1. Welcome! Memorial University Faculty of Medicine Gynecological Teaching Associate Information Session February 9, 2009 4:30 – 6:00 Liz Ohle, SP Educator

2. Gynecological Teaching Associates How do Medical Students learn to do breast examinations and pap tests?

3. The Standardized Patient Program  Medical students must learn to interview and examine patients with all types of physical and mental ailments.  The GTA program is one part of a much larger program, the Standardized Patient program, that allows students to learn and practice skills in non-threatening learning environments that will do no harm to people who are sick.  Introductions of the SP staff.

4. Topics for this evening  What is a GTA?  How do you learn the GTA curriculum?  What is it like to be a GTA?  What is the time frame.  How are you paid?  How do you apply?

5. Learning from a woman, including hearing about a patient’s perspective  A GTA is a teacher and a patient simultaneously.  She teaches proper examination techniques to students, using her body as the instructional tool.  It is medically accurate, plus gives information about patient’s concerns during a very personal examination.  No physicians are present.

6. GTA Sessions  Focus specifically on interviewing a woman about her sexual health and learning to examine her breasts, vulva, vagina, cervix, uterus and ovaries.  Each GTA must have these anatomical parts so that students can learn to ‘find’ them and examine them.  GTA sessions are ‘well-woman exams,’ like an annual check-up with no medical problems.

7. Content of a GTA session  Focused history taking. Students learn to use non-offensive, non-judgmental language about sensitive topics in a way that helps the patient feel emotionally safe.  Breast examination review, while teaching the patient the skills to perform self exams.  Examination of the external genitalia.

8. Content, continued  Inserting a speculum to view the cervix.  Students do not practice scraping the cervix to take specimens for a Pap.  Bi-manual examination with two fingers in the vagina and one hand on the lower abdomen.  Continuous feedback from the GTA about the student’s techniques and use of language.

9. See how it works….  It can be difficult to envision being the teacher while being the patient.  Not like the common experience of an uninvolved patient lying flat on the exam table.  As the teacher/patient, you are completely in charge of the session, even though you are in a traditionally vulnerable position.  It is the GTA’s role to create a safe learning environment for the students. They are very nervous.

10. Video of a session in progress  This is made for training purposes by the GTAs and SP staff of our program. It helps you visualize the exact role of a GTA.  We will see one section of the video as a demonstration of how the GTA is in charge, and teaching even when she is exposed.  The full video is about an hour long. (For privacy reasons, the video is not included in the Powerpoint.)

11. Training  This is an extensive process so that each GTA learns the anatomy and proper exam techniques.  We use discussion, didactic instruction, video resources, and hand outs.  You will have ‘hands on’ practice with each other.  You will have an examination by a gynecologist to learn specific information about your body that will help you direct the students.

12. Training, continued  You will observe an actual session with medical students instructed by an experienced GTA.  You will gradually teach portions of the curriculum with the support of an experienced GTA.  Finally, you will be ready to conduct sessions independently.  A session consists of one GTA teaching two students with staff support nearby.

13. When is training?  Trainings will occur on Mondays, the same time as our GTA sessions. They will take place in our training area on the first floor.  After screening applications and conducting interviews, training sessions will begin.  These will be weekly for 6 – 8 weeks. All sessions are required.

14. Time commitment for sessions  GTA sessions take place monthly. Two or three GTAs are needed each month.  We need 6 – 8 trained GTAs in our group due to scheduling complications related to menstrual cycles, holidays, etc.  Each GTA works 4 – 6 sessions annually.

15. Comments from one of our experienced GTAs  What was it like initially during the training? Were you embarrassed? Was it hard to learn all of the information?  What is it like working with the students?  What is one of your best experiences?  Have you had any bad experiences?  Why do you like being a GTA?

16. Pay  You become a casual employee of Memorial University.  All of our Standardized Patients progress through 5 pay levels until they reach the top of the scale, $20 per hour. You will follow this progression during your training.  Following training, during full GTA sessions when you are teaching the students, you are paid $98 per student (usually two per evening) plus the $20 hourly rate.

17. Any Questions?

18. What now?  If you are interested, fill out the application and return it to our office by Monday, February 16 th, 5:00pm. We will contact those we want to interview.  Interviews will take place during the week of March 9 th.