Last week, my small group consisting of Jackie, Christi, and myself, met our “Standardized Patient Examination Teaching Associates,” SPETA for short, and learned how to properly introduce ourselves to patients and how to obtain basic vitals signs- pulse, respiration rate, blood pressure, etc. Our SPETA is an actor in his mid to late forties, trained in ballet and martial arts, who now focuses on his work as a teaching associate for CU. It’s hard to imagine your teacher as anything else, but while celebrating my most recent birthday at The Fort restaurant in Morrison, my mother told the flute player of my entry into medical school, and he told us that he was, in fact, a SPETA as well. I had to chuckle; I guess the kind of personality that likes being probed and fondled by noobie med students isn’t that rare after all. At some point money is money, and at the end of the day, paying the bills can be accomplished by playing the flute, selling your plasma, or even getting your prostate checked.
This last Monday, we had our first official session with our SPETA, learning how to perform lower limb and back musculoskeletal exams. It seemed pretty straight forward as I read down the list of learning objectives- tapping the patellar tendon for reflexes, manipulating the knee to test for ligament stability, examining the spine for scoliosis. And then I read a little further down, to palpating the pubic symphysis and taking the femoral pulse. I’m not squeamish, and I like the fact that in this business I will get to touch people, but I thought it might be a few more weeks before we got into the touching of groins. Conveniently, this procedure was not in the tutorial video that we were supposed to watch before hand.
I walked into our tiny classroom, and there was our SPETA in his little blue and white gown sitting on the end of the exam table, swinging his feet. I felt a momentary twinge of jealousy for other groups that had female SPETAs. Jackie drew the metaphorical short straw and went first. Our SPETA told her what to do, starting with asking the patient to walk a little to observe their gait for limping or anything else. Next, she inspected his spinous processes (the part of your spine that you can feel sticking out of your back) and had him bend at the hips to see if he had any weakness in the muscles of his back. Skipping ahead… he lay down on the exam table, and Jackie palpated his iliac crests, which are what women rest their babies on and what people generally think of when they think of “hips.” If Jackie felt uncomfortable at all when she slid her hands under the waist band of our SPETA’s boxer shorts, she showed no sign. When my turn came around, my apprehension was gone. Maybe it helped that he had some curly hairs on his chest and belly, but he was so matter-of-fact about the whole process, that there was nothing to feel awkward about. Having never found a femoral pulse on anyone, including myself, I had to dig around a bit, but he had nothing but patience.
Today we did upper limb exams, and it was nice to be back in the comfort zone, having enough anxiety about our up-coming test to sustain me for a while. Not that it won’t be intrusive to do these sorts of exams on other women, but I’m glad I have a male SPETA, so I can get over the weirdness of sticking my hand down a stranger’s pants in a “safe place” rather than in the Stout Street Clinic for homeless in a few weeks.
the "only" equation we need to know in med school -----> P=MD
pass = medical doctor
