title: Effectiveness of a dynamic breast examination training model to improve clinical breast examination (CBE) skills.
abstract: Despite the potential utility of clinical breast examination (CBE), doctors' palpation skills are often inadequate and difficult to train. CBE sensitivity ranges from 39-59%, in part because current training does not effectively teach tactile skills. To address CBE training limitations, we developed a breast examination training model with 15 dynamically controlled lumps, set to desired hardness within underlying rib and muscle structures, in a silicone breast. In an experiment of 48 medical students, training with the dynamic model increased lump detection by 1.35 lumps compared to 0.60 lumps for a traditional breast model (P=0.008), reduced false positives by -0.70 lumps compared to +0.42 lumps (P=0.0277), and demonstrated skill transfer with a 1.17 lump detection improvement on the traditional device compared to only a 0.17 lump detection improvement by traditional device trainees on the dynamic device (P<0.001). Findings demonstrate the advantage of the dynamic model over conventional models in training CBE tactile skills.
authors.affiliation: Department of Industrial Engineering, University of Iowa, Industrial Engineering, 3131 Seamans Center, Iowa City, IA 52242, USA. gregory-gerling@uiowa.edu
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Gerling
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Weissman
authors.forename: Geb W
authors.initials: GW
authors.lastname: Thomas
authors.forename: Edwin L
authors.initials: EL
authors.lastname: Dove
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology* / Q000517:prevention & control*; D004504:Education, Medical, Undergraduate / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008953:Models, Anatomic; D017145:Models, Educational; D010173:Palpation; D010808:Physical Examination; D015397:Program Evaluation