An evaluation of the educational impact of Gynaecological Teaching Associates in teaching female pelvic examination

Gynaecology Teaching Associates (GTAs) are lay women trained to undergo and teach gynaecological examination giving immediate feedback to medical students. However, there are only limited data evaluating the acceptability, effectiveness and economic viability of this teaching innovation. This thesis appraises the educational impact of GTA-led teaching of female pelvic examination. An online survey showed that GTAs were used by under a third of UK medical schools. A study was conducted to establish validity and reliability of a newly developed pelvic examination assessment tool by comparing the performance of novice and experienced students and junior doctors in obstetrics and gynaecology (O&G). This study did not establish adequate psychometric properties so the tool will need further refinement. A large single blinded randomised controlled trial demonstrated an improvement in competence and confidence of medical students taught by GTAs compared with pelvic manikins at the start of their O&G placement. A parallel economic analysis showed that GTA teaching was considered cost-effective, with an investment of £640.20 needed to acquire an additionally competent student and £274.37 per student competent at merit and distinction levels. A qualitative study using semi-structured interviews found that GTA-led teaching was acceptable and considered a positive experience by stakeholders.