I precept in the obstetrics/gynecology clinic, and teaching students how to insert a speculum into the vagina and locate the cervix can often be a challenge. An analogy I came up with has really helped. Instruct the student to gently insert the speculum into the vagina like he or she was inserting a gas nozzle into a car.

Insert the speculum into the vagina while gently pointing it downward toward the anus. When the speculum is inserted all the way into the vagina pointed down toward the anus, I tell the student to open up the speculum and slowly tilt his or her wrist upward until the cervix is fully visualized. — Aimee Holland, DNP, WHNP, FNP, RD, Birmingham, Ala. (169-6)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it, here.

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