Last spring the women’s bathroom on A-level of Mudd became a forum for complaints about the practices of Student Health. Specifically, women voiced dissatisfaction with gynecological examinations at the facility.
This semester, many changes have been made, particularly in the realm of sexual health practices. In addition to moving to an office that is larger and closer to campus, the Student Health staff has worked to respond to some of the criticism.
Sophomore Emily Alexander has played a major role in facilitating these changes through the Student Clinical Assistant Program, which she created and developed over the past summer. Alexander is also a Sexual Information Center counselor, as well as the student liason between Student Health and the student body.
The goal of the program is to “open lines of communication between Student Health and patients,” Alexander said, adding, “our job is not only to give feedback to Student Health from students, but also to communicate changes, actions, new ideas from healthcare to students.”
Alexander put together a resource book and trained sophomore Rebecca DeCola and senior Angela Martin as clinical assistants, early this semester. The assistants make themselves available at Student Health to “shadow” or chaperone visiting patients if they so request. This is done confidentially in order to increase the level of comfort for the patient.
The biggest change made by the program to date is implementing a written personal health history test, which replaces the former method of a verbal interview by the practitioner. This is a direct response to student complaints that the questioning made them uncomfortable and was invasive.
“It gets a lot of things out there. I feel like I would be more likely to answer those questions honestly and in detail in writing rather than talking,” DeCola said, who also volunteers as an abortion escort in Cleveland and at the Free Clinic in addition to teaching an ExCo on women’s health.
Director of Student Health Laura Hieronymus agreed that the written questioning is an improvement over previous methods. “There’s something much less threatening about writing things down. It is helpful to us and also to the patient,” she said.
“It streamlines what people are going to be talking about,” Alexander said, adding that this is both efficient and more comfortable for the patient.
Student Health runs under the model of a family practice, meaning that all doctors provide a full range of medical procedures, but none is an expert in any particular field. “The written history form is typical of a family planning model,” Alexander said. This was one example of an influence that could improve the structure of Student Health’s relationship with patients.
The questionnaire asks whether the patient has experienced any of a list of infections and symptoms, and about her menstrual, sexual and contraceptive history.
Below the medical history questions, the form says: “There is a wide range of emotions that one might feel in relation to or during the course of a pelvic exam. We will try our hardest to make sure this experience is as positive as it can be for you.”
The patient then has the option of letting the practitioner know whether she has had any former experiences that might affect her comfort during the procedure and whether she has any specific requests to make.
“One of my main interests is talking about how protocol, language, and presentation really affect the ways that people get healthcare,” DeCola said.

“Certain things have to happen during a pelvic exam, like a pap smear, but the way those things happen makes a huge difference in the quality of the healthcare,” Alexander said.
Hieronymus said the program has been beneficial in terms of getting patient feedback from students to the staff. “The problem is that people don’t want to talk to someone like me about these things,” she said, adding, “The assistants are the ones who get feedback from their fellow students.”
Another service provided by the clinical assistants is an optional exit interview, which gives the patient an opportunity to speak with a clinical assistant about her experience in the examination before she leaves. “This is just a specific and direct way to ask how it was, and I think that’s a pretty powerful statement,” Alexander said
“Some people just want to leave when they are done, which we understand,” Alexander said. While this addition to the appointment structure has been successful, other modes of outreach are being considered as well.
“One thing we want to expand is giving people other ways to give feedback, in e-mail or calling and contacting us. Also, we are available for doing research and referring people to resources in the community,” Alexander said.
“If we are saying things that are inappropriate or making students uncomfortable, then they would tell us that, but so far, that hasn’t been a problem,” Alexander said, adding, “I don’t think it has really changed anyone’s personal style.”
Hieronymus spoke of the importance of receiving student feedback, saying, “Our attitude at Student Health is, if we have a problem, we want to fix it, but if we don’t know about it, we can’t do anything to make it better,”
The Student Clinical Assistants have stressed the importance of education in matters of sexual health and healthcare.
“Our challenge now is taking into account a lot of the social provisions in healthcare, but also the medical, structural, protocol aspect. Our goal is to reach a balance between those things,” Alexander said.
“Part of doing this program and peer-counseling is to give people more information and thereby empower them when they are in the exam,” DeCola said.
“One of our larger goals is to educate students as healthcare consumers. A large part of our program is providing that information,” Alexander said.
Student Health has taken up the issue of education as well. Now, when a student makes an appointment for a pelvic exam, Student Health sends a letter explaining what to expect during the procedure, the name of a clinical assistant in case she wants to contact someone to ask questions or request a chaperone and a brochure on pelvic exams.
In addition to changes in communication methods, Student Health is in the process of making pap smears results more informative to patients.
The biggest change on the horizon for women’s health at Oberlin and for all community residents, however, is Planned Parenthood’s upcoming arrival at Student Health next semester.