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Historically, draping techniques have taken a secondary seat
to other physical exam skills taught in our first year Normal
Physical Exam Course. Fourth year students, who mentor the
first year students in this course have taught techniques occasionally, but inconsistently. SPs have given draping
feedback when there is time. We discovered that students
consistently report that they crave more feedback on patient
comfort and draping, according to our end-of-session student evaluations.
A search of available resources showed that there was little
information on the basics of draping during a normal physical
exam. Videos on basic physical exam skills did not include
draping.
In 2007 a perfunctory draping demonstration was given to
students in the lecture hall immediately before performing a physical exam with SP’s for their first time.
Although this had its benefits, the flaws of this method were
evident. The need for staff and SPs to demonstrate, and time
pressure created by the challenge of running tests in 16 exam
rooms at the same time caused a physical demonstration to
be prohibitive.
It was decided that students would better learn the basics of
draping before their first SP physical exam encounter so that
they would have time to visualize and practice the techniques.
Properly draping a patient during the physical exam has the proven benefits of providing warmth, comfort, respect, and
increased trust in the physician-patient relationship. It is a
simple matter once you have seen the techniques and
learned the principles.
Practice of technique ahead of time increases the students’
confidence during the physical exams, and likewise
increases the patient’s satisfaction with the exams.
For additional information:
vfulmer@medschool.pitt.edu 412-648-8702
UTILIZATION OF VIDEO FOR THE INSTRUCTION OF DRAPING TECHNIQUES
Valerie L. Fulmer, Mary Poshadel Koopman, Janice K. Johnson, John F. Mahoney, Hollis D. Day
University of Pittsburgh School of Medicine
RESULTS BACKGROUND
METHOD
PURPOSE CONCLUSIONS
Once techniques and principles have been witnessed, draping
is a straightforward skill. However, it does require familiarity
and practice in order to achieve mastery.
Clear communication of expectations and consistent
instruction has helped the first year class of 2008, as
indicated by standardized patient checklist data taken from
the physical exam.
In 2009 we plan to post the draping video on the student
educational site (Navigator) so that the students of all years
can access the material for reference.
We look forward to second year test scores which will indicate
whether or not students are incorporating this newly taught skill year to year.
Our solution was to create a comprehensive video on
draping the patient during the physical exam. In 2008 this
video was made available to students ahead of testing time
in the lecture hall prior to students performing their first physical exam on SPs. It is only 7 minutes long and gives
the students comprehensive and reliable information that
they can use in a variety of patient care settings.
Each year after this exam, SPs are asked to give students
written feedback on what went well and areas for improvement.
Each year students are asked what three things on which
they would most like to receive feedback.
Figure 1 shows the percent of positive comments given by
SPs that related to students’ draping techniques in 2007 before
the draping video was developed, and in 2008 after the video
was utilized.
As the figure shows, SPs gave more than twice as many
positive comments about draping techniques in 2008 than in
2007.
Figures 2 and 3 show the topics that students expressed
interest in wanting feedback on in 2007 and 2008,
respectively, according to post-testing student evaluations.
As the figures show, in 2008 students wanted feedback on draping techniques nearly twice as often as in 2007.
Additionally, of the 147 first year medical students queried,
99.9% reported that they found the video helpful:
“I was very nervous about draping, but the video cleared up my questions and concerns.”
“It's something that I was just going to improvise, but the video gave me a standard method, which I knew would make them comfortable.”
“Very much so, it was an aspect we really didn’t practice and made me more comfortable about the whole thing.” “Yes—gave great insight into how to drape properly—wouldn’t have been sure without.”
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