“Physical touch” contact points used in procedural touch, from educational checklists, by undergraduate medical students.
DOI:
https://doi.org/10.22024/UniKent/03/ajpp.1317Resumen
Introduction: Despite being a fundamental form of human interaction, touch has received little focus in the literature, particularly as a tool in primary care consultations. The GMC outlines, in Outcomes for Graduates, that clinicians need to practice person-centred care, integrating safety and sensitivity into every consultation with a patient. As described by Cocksedge, George and Chew-graham, 2013, touch may be “procedural touch” (part of a clinical task) or “expressive touch” (physical contact unrelated to a procedure).
Methods: A qualitative study was conducted to identify which anatomical locations are most touched in clinical examinations and procedures by clinicians. Physical Examinations and Procedures were identified via the GMC Medical Licensing Assessment (MLA) content map. Data was collected from Objective Structure Clinical Examination (OSCE) checklists from reputable digital sources and analysed quantitatively.
Results: 37 checklists were analysed, with the Upper Limb, and Head and Neck, bodily regions being the most frequently touched across procedures and examinations. There were discrepancies between procedures and examinations, in terms of the proportion of required palpation such as otoscopy and examination of the ear. The blood transfusion procedural checklist lacked significant physical touch, which possibly contrasts the patient’s feelings around the daunting experience.
Conclusion: This research illustrates the frequent interaction with the upper limb for physical interaction between patients and clinicians during examinations or procedures, and the importance of educating students to demonstrate compassion and provide reassurance in a socially acceptable manner, while simultaneously assessing patients for signs of illness in the consultation. The hand emerged as a primary site of physician- patient interaction, so may warrant targeted research into how medical students are educated on the use of touch in their clinical practice. The project findings emphasize the necessity for further inquiry into the perspectives of medical students on the inclusion of expressive and procedural touch in their skills education.
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