Using students in invasive exams

A student on her way to a transvaginal probe.
[Captives via wikimedia]

This situation at Valencia State College makes me extremely angry: Students sue Florida college for alleged forced vaginal probes. "Two female college students said they were forced to endure almost weekly vaginal probes as part of a medical diagnostic sonography class at a Florida community college, according to a civil rights lawsuit filed in federal court."

This violates at least three values that are very important to me as an SP:

• Power differential: Students should not even be in a position to refuse something like this. It's ridiculous. "The complaint states that the clinical and laboratory co-ordinator initially told the students that the probes were voluntary." Even if that is true, when someone has control over your grades and future, the power differential makes it very difficult to refuse. In addition, this communicates to students that the institution values cooperation over modesty/comfort. When those students graduate, I guarantee they will carry that attitude over to patients when they are the ones in power.

• Consent: If a student refuses a transvaginal probe, that's it. Full stop. No coercion, no harassment, no threats. But based on my experiences as an SP, I don't doubt this claim:"When the women protested they were told they could find a different school, would be blacklisted from local hospital jobs and their grades would be reduced."

• Respect: This? Is the opposite of respect: “Plaintiffs endured these invasive probes without a modicum of privacy. Plaintiffs would disrobe in a restroom, drape themselves in towels, and traverse the sonography classroom in full view of instructors and other students.” So is this: "It also claims Ball made inappropriate comments during the procedures. According to the lawsuit, Ball told a student undergoing the procedure that she was “sexy” and that she should be an “escort girl”." Honestly, even colleges that do hire SPs for these exams are sometimes not as respectful as I'd like them to be. To subject students to this is infuriating.

So yeah, students used to practice invasive exams on each other. As an old-time faculty member once told me, "You never knew whether to pick a partner you liked -- or one you didn't."

But very few schools still practice this for reasons that should be extremely obvious. In fact, schools have used SP models as "gynecological teaching associates" since 1968. The VCA spokesperson states "using volunteers, including students, for medical sonography training [is] a nationally accepted practice." If true, then apparently sonography programs need to get their act together and adopt the more rigorous and respectful standard that the medical community has been using for aeons. If not, then the college is being deliberately disingenuous. Neither of these things gives me confidence in the strength of their educational program.

I suspect the college uses students because GTAs are expensive, and rightfully so. But they are worth every penny, not the least because it avoids this outrageous and uncomfortable tangle between students, peers & faculty.

Extra credit
Relatedly, I cringed when I recently read this from The Naturopathic Diaries: "It was not uncommon for students to perform prostate and gynecological exams on each other in order to complete the required examination for competency. And in fact, the instructor of our advanced gynecology class (an elective course) asked the female students taking the course to act as standardized patients. When I learned this, I was happy that I did not register for the weekend elective course. The lack of actual patients to practice examinations significantly hinders naturopathic clinical training." I know this is not true for all naturopathic colleges, but I imagine it's true for many. Argh!

Setting the Standard:

Students should never have to be put in a position to refuse an invasive exam. Instead, schools should always hire male and female models for those exams. When they do, they should be paid well and treated respectfully.