Journal Article

Improving the competency of medical students in clinical breast examination through a standardized simulation and multimedia-based curriculum

Tawil, Mauricio, Ayala, Juan Carlos, Castelo, Matthew, Angarita, Fernando A., Price, Benjamin, Torregrossa, Lilian

2019

Overview

Purpose Clinical breast examination (CBE) is an important step in the assessment of patients with breast-related complaints. We developed a standardized simulation and multimedia-based (SSMBI) curriculum using current evidenced-based recommendations. This study aimed to determine if SSMBI training resulted in better performance (examination scores and detection of abnormal findings) than the traditional teaching method. Methods Novice fourth-year medical students were exposed to the SSMBI curriculum ( n  = 68) or traditional ( n  = 52) training. The traditional group was taught by a lecture and attending weekly clinics where they had hands-on experience. The SSMBI group underwent a structured lecture followed by an instructional video and dedicated simulated teaching. Both groups were assessed through a written knowledge exam and an objective structured clinical examination (OSCE). Student’s t test and χ 2 tests were used to assess differences in CBE technique and knoweldge. Results Students who underwent SSMBI training had significantly higher numbers of correct answers describing the different steps and justifications of CBE. OSCE performance was significantly higher in the SSMBI group. SSMBI-trained students were more likely to complete all the necessary CBE steps compared to traditionally-trained students (88.2% vs. 28.2%, p  < 0.00001). The SSMBI group was also more systematic and more likely to perform adequate inspection, palpation, examination of the nipple-areolar complex, and identify and characterize a palpable lesion ( p  < 0.05). Conclusions Formal SSMBI training is an important asset when teaching medical students how to perform a CBE. Real clinical experience is still necessary to refine this skill and the physician–patient interaction.

• Publisher: Springer US,Springer,Springer Nature B.V
• Subject: Academic Performance - statistics & numerical data / Breast / Breast cancer / Breast Neoplasms - diagnosis / Cancer research / Clinical Competence / Curricula / Curriculum / Education, Medical / Epidemiology / Female / Humans / Medical examination / Medical personnel training / Medical schools / Medical students / Medicine / Medicine & Public Health / Multimedia / Oncology / Palpation - methods / Physician-patient relations / Physicians / Simulation Training - methods / Students / Students, Medical - statistics & numerical data / Teachers