title: Evaluation of consent for peer physical examination: students reflect on their clinical skills learning experience.
abstract: BACKGROUND
  Early clinical skills teaching often requires students to learn through examining one another. This model should acknowledge ethical, practical and individual issues, disclosure and identification of abnormalities. Consent to peer physical examination (PPE) is usually expected rather than discussed and sought.
  
  
  OBJECTIVE
  We sought to evaluate a formal written consent process for PPE and to explore students' views of this approach.
  
  
  METHODS
  A survey tool was designed and distributed to all years 2 and 3 students in the Auckland University medical programme (2004). Results were analysed using univariate statistics and thematic analysis.
  
  
  RESULTS
  The response rate was 57% (146/258). Most students had read the participant information sheet prior to signing, with 78% giving consent. They had not felt coerced and the in-course experience matched the 'promise'. Comments included: PPE gave insights into the 'patient's world', encouraged peer learning and raised some professional issues. More than 95% of students took the examination role at least once (less likely if female, P = 0.002). Some European, Maori and Pacific students never took the role; all Asian students did at least once. Students preferred PPE in groups consisting of 'friends'. The task influenced group composition by sex (P < 0.0001) but not ethnicity.
  
  
  CONCLUSIONS
  Students accept and support a formal consent process. PPE participation rates are similar to predictions. The experience must match the promises made. Formal preparation alone might have produced similar student outcomes. Female students are more selective about tasks undertaken. The influence of ethnicity and the effect on future behaviour and attitudes needs further exploration.
authors.affiliation: Clinical Skills Resource Centre, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, Auckland, New Zealand. a.wearn@auckland.ac.nz
authors.forename: Andy
authors.initials: A
authors.lastname: Wearn
authors.forename: Harsh
authors.initials: H
authors.lastname: Bhoopatkar
mesh_terms: D000293:Adolescent; D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D009520:New Zealand; D010379:Peer Group; D010808:Physical Examination / Q000592:standards*; D013337:Students, Medical / Q000523:psychology*; D013663:Teaching / Q000379:methods*