title: Structured clinical breast examination (CBE) training results in objective improvement in CBE skills.
abstract: BACKGROUND
  A statewide breast cancer care provider needs assessment had identified CBE training as a target educational need. Accordingly, the authors implemented a one-on-one skills-based course for primary care providers (PCPs) across the state.
  
  
  METHODS
  The course had two components: a prerequisite self-study manual, followed by a 1 1/2-hour skills-based practicum. As part of the practicum, pre- and post-course testing were performed on standardized silicone breast models.
  
  
  RESULTS
  Pre- and post-testing data were available for 205 PCPs who completed the course. In the pre-test period, 59% of PCPs examined could detect 60-100% of the lumps. In the post-test, that rose to 94% of PCPs detecting 60-100% of the lumps. This improvement reached statistical significance. Further, false-positive lump detection declined in the post-test period to 59% of the pre-test rate (236 to 139).
  
  
  CONCLUSIONS
  Formal CBE training for PCPs significantly improves the sensitivity of lump detection and concurrently reduces false-positive detection. The program is currently being extended to a greater number of providers across the state.
authors.affiliation: Department of Surgery, OHSU Cancer Institute, Oregon Health and Science University, Portland 97201-3098, USA. vettoj@ohsu.edu
authors.forename: John T
authors.initials: JT
authors.lastname: Vetto
authors.forename: John K
authors.initials: JK
authors.lastname: Petty
authors.forename: Nancy
authors.initials: N
authors.lastname: Dunn
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Prouser
authors.forename: Donald F
authors.initials: DF
authors.lastname: Austin
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D016504:Breast Self-Examination; D002983:Clinical Competence; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008495:Medical Oncology / Q000193:education; D020380:Needs Assessment; D009922:Oregon; D010808:Physical Examination / Q000379:methods*; D011320:Primary Health Care / Q000379:methods; D016730:Program Development; D015397:Program Evaluation; D012680:Sensitivity and Specificity