Learning from our Patients: Clinical Teaching Associates in Gynaecological Examination (pp. 275-280)
Authors: (Marie O’Sullivan, Kevin Jones, Great Western Hospital, Swindon, UK)
Abstract: Performing a pelvic examination can cause much anxiety for the both the patient and the trainee clinician. Previous poor experiences and psychological barriers are responsible for a large proportion of the female population not taking appropriate health-seeking behaviour, whether that be attending for routine screening or pursuing medical advice when an abnormality is detected. 
In the UK the number of women (25 -64 yrs) who have had cervical screening at least once in the last 5 years has dropped to 78.9% (from 81.3% in 2001), this falls below the government 80% target.  There are physical barriers to screening attendance such as busy lifestyles and difficulty in securing convenient appointments. Women from minority groups, those who have been sexually abused and those with learning disabilities are also under-represented in screening attendances. In addition there is evidence that woman from lower socioeconomic groups and of lower educational levels are less likely to attend. 
To improve the number of women attending for gynaecological screening, there is a clear need for health education initiatives, especially targeting those groups that poorly attend and attempting to dispel some of the health myths and beliefs that may be discouraging attendance. But many women do not attend due to beliefs of pain or embarrassment, perhaps due to lack of education or perhaps due to previous poor experiences.  How can we as a health profession tackle this?
One such way is to involve women in womens’ health – allowing women to teach medical students how best to counsel and examine women in these crucial situations. Such women are named Clinical Teaching Associates or Gynaecology Teaching Associates. Women have been teaching medical students in this way for many years in the USA, Australia and some UK medical schools. [4, 5]