps if women have the chance to see a vital part of their anatomy that remains perpetually hidden and mysterious, they would be more motivated to seek health care on an annual basis (pap smears, STI testing, well-woman exams). Would this be an extra 5 minutes well spent on the part of the physician?
If you've never seen a cervix and are curious, I'll direct you to The Beautiful Cervix Project, bravely made by a midwivery student who did a daily photo documentary of her cervix over an entire menstrual cycle.

To end on a lighter note, I've started the Gathered Pullover by Hana Jason. The yarn is Berocco Ultra Alpaca Light, in Peat Mix. So far, so good!


Heather said...

Wow...great entry! No pun intended. (^_^) Sounds like a terrific way to learn.

And Gathered Pullover looks very promising indeed.

Yarndude said...

Hey Jess! Thanks for the comment on my blog. I just checked yours out and I'm sure it will soon become a new favorite. :)

Anonymous said...

Hey Jess, Wow! Sounds like you had a really neat, and valuable experience. I had never heard of GTA's and appreciated learning about them. That's a neat program.

Thanks for your comment on my blog, and for your congratulations! I'm glad to have now found yours, and hope to stop in here more often :) ,

Marie said...

Hi Jess,
You make such perfect, even stitches. My knitting never seems to look quite that perfect!

Don said...

Hi Jess,

Although I am a male I found the information you provided very interesting and educational. You are such a great writer.

Your no. 1 fan!


aka Dad

Cha said...

Jess, not only does this sound like a fantastic learning program, it sounds like one that could have lots of beneficial applications.

For example, NL has a very poor rate of annual PAP exams and also therefore has an unacceptably high rate of uterine cancers.

I'd love to see the school curriculums include as health/biology classes the sort of information you've just outlined. We need young adults who know how to communicate with school-aged kids...the midwifery student's site you mentioned sounds like an excellent example.

Do you ever listen to "White Coat, Black Art" on CBC Radio. I love that show...