Barriers Preventing Medical Students From Performing Pelvic Examinations During Obstetrics and Gynaecology Clinical Clerkship Rotations.

OBJECTIVE: This study sought to identify barriers that prevent medical students from performing pelvic examinations in their obstetrics and gynaecology (Ob/Gyn) clinical clerkship rotations and to compare the perspectives of faculty, residents, nurses, and students regarding perceived barriers. METHODS: An electronic survey was distributed to third-year Dalhousie University (Halifax, NS) medical students on completion of their Ob/Gyn clerkship rotations in the 2015-2016 academic year and to Ob/Gyn nursing staff, faculty, and residents (Canadian Task Force Classification III). RESULTS: There were 82 responses, giving an overall response rate of 28%. Students reported performing an average of 9.2 speculum examinations, 3.8 cervical checks, and 2.8 bimanual examinations during their 6-week rotations. They reported being declined the opportunity to perform an examination an average of 7.1 times. Students perceived themselves to be more competent performing these examinations compared with staff perception of student competency. Students perceived resident interest in teaching, resident and staff time constraints, and patient willingness to have a medical student involved in their examination as frequent barriers. Faculty, residents, and nurses perceived student gender, patient willingness, difficulty of examination, and resident time constraints to be significant barriers. CONCLUSION: This study is the first to examine multidisciplinary perspectives on perceived barriers to medical students performing pelvic examinations. Staff and students have different perceptions of a student's competence performing these examinations. Existing barriers are likely multifactorial.

The impact and specificity of nerve perturbation on novel vibrotactile sensory letter learning.

The purposes of this study were to determine if induced radiating paresthesia interferes with (a) acquisition and/or (b) utilization of complex tactile information, and (c) identify whether interference reflects tactile masking or response competition. Radiating ulnar (experiment 1) and median (experiment 2) nerve paresthesia was quantified on ulnar innervated vibrotactile Morse code letter acquisition and recollection tasks. Induced paresthesia differentially impacted letter acquisition and recollection, but only when presented to the same anatomical spatial location.

Expression pattern diversity and functional conservation between retroposed PRAT genes from Drosophila melanogaster and Drosophila virilis.

Gene duplication by retrotransposition duplicates only the coding and untranslated regions of a gene and, thus, biases retroduplicated genes toward having different expression patterns from their parental genes. As such, genes duplicated by retrotransposition are more likely to develop novel expression domains. To explore this idea further, we used the Prat/Prat2 gene duplication in Drosophila as a case study to examine the aftermath of a retrotransposition event that resulted in both the parent and the child gene becoming essential for survival. We used the Gal4-UAS transgene system with EGFP as a reporter to determine the developmental expression patterns of Prat and Prat2 from D. melanogaster (DmPrat and DmPrat2) and Prat from D. virilis (DvPrat). We also tested the functional equivalence of the protein products of DmPrat and DmPrat2. We found that each of the proteins could rescue DmPrat mutations, showing that the requirement for both Prat and Prat2 in Drosophila is not simply due to differences in protein function. In contrast, we found that the DmPrat and DmPrat2 genes have developed nonoverlapping patterns of expression, which correlate with their respective loss-of-function phenotypes. We further found that DvPrat expression is similar to DmPrat during development but differs in adult gonads. Thus, the function of the Prat retrogene has not diverged in the D. melanogaster and D. virilis lineages, while some aspects of its expression pattern have evolved. Finally, we have identified promoter elements, conserved upstream of DmPrat and DvPrat, that this retrogene has acquired to drive its expression.