Genitourinary exam skills training curriculum for medical students: a follow-up study of comfort and skill utilization.
OBJECTIVE
We developed a genitourinary skills training (GUST) curriculum for incoming third year medical students (MS3) and performed a follow-up study of comfort with and utilization of these skills.


METHODS
GUST consisted of a didactic lecture followed by skills sessions including standardized patient testicular examination (TE) and digital rectal examination (DRE), male and female Foley catheter (MFC and FFC) placement training, suture-knot tying, and a faculty-directed small group learning session. Precourse and postcourse, and 6 and 18 months after the course, MS3 rated comfort with each skill (Likert scale 0-5), and quantified skill usage. Results were compared with 4th year students (MS4) who had not undergone GUST.


RESULTS
Participants were 281 MS3 GUST students and 44 MS4. Post-GUST, mean comfort on a Likert scale (0=uncomfortable) increased for all four skills (88.2%-96.9% vs 8.3%-18.5%, P<0.0001). This was maintained at the 6-month and 18-month follow up time points (P<0.0001). At 18 months, MS3 trended toward higher comfort with TE compared with MS4 (74 vs 54%, P=0.068), while with the other skills, both groups showed equal comfort. MS4 learned exam skills from faculty and MFC and FFC from nurses on the wards. Eleven percent of MS4 were never formally taught TE or DRE. MS3 and MS4 performed TE and/or DRE on <8% of newly admitted patients.


CONCLUSIONS
MS3 described improved comfort with the GU skills at all time points during follow-up. This was particularly important because both MS3 and MS4 reported using their skills infrequently during their clinical training years.
Department of Urology, University of California-Irvine Medical Center, 333 City Blvd. West, Orange, CA 92868, USA.
Adam G
AG
Kaplan
Corollos S
CS
Abdelshehid
Narges
N
Alipanah
Tahereh
T
Zamansani
Jason
J
Lee
Surendra B
SB
Kolla
Petros G
PG
Sountoulides
Joseph
J
Graversen
Achim
A
Lusch
Oskar G
OG
Kaufmann
Michael
M
Louie
Ralph V
RV
Clayman
Elspeth M
EM
McDougall
D002983:Clinical Competence; D003479:Curriculum / Q000592:standards*; D004501:Education, Medical / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010808:Physical Examination; D013337:Students, Medical; D011795:Surveys and Questionnaires; D013997:Time Factors; D014572:Urology / Q000193:education*