Conscious engagement within patients’ and simulated participants’ personal space: medical students' perspective

Abstract

Background: #MeToo prompted a shift in acceptable societal norms, sparking global recognition of the complexities of entering another’s personal space. Physical examinations are an integral part of medicine yet have the capacity to encroach upon patient’s personal space, whether in simulated or clinical environments. Examinations may be misconstrued as inappropriate advances, with negative effects for both patient and doctor. Medical educators must consider how they teach students to approach this complex task. This study aimed to gain insight into the lived experiences of medical students when working within patient’s personal space. This builds on previous research from the perspective of simulated participants. Method: A hermeneutic phenomenology approach was used to explore lived experiences of working within patient’s personal space. Data was collected from seven medical students through semi-structured interviews and thematically analysed using template analysis. Results: The analysis yielded four main themes: (1) transitioning into a privileged position; (2) negative role modelling: emphasising the physical; (3) consent: a dynamic and fragile state; and (4) a simple act or a complex performance? Discussion: This study provides a unique insight into the lived experiences of medical students when working within a patient’s personal space. The physical examination is a complex process; the experiences of medical students can shape learning on crossing boundaries. Medical educators need to reflect this complexity in teaching, mirroring societal interest around the boundaries of consent. Students need a pedagogical space to develop these interpersonal skills, to prevent early adoption of the clinical gaze, and to create more consciously engaged doctors for the future.