I learned the hard way, the old-fashioned way. I did my first pelvic exam on a colleague, who then did her first on me. We were terrified amateurs, willing to endure all just to get through. "You did great!" we congratulated each other, masking the inevitable discomfort with hearty words of encouragement. I did my second pelvic exam on a patient. What that patient experienced, I'll never know, because she didn't tell and I didn't ask. It took a year or two for me to begin to feel comfortable with the procedure and more years to feel skilled at it. And still I couldn't gauge my patient's experience. I'd say, casually, "You okay?" as I inserted the speculum. She'd say "Uh huh." Sometimes she convinced me, sometimes not.