To make the play exam more interesting and exciting, and to perhaps give the woman some new experiences and enhance the sensations for her, yes I do tend to insert the speculum in different postions.
The regular position of course, laying on back knees up and apart. But as fit for purpose stirrups are not normally available during a play exam, I would normally place a pillow under the woman's bottom. This enables me to use the speculum with the handles facing down, and with the hips raised the angle makes the cervix easier to locate. Another tip is to use two high back wooden chairs with their backs against the bed for the woman to place her legs/feet up on, the cervix is normally very easy to locate in that postion.
And with the Sims speculum, laying on her side, one or both legs bent up to her chest. And of course kneeling on all fours, speculum inserted from behind. This position shortens the vagina and yes is rather nice. Another alternative to that, would be for the the woman to stand and bend over the bed or table.And another interesting option would be the diaphragm insertion position, standing with one foot up on a chair or the bed and the doctors hand/speculum coming up from underneath...
Dr Philip - The UK Play Doctor.