Teaching Digital Rectal Examination to Medical Students Using a Structured Workshop—a Point in the Right Direction?

Isherwood, John; Ashkir, Zakariye; Panteleimonitis, Sofoklis; Kumar, Nisha; Hemingway, David; Miller, Andrew; Norwood, Mike N.

doi:10.1016/j.jsurg.2012.09.009

Cited by 14 publications

(13 citation statements)

References 7 publications

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“…These have been shown to reduce anxiety and improve both the students' comfort in clinical settings and their clinical expertise in performing the genitourinary examination. [3][4][5][6]8 This study found that Canadian medical students attending English-speaking programs are introduced to the urogenital physical examination in the first two years of their medical education. Preparatory resources, although available to students, vary wildly between schools.…”

Section: Discussionmentioning

confidence: 85%

“…Various approaches to support students through their initial experience with genital examinations have been found to successfully improve students' comfort and perceived ability. [3][4][5][6]8 The results of these studies, however, are based on questionnaires administered immediately before and after sessions specifically aimed to alleviate stress in an artificial environment, creating a huge bias. As students' focus is shifted to other areas of medical studies, their confidence in performing the urogenital examination diminishes.…”

Section: Discussionmentioning

confidence: 99%

“…2 The introduction to sensitive physical examinationsincluding breast, female pelvic, male genital, and digital rectal exams -has repeatedly been found to induce stress and anxiety in medical students. [3][4][5][6] The personal nature of these encounters, as well as the fear of inflicting pain or harm, contribute to students' hesitancy. 6 Medical educators face the challenging task of developing well-supported clinical skills sessions to introduce these sensitive exams.…”

Section: Introductionmentioning

confidence: 99%

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Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

McAlpine

Steele

2016

CUAJ

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Introduction: The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students' anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported. Methods: This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination. Results: A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over onethird of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years. Conclusions: To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students' exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

McAlpine

Steele

2016

CUAJ

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“…11 19 22–24 The rectal model augmented with a computerised virtual patient was reported to have a similar effect on confidence as the non-augmented rectal model after simulation training. 11 The remaining four papers 19 22–24 reported that the improvement in students’ confidence was more than five percentage points after simulation training with a standard rectal model. According to Janjua et al , 28 a five percentage point increase in competence and confidence is considered clinically/educationally meaningful.…”

Section: Resultsmentioning

confidence: 96%

“…Most of the 12 papers combined TES with other learning strategies. TES was combined with lectures in five, 9 19 23–25 with video in three 20 25 26 and with TAs in three. 9 20 21 Curricular integration of the simulation training was identifiable in four, 20 24–26 skill acquisition was measured in five 9 11 18–20 and confidence was measured in five.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of technology-enhanced simulation in teaching digital rectal examination: a systematic review narrative synthesis

Asmri

Ennis

Stone

et al. 2020

BMJ Simul Technol Enhanc Learn

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BackgroundDigital rectal examination (DRE) is a challenging examination to learn.ObjectiveTo synthesise evidence regarding the effectiveness of technology-enhanced simulation (TES) for acquiring DRE skills.Study selectionEMBASE, Medline, CINAHL, Cochrane, Web of Knowledge (Science and Social Science), Scopus and IEEE Xplore were searched; the last search was performed on 3 April 2019. Included were original research studies evaluating TES to teach DRE. Data were abstracted on methodological quality, participants, instructional design and outcomes; a descriptive synthesis was performed. Quality was assessed using a modified Medical Education Research Study Quality Instrument. The study design domain was modified by scoring the papers based on (1) evaluation of risk of bias for randomised controlled trials, (2) description of participants and (3) assessment of robustness and degree of simulation fidelity of the assessments used to evaluate learning.Findings863 articles were screened; 12 were eligible, enrolling 1507 prequalified medical/clinical students and 20 qualified doctors. For skill acquisition, role player was statistically significantly superior to a static manikin (2 studies). For knowledge acquisition, manikin use was significantly superior to role player (1 study); 2 studies showed no difference. For confidence, manikin use was significantly superior to no manikin (4 studies). For comfort, manikin use was significantly superior to no manikin (2 studies). For anxiety, role player was significantly superior to manikin (1 study).Median overall quality score (QS) was 48% (27–62). Highest median QS was 73% (33–80) for data analysis; lowest median QS was 20% (7–40) for the validity of instrument. Six papers scored over 50% of the maximum score for overall quality.ConclusionsTES training is associated with improved DRE skills and should be used more widely.

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Visiting a Coloproctology Patient: Rules and Suggestions

Ratto¹,

Litta²,

Donisi³

et al. 2016

Colon, Rectum and Anus: Anatomic, Physiologic and Diagnostic Bases for Disease Management

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Teaching Digital Rectal Examination to Medical Students Using a Structured Workshop—a Point in the Right Direction?

Cited by 14 publications

References 7 publications

Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

Effectiveness of technology-enhanced simulation in teaching digital rectal examination: a systematic review narrative synthesis

Visiting a Coloproctology Patient: Rules and Suggestions

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