Beyond technical skills: women's expectations regarding the relational dimensions prior to gynecologic examinations.

INTRODUCTION

Gynecologic examinations expose women to particular vulnerability, making relational and ethical aspects essential beyond technical skills. While professional societies outline recommended behaviors, the importance women attribute to these non-technical elements remains insufficiently characterized. This study aimed to assess how women value key relational components of gynecologic examinations.

METHODS

In this exploratory cross-sectional study, a questionnaire was developed from gynecologic and ethical guidelines, and distributed via QR codes in outpatient gynecology and general practice settings. Eleven items (Q1-Q11) were rated on a numeric scale (0-10). Principal component analysis (PCA) assessed internal coherence and identified thematic dimensions. Descriptive and comparative analyses were conducted, including stratification by age and prior gynecologic examination.

RESULTS

A total of 540 women participated (mean age 37 ± 10 years). PCA identified three dimensions: consent (Q1, Q5, Q9-Q11), privacy (Q6-Q8), and feelings/experience (Q2-Q4). Consent-related items received the highest scores (all >9/10 except Q1). Privacy items showed greater variability, with lower importance assigned by women over 50 to partial undressing (p = 0.006) and draping (p = 0.007), while women undergoing their first examination assigned greater importance to undressing out of the provider's sight (p = 0.01). Feelings-related items were more heterogeneous, although attention to patients' feelings during the examination was highly rated (9.7 ± 0.8).

CONCLUSION

Women consistently prioritized explicit and ongoing consent and sustained attention to their feelings. Privacy was also important, though more variable. These findings support the integration and structured assessment of non-technical competencies in training related to gynecologic examinations.