Earlier this year, 1700 students filled out a questionnaire by the website De Geneeskundestudent. Television programme Nieuwsuur reported on it: one third of respondents said they found the compulsatory nature of practising on each other – a regular part of the programme – problematic. A quarter said they felt uncomfortable and a further quarter said they wouldn’t mention that discomfort to a supervisor or the university.
Does that match the feelings at Maastricht? It would appear not. Pulse, the study association for medical students, responded to questions by saying they haven’t received any signals of students who strongly object. There is occasionally discomfort, they say, “but that is not the same as an objection”.
Practicing on each other is just a part of it
Femke Jongen agrees. She leads the Skillslab for the Faculty of Health, Medicine and Life sciences (FMHL). Medical students practise their practical skills there, from consultations and reanimating to various physical exams. On mannequins (models), simulated patients, real patients, and of course, each other. The latter is just a part of it, emphasises Jongen: “You can practise more often on your fellow students than on simulated patients. It means you interact with many more people and really learn that every body is different. Moreover, it helps students learn what it is like to undergo physical exams and give each other feedback.”
No concessions in learning outcomes
Students who struggle with practicing on each other, can practise on someone they already know by signing up for a session together, or sign up specifically with a male or female teacher, if they are available. Any questions they might have, they can ask their ‘skillscoach’ – a teacher assigned to the students, who follows their progress and eventually assesses them. Since 2019, there is also an independent ‘contact person’ at the Skillslab who deals with questions and objections. Jongen says that students make little use of that last option: “We have to make special arrangements with a student about five times a year.”
She doesn’t go into much detail about the reasons why, other than to say they are “wide ranging”, different for each student, and that “as long as we’ve been here, we’ve always found a way to sort it. Meaning that we have found a solution that did right by the student, the programme, and the learning outcomes” – she emphasises that no concessions are made in what a student must be able to do.
"Improve the communication"
Jongen is the chair of the clinical skills workgroup of the Dutch Association for the Study of Medicine (NVMO), which has been working on a national guideline for skills training since before the Nieuwsuur broadcast. “Precisely because there were more questions about practising on each other.”
The guideline, published in November, won’t change all that much for FHML, she says. “However, we can improve the communication towards prospective students: make it very clear that skills training that includes practising on each other is an integral part of studying Medicine, and that we expect all students to actively participate.”