title: Lost in translation: unfolding medical students' misconceptions of how to perform a clinical digital rectal examination.
abstract: BACKGROUND
  Digital rectal examination (DRE) skills are difficult to teach and assess. This study sought to assess the construct validity of newly developed DRE simulators, which were then used to evaluate DRE palpation techniques and accuracy based on experience.
  
  
  METHODS
  Medical students (n = 30), residents (n = 24), and experienced clinicians (n = 24) performed clinical DREs on the simulators and documented their findings. During the examinations, computer-generated quantitative performance data were collected.
  
  
  RESULTS
  Students focused more on pronating and supinating their examining finger in the rectum. In addition, students were less accurate when assessing the prostate gland compared with experienced clinicians and residents (students = 33%, residents = 64%, and clinicians = 76%; P <.05.
  
  
  CONCLUSIONS
  The DRE simulators were useful in defining specific differences in clinical DRE palpation techniques based on experience. We believe the observed differences are largely caused by students' misconceptions about how to perform the DRE.
authors.affiliation: Howard University, Washington, DC, USA.
authors.forename: Rishi
authors.initials: R
authors.lastname: Balkissoon
authors.forename: Katherine
authors.initials: K
authors.lastname: Blossfield
authors.forename: Lawrence
authors.initials: L
authors.lastname: Salud
authors.forename: Debra
authors.initials: D
authors.lastname: Ford
authors.forename: Carla
authors.initials: C
authors.lastname: Pugh