The pelvic exam is a critical diagnostic tool used to identify infections, abnormalities, and cancers, and it requires both technical skill and empathy to ensure patient comfort. As a key component of comprehensive care, its proper teaching is essential; however, there is limited data on how providers are educated in performing pelvic exams. While there is extensive literature on the use of standardized patients (SPs) in medical education, training methods for pelvic exams vary widely across medical schools. Many students report apprehension due to lack of exposure, limited training on realistic models, and the sensitive nature of the exam, which makes it challenging to teach and perform on live patients.

Standardized patients have been shown to be an effective educational tool, as they simulate real clinical scenarios that enhance both technical skills and communication. They also provide a safe environment for practice, allowing students to receive feedback and improve. Training with SPs has been associated with increased comfort, confidence, and proficiency, as well as reduced anxiety, and has demonstrated improved outcomes compared to model-based training alone.

Given that pelvic exam training is not standardized across medical schools, there is a clear need for more uniform educational approaches. Implementing standardized training methods can improve student competence, enhance patient care, and ensure that future providers are better prepared and more confident when performing pelvic exams in real clinical settings.

We conducted a single-institution, one-group pretest–posttest study evaluating third-year medical student confidence and preparedness in performing pelvic examinations following a standardized patient (SP) training session during the obstetrics and gynecology clerkship. Students completed pre- and post-intervention surveys using 4-point ordinal scales assessing confidence and preparedness. Wilcoxon signed-rank tests were used to compare pre- and post-scores. Ordinal logistic regression with generalized estimating equations was performed to estimate the odds of higher post-training scores while accounting for repeated measures. Analyses were stratified by sex, prior career, gap year, and prior pelvic exam experience.

Twenty-eight students completed both pre- and post-surveys. At baseline, 86% of students reported low confidence and 96% reported low preparedness, with minimal prior pelvic exam experience. Following SP training, confidence and preparedness improved significantly (both p < 0.0001). Median confidence increased from 1 to 2 points (on a 4 point scale), with 86% of students reporting average or extremely high confidence post-training. Preparedness similarly improved, with nearly half of students reporting feeling very or extremely prepared. Students had approximately 35-fold higher odds of greater confidence (OR 34.5, 95% CI 9.0–132.5) and preparedness (OR 35.3, 95% CI 5.1–242.5) after training. Improvements were consistent across all subgroups, with no significant differences by sex, prior experience, or background characteristics.

Standardized patient–based pelvic exam training significantly improves medical student confidence and preparedness and addresses a critical gap in baseline experience. This structured, feedback-driven intervention is effective across diverse learner backgrounds and is strongly supported by students. Incorporating SP-based training early in clinical education may enhance skill acquisition, increase learner engagement, and improve the delivery of patient-centered care in women’s health.