OSCE skills: Practical Procedures- Intimate Examinations

Hello fellow medics,

I hope we have been staying well.

Some quick reminders to get us thinking when doing intimate examinations in OSCE.

The intimate examinations that may be tested include:

1) Rectal examination

2) Breast examination

3) Testes examination

For these examinations, having the knowledge of the anatomy and technique is great, but you can read that in a test book. I am here to give you some “must do’s” to avoid failing the station. The principles are aimed at communication skills and general principles of all exams. So keep reading..

1) WASH HANDS

On entering the room (any room!) always wash your hands. Say it and do it (in the exam it may be hand sanitiser). Make a thing of it to show you understand and appreciate the importance of this.

2) INTRODUCE YOURSELF

Always introduce yourself. Tell the patient/mannikin your name and status.

3) CONFIRM PATIENTS ID

Ask for name and DOB/check wrist band (if no actor is present to answer!) and compare these to the notes.

4) EXPLAIN THE PROCEDURE

Explain what you are going to do. Intimate examinations can be uncomfortable (physically and emotionally) and therefore a clear explanation of the procedure alleviates any anxiety. Explain that the examination may be uncomfortable, but shoudln’t be painful and that you can stop at anytime. Something as simple as this shows you are empathetic, professional and have great communication skills.

5) GIVE PATIENT PRIVACY TO GET UNDRESSED

Close the curtains whilst the patient is getting dressed/undressed. This is common courtesy and shows respect and dignity for the patient.

6) EXPOSE ONLY THE NECESSARY AREAS

When examining breast, expose waist up

When examining Testes, expose waist down. You can cover the genitalia with a bed sheet/ask the patient to cover up

When examining the rectum, expose waist down. Again, you can cover the genitalia with a bed sheet.

7) END OF EXAMINATION

  • Thank the patient

  • Allow the patient to get dressed in privacy

  • Take off gloves/apron

  • Wash hands

  • Explain to the patient that you are now going to speak to the examiner to summarise your findings

I hope this has been a guide and revision for you. It is easy to get bogged down with the tick list of the examination and then miss basic principles that can fail you.

Please follow my social accounts or if you are interested in one to one revision, sign up for this via the website (see link below for ease!).

Happy revising :)

Sign up for one to on revision