Dear Sir
We have, appreciatively, read the article “The need for a peer physical examination policy within Australian medical schools” (Koehler, N. & McMenamin, C. 2014) and agree with the authors’ concerns regarding the lack of a thorough Peer Physical Examination Policy in Australian Medical Schools.
In 2013, we set about rectifying this problem by drafting guidelines for student participation in Peer Physical Examination.
At the beginning of the 2014 Academic year, The University of Queensland School Of Medicine implemented a Peer Physical Examination Policy. This policy meets the authors’ recommendations of including the following components: (a) informing students of benefits, (b) potential issues arising and an action plan to follow, (c) general information about PPE, (d) written consent form, and (e) ensuring students’ learning is not compromised amongst non-participants.
Our Year 1 cohort of 570 students is enrolled in the year long Clinical Skills Program that focuses on developing students’ skills in history taking, examination and basic procedures. The program is delivered by way of small group (10 students) tutorials under the guidance of experienced clinicians.
Peer Physical Examination (PPE) is a method of teaching and learning clinical skills where students act as model patients for one another to allow practice of physical examination techniques. It forms an integral part of our Clinical Skills Program, and as such all students are expected to participate in this learning activity. Participation in PPE requires students to adhere to agreed policy and guidelines on appropriate behaviour and sign the Peer Physical Examination Consent and Confidentiality form.
We understand that students’ culture, religion, gender, background, upbringing and prior experience may influence their willingness to participate in PPE. While participation in these tutorials in the examining role is mandatory, participation as a subject of peers’ examinations is encouraged, but students who do not wish to participate as subjects must discuss this with the course coordinator. All discussions are handled sensitively and confidentially. Our expectation is that every student should be willing to contribute to each tutorial in a way that is acceptable to them.
The formalisation of our PPE policy is very new, but early indications are that it has been well accepted by both clinicians and students. All participants are aware of their roles and responsibilities in the program and the appropriate course of action to be taken when problems are encountered. The PPE policy has already led to some productive conversations and innovative solutions ensuring an optimised learning environment and improved participation.
Declaration of interest: The authors report no conflicts of interest.