Gender and culture impact on student willingness for peer examination

Introduction: Peer examination (PE) is an educational strategy whereby students learn by using each other as models in supervised clinical skills sessions. The James Cook University (JCU) medical school intends to implement PE with Year 1 students in 2011. This study investigated the willingness of these students to learn basic examination skills through PE.\ud \ud Methods: The Examining Fellow Students questionnaire, modified to include questions on ethnic background, rurality of hometown at application to medical school, and comfort levels with aspects of PE, was administered to all Year 1 JCU MB BS students in 2011 (n = 155; response rate = 78%).\ud \ud Results: Most students (>94%) were willing to examine, or be examined, on the head, neck, feet, legs, hands, arms, shoulders and back, of same or opposite gender peers. Female gender and having a non-Australian cultural background was associated with reluctance to undertake PE of both moderately and highly intimate body regions, while Australian students who came from metropolitan areas had greater reluctance to undertake PE of moderately intimate body regions (abdomen, back, upper body and inguinal areas) than those who came from more rural areas. Specifically, female students wanted to be able to choose their partner (p = 0.005), felt very exposed if in some form of undress in front of other students (p = 0.004), and were very concerned about being observed by a tutor of opposite gender (p = 0.014), than their male counterparts. In contrast, students of non-Australian cultural backgrounds were more likely to prefer their partner was from their own cultural background, than did mainstream Australians (p = 0.034). There were no significant associations between willingness to undertake PE and age or rurality of hometown at application to medical school.\ud \ud Discussion: Many early-year JCU medical students are sensitive about undertaking PE on more intimate areas during clinical skills sessions, likely due to a student cohort that is predominantly female and/or from non-western cultural backgrounds.\ud \ud Conclusions: PE involving predominantly female and/or multi-cultural students should be voluntary and only used for non-intimate body regions. Clinical skills staff must give consideration to same gender PE and always maintaining privacy and respect