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Unconscious Bias in GTA Exams


Date(s) - 12/06/2020
1:15 pm - 2:15 pm


Authors/Presenters:  Jennifer Lanier | Tru Chatelain, AAS

CE Hours: 1

One sentence presentation summary:  Having recently implemented a MUTA/GTA program at our institution, we have been navigating what that training looks like and what our best practices are.  This presentation will explore some of the identified biases and ways to improve patient outcomes.

Abstract:  Part of the curriculum is educating GTAs on how to determine the appropriate speculum size for each patient. In doing so, we have learned (from stories shared and personal lived experiences) that there are areas for real and potential bias for patients during pelvic exams. We aim to identify some of these biases and look for ways to improve outcomes for patients in need of gynecological care.

Although we do not have an active research study ongoing (yet!), we are exploring the following questions for further analysis and discussion:

  • Are low BMI/Caucasian Patients (or GTAs/Standardized Patient Pelvic Models) more frequently offered smaller sized specula based on outward appearance?
  • What can we do to advocate for more thoughtful preliminary exams to determine appropriate, comfortable, examinations for patients based solely on anatomy, measurement/exam and sexual & reproductive history, rather than appearance?
  • How do uncomfortable examinations and bias deter some patients from being proactive about their reproductive and sexual health?
  • What can we do to better advocate for our diverse communities and focus on comfortable, considerate, affirming care for marginalized communities who have experienced discrimination in healthcare?
  • Who makes recommendations on which specula are stocked at your institution?

o   What is their experience in Healthcare training (if any)?

o   Are their recommendations evidence-based facts or are they assumptions based on what has been traditionally ordered by other institutions?

o   What are our obligations to healthcare simulation and training to improve patient comfort/outcomes?

In conclusion, bias can and does play a role in painful pelvic exams in otherwise healthy people who require gynecological care. We hope to clarify that race, gender identity, height and/or BMI is not indicative of the size of a person’s vaginal canal. That with thoughtful questions, history taking and careful examination/positioning, we can eliminate a lot of pain and anxiety for people seeking fair, affirming and unbiased gynecological, sexual and reproductive care.

Three anticipated learning outcomes:  Participants will be able to:

  1. Understand unconscious bias training tools
  2. Share examples of unconscious biases in room with GTA exams
  3. Define standard work and creation of a culture of safety

Registration

Registrations are closed for this presentation.

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