Developing Gynecological/Male Urological Teaching Associate Programs in New Locations, Including Internationally

By Liz Ohle and Kat Wentworth

Teaching with Gynecological/Male Urological Teaching Associates (GTA/MUTAs) has become common in recent decades, especially in North America but also in a few countries outside of North America, where this instructional mode is culturally more difficult to understand and accept.   There have been many challenges for devoted practitioners working to develop a climate for change within their institution, advocate for adequate resources, and create (or borrow) GTA/MUTA program guidelines.

GTA/MUTA’s are instructors who are specifically trained to teach, assess, and provide feedback to learners about accurate pelvic, rectal and/or breast examination techniques. They also address the communication skills needed to provide a comfortable exam in a standardized manner, while using their bodies as teaching tools in a supportive, non-threatening environment

Some institutions use task trainers and/or mannequins for student learning, and clinicians for teaching genital exam skills.  In this case, students have their first experience performing genital exams on actual patients in the clinics. Other institutions use clinic patients or standardized patients as “models” and students are lead through the exam by a preceptor without the benefit of instruction and feedback from the person receiving the exam. However, instruction by GTA/MUTAs is viewed as the preferred instructional method due to the emphasis on patient-centered care, immediate feedback from the “patient” teaching and receiving the exam, and overwhelmingly positive post-instruction evaluations by students taught by the GTA/MUTAs.

In spite of multiple challenges, many programs in isolated areas, or with cultural components different than North America, do commit to the GTA/MUTA instructional method, through creative individualized solutions, as well as some common strategies.

Combined methodology:

SPs are sometime implemented for portions of the exam such as history taking or patient positioning, with task trainers or mannequins used for the actual examination instruction.  SPs in these cases are not teaching associates, but their use may help soften barriers to SP involvement with sexual and reproductive health teaching and can provide patient-centered guidance in the use of appropriate language.

Contracting with existing GTA/MUTA programs

Institutions within North America, Australia, Asia and the Caribbean have found it easier to contract with experts nearby or from half way around the world, when faced with difficulties recruiting from the local population.

Sometimes the trainers do not have the expertise and cannot manage a busy program and devote the necessary time to setting guidelines and training GTA/MUTAs.  If a geographic location has people who would like to become GTA/MUTAs, it is possible to contract with experts to travel to train the trainer and the local GTA/MUTAs as the new program becomes established.

Some programs have contracted with others to provide GTA/MUTAs for the actual instructional sessions with students, so as to avoid the complications and growing pains of starting their own program but benefit from having the students learn from GTA/MUTAs.

This option is ideal if an institution only utilizes GTA/MUTAs once or twice per year.  The annual training required to keep local GTA/MUTAs skills up-to-date may be impractical, or there may be cultural, religious or societal considerations that keep local people from becoming GTA/MUTAs.  GTA/MUTAs from external sources can provide the training necessary for health care professionals without causing embarrassment, or being culturally inappropriate.

Many SP educators have helped their institutions successfully provide thorough instruction by GTA/MUTAs by creatively addressing the issues that exist within their specific environment.

If you have been charged with creating a GTA/MUTA program at your institution, we encourage you to join the ASPE GTA/MUTA/MUTA Special Interest Group (SIG) to tap into the wealth of knowledge possessed by its members.  Please contact Isle Polonko at

Also, read an article on the ASPE website for more information on creative ways to recruit GTA/MUTAs:   

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