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Teaching assessment of opposite gender patients


Riblett

  

23 members have voted

  1. 1. Should EMT students be practicing assessment skills on opposite gender classmates?

    • Yes, because they will have to do it in the field
      23
    • No, it is inappropriate and should not be done.
      0
    • They should be allowed to opt out if they choose.
      0


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I've had a similar experience, though it came from the female students more-so (the younger majority of students). For the first week of EMR, we were allowed to choose our own groups. This allowed ample time to get comfortable with each other and those who were shy could practice within their comfort zone for a while. The following weeks our practice groups of three were randomized (students selected a colored bouncy ball from a box which coordinated with two others). The randomization gave us a chance to work with others (and learn how others approach certain tasks), and for many get outside their comfort zone.

In my opinion, the notion of having to allow students the option of "opting out" of contact with certain classmates based on gender is counterproductive. You can't opt out of dealing with certain genders in the real world, and if it's anywhere you should be learning how to deal with those whom you are uncomfortable with it's in the classroom.

I have to disagree that instructors should have to give students an incentive to conduct themselves properly and professionally. Telling students that they can (metaphorically) have a cookie each time they act their age (or at least the level of maturity the profession requires) is also counterproductive. Additionally, letting students treat others in the class as a walking box of cookies, for if and when they act professionally with that student would in my mind leave the wrong impression. I believe there to be a line between telling a student they completed a good assessment (or task), and giving them points or prizes for completing a good assessment (or task) on a particular person or gender.

I think students should be given a reasonable amount of time to work within their comfort zone, and work outside of it when their able. That said if it begins to continually effect the rest of the class a discussion would be in order, either with the particular student or the class as a whole.

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Dwayne, great story and you're right, that girl and the medic were the epitome of professionalism and objectivity. Still, I bet that that was the last time the poor lady ever showed up to class commando style!

-Bieber

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All medical science works best and is best understood when approached from an objective point of view. When preforming the assessment of a patient there is a moment when they become a complex problem I have to decipher. I know that this dehumanizes them for a few seconds, I cannot hear their screams, I cannot feel their pain, they cease to have a face or feelings. For a moment there is riddle in this person that has to be found solved and defeated. Their gender or degree of hotness cannot be a factor. This moment is short lived and flighty, after which my patient once again becomes more than a compilation of data

For me when a student is giggling and not controlling his emotions shows blatant disrespect for the institution, the mock patient, the instructor and the science that is being practiced. If you pull them aside and tell them that a lack of respect will not be tolerated you will find that most will change their attitude towards assessment.

Dwayne, During practicals I had a similar situation. We were toned out of class to an MVC down the road. Everything looked like the real deal (we knew it was training). A car and a truck in a t-bone collision. The dents were in the right place and everything. My patient was a middle aged lady in the same scenario as the one you describe. She was in the front seat of her truck complaining of pain everywhere. I did not cut off her clothes but did give a full assessment. I don't think she had been debriefed and she was a little surprised and uncomfortable but did not break character.

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All medical science works best and is best understood when approached from an objective point of view. When preforming the assessment of a patient there is a moment when they become a complex problem I have to decipher. I know that this dehumanizes them for a few seconds, I cannot hear their screams, I cannot feel their pain, they cease to have a face or feelings. For a moment there is riddle in this person that has to be found solved and defeated. Their gender or degree of hotness cannot be a factor. This moment is short lived and flighty, after which my patient once again becomes more than a compilation of data

This is just oh-so-true.

One of my biggest struggles is switching in and out of this mentality, to provide well rounded care. I usually get into it, and dehumanize my patient in my mind for the entire call. I always have... but I am working to switch on and off. Pretty cool to see it written down like this.

Back to the thread....

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Being serious about EMS doesn't mean being miserable. Intensity can be fun too... I'd be willing to bet that 80%+ of the students in the class are disappointed that the gigglers are ruling the class.

Dwayne

True enough, having fun in the classroom doesn`t mean, that fun has to consist of stupid giggling and immature behaviour.

I for one, often had lots of fun during classes.

A buddy of mine and me always tried to be better than the other one. So each of us always tried to give the better answers, be the better one during the practical exercises and stuff - only to, you know, mock the other one because you were a tad better.

We also played Medicine Jeopardy and tried to outrun the other.

Like: "Complete Right bundle branch block, left anterior hemi-block and a 1st class atrioventricular block!"

Answer: "What`s a trifascicular block!"

I can`t really remember who won most of the times (but Ì`m sure it was me... ;) ).

Edited by Vorenus
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When I teach I do as those that instructed me I design scenarios that require the students to get to know their fellow student extremely well. I understand early on it is difficult to intrude on peoples personal space, but they still better act mature about it. I will move the students hands to proper locations for assessment if they keep avoiding certain areas.

I recall when I had a skills instructor push my hand up under her breast to place the stethoscope correctly because I kept avoiding it when I was a student. I have always remember her doing that and saying if you can't properly check a healthy person you'll never be able to properly assess and treat a sick one.

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Being one of the youngest in both my EMT class and my medic class, I thought I would chime in here. There is no reason for them to be screwing around when it comes to learning how to appropriately do a patient assessment. We didn't have that problem for long in either one of my classes. In EMT school, day one we were put into groups and whoever was in our group was who we worked with. The instructor did a great job of meshing all of the various ages together in these groups. We had people ages 18-mid 30s in our class. One guy in my group had a hard time doing an assessment on me because I was the same age as his daughter. He quickly got over that on our first test day. Our program brought back former students who posed as patients and it went from "going through the motions" like we did in class on our clothed classmates, to actually having to perform a legit assessment and treat what we found...that included removing the clothes from our simulated patients. We had a few students that had to repeat the assessment station because they would not touch their patient, remove the necessary clothes, etc and they missed "fatal wounds" and had they not passed the retest, they would have been kicked out. This actually scared everyone into taking things more seriously, and the shyness issue went out the window. Another thing that it taught us was that we are probably never going to see our patients again (unless they are a frequent flyer, but that's another issue), so it didn't really matter if we were embarrassed or uncomfortable doing an assessment and removing clothes. Those that had a problem with physical contact with their classmates during an exercise got over it quickly knowing that they could fail out that easily and finally realizing that 1. your patient probably isn't going to care as long as you make them feel better in some way, and 2. that it's your license on the line if you miss something because you are shy, and 3. the first time you show up in the ER with a fully clothed patient that RN is going to kill you (our instructor worked in the ER and had some scary stories).

In medic school to get everyone to stop being stupid, we had to actually cut off the clothes of our classmates during assessment scenarios. We were all told day one to bring clothes we didn't mind getting ruined, and the girls were told to bring sports bras for lab days because we were all expected to play faking patient. And "affective domain" was a big part of our grade, so one smart ass comment or smirk during lab days and you would see it reflected in your grade. My point in this big long rant is, make these skills a big part of your student's grades. Do not let this behavior go on any longer. If that means pushing them and making them uncomfortable, then do it. They have to get over it sometime, and the classroom is supposed to be the place to do stupid stuff and make mistakes. They need to learn that now, rather than on a ride out with a preceptor who will chew them out for acting like that, or even worse, when they are actually out in the field working. No patient wants to be exposed, but sometimes there is nothing we can do about it. They expect us to be respectful and professional about it, and you should make it known that that is what you expect from your students.

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If you are that immature you can't handle examining somebody of the opposite sex you shouldn't be in a position requiring it

Except me, I am allowed to be sexually inappropriate because I'm so fucking awesome at it nobody takes offence :D

well i am offend by that........... :whistle:

Edited by craig
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