Teaching medical students how to perform a clinical breast examination

Abstract

One challenge in medical education is to provide training in physical examination skills. The authors conducted a randomized study to compare standardized and unstandardized methods of teaching clinical breast examinations and to determine whether trained non-medical women could teach as well as medical faculty. Sensitivity, specificity, and examination techniques were compared between first-year students at the University of Calgary Faculty of Medicine who in 1992-93 received standardized teaching from family medicine faculty or well women teachers and 70 second-year students who received unstandardized teaching during their clinical rotations. Standardized teaching included a specific examination technique using silicone breast models. The students taught by the well women teachers also examined the women's breasts. The standardized-teaching group had more consistent examination techniques and significantly higher sensitivity but lower specificity. The students taught by the well women teachers performed as well as those taught by the family medicine faculty. The teaching methods used by trained teachers and standardized models improved the students'accuracy of breast lump detection and examination skills.