title: The effect of a standardized patient instructor experience on students' anxiety and confidence levels performing the male genitorectal examination.
abstract: BACKGROUND
  Standardized patient instruction (SPI) is recommended as a nonthreatening method for teaching the male genitorectal examination. The article's purpose is to describe the method's effectiveness in reducing anxiety and increasing confidence among men and women students from diverse cultures.
  
  
  METHODS
  We implemented an SPI program in 1993 to teach the examination to 2nd-year students. Students performed their examinations in mixed gender groups of three; a man student was responsible for disrobing the SPI and performing the first exam. During the 45-min session, each of the three students performed the examination in turn, and each received immediate feedback on their technique and interpersonal approach to the patient.
  
  
  RESULTS
  All students (n = 190) evaluated their SPI encounter immediately after the session had ended.
  
  
  CONCLUSIONS
  Men and women students from all ethnic groups reported decreased anxiety and increased confidence levels after the SPI session. These findings indicate that a carefully orchestrated SPI session is effective in reducing students' anxiety about crossing personal space boundaries, overcoming a variety of proscriptions on gender-appropriate interactions, and increasing their confidence to perform this sensitive examination.
authors.affiliation: Department of Medical Education, University of Michigan Medical School, Ann Arbor, USA. lrobins@umich.edu
authors.forename: L S
authors.initials: LS
authors.lastname: Robins
authors.forename: G L
authors.initials: GL
authors.lastname: Alexander
authors.forename: L L
authors.initials: LL
authors.lastname: Dicken
authors.forename: W D
authors.initials: WD
authors.lastname: Belville
authors.forename: A J
authors.initials: AJ
authors.lastname: Zweifler