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

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

Abstract

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 χ2 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.

Keywords

Clinical breast examination Breast disease Breast cancer Breast 

Abbreviations

CBE

Clinical breast examination

OSCE

Objective structured clinical examinations

SSMBI

Standardized simulation and multimedia-based

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

Ethics approval was obtained by the review board from the Pontificia Universidad Javeriana School of Medicine in Bogota, Colombia.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Fernando A. Angarita
    • 1
  • Benjamin Price
    • 2
  • Matthew Castelo
    • 1
  • Mauricio Tawil
    • 3
    • 4
  • Juan Carlos Ayala
    • 3
  • Lilian Torregrossa
    • 3
    • 4
  1. 1.Division of General Surgery, Department of SurgeryUniversity of TorontoTorontoCanada
  2. 2.Melbourne Medical SchoolThe University of MelbourneMelbourneAustralia
  3. 3.Department of SurgeryPontificia Universidad JaverianaBogotaColombia
  4. 4.Department of SurgeryHospital Universitario San IgnacioBogotáColombia

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