Simulation training for breast and pelvic physical examination: a systematic review and meta‐analysis

Abstract

Background Breast and pelvic examinations are challenging intimate examinations. Technology-based simulation may help to overcome these challenges.Objective To synthesise the evidence regarding the effectiveness of technology-based simulation training for breast and pelvic examination.Search strategy Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was January 2012.Selection criteria Original research studies evaluating technologyenhanced simulation of breast and pelvic examination to teach learners, compared with no intervention or with other educational activities.Data collection and analysis The reviewers evaluated study eligibility and abstracted data on methodological quality, learners, instructional design, and outcomes, and used random-effects models to pool weighted effect sizes.Main results In total, 11 272 articles were identified for screening, and 22 studies were eligible, enrolling 2036 trainees. In eight studies comparing simulation for breast examination training with no intervention, simulation was associated with a significant improvement in skill, with a pooled effect size of 0.86 (95% CI 0.52-1.19; P < 0.001). Four studies comparing simulation training for pelvic examination with no intervention had a large and significant benefit, with a pooled effect size of 1.18 (95% CI 0.40-1.96; P = 0.003). Among breast examination simulation studies, dynamic models providing feedback were associated with improved outcomes. In pelvic examination simulation studies, the addition of a standardised patient to the simulation model and the use of an electronic model with enhanced feedback improved outcomes.Author's conclusions In comparison with no intervention, breast and pelvic examination simulation training is associated with moderate to large effects for skills outcomes. Enhanced feedback appears to improve learning.

Évaluation du savoir-faire en sémiologie clinique des étudiants en fin de deuxième cycle des études médicales

“…Des ateliers pratiques sont envisageables sous la forme d'enseignements dirigés, avec examen simulé sur des camarades ou mannequins [23,24]. Aux États-Unis, l'utilisation de « patients standardisés » joués par des acteurs formés pour simuler un patient ayant tel ou tel problème médical est de plus en plus répandue pour la formation et l'évaluation des étudiants en médecine [25] ou l'accréditation des médecins formés à l'étranger [26].…”

Women’s experiences of working as a Clinical Teaching Associate teaching sensitive examinations: A qualitative study

“…Teaching pelvic examination to medical students is challenging and traditional methods have limitations for learning appropriate technical and communication skills Professional patients (Clinical Teaching Associates in this study) provide an opportunity for students to learn appropriate skills from women who provide teaching in the examination as they are examined Women who teach students to perform pelvic examination are motivated and engaged in their role because they recognise the importance of appropriate training in these skills for medical graduates Understanding more about the experiences of women who undertake this challenging and important work may inform approaches to recruiting women to similar programs research suggests improved learning outcomes result when standardised patients provide feedback as part of teaching pelvic examination (Dilaveri et al 2013). In the CTA program, students from different backgrounds (such as medical students, international medical graduates, and nurse practitioners) are taught to competently perform a pelvic examination in a manner that is acceptable to the patient.…”

Genital examination training: assessing the effectiveness of an integrated female and male teaching programme

“…Internationally there has been a shift towards the use of paid, trained gynaecological teaching associates (GTAs) especially for learning to examine the female pelvis [12]. However there have been few studies investigating the effectiveness of female and male genital examination training using Teaching Associates (TAs) undertaken as part of the same programme [8, 13]. …”

“…For example, the addition of a standardised patient to a simulation model and use of electronic feedback [13], the use of standardised patients to teach genital examination prior to using the mechanical simulation, [15] and the use of an online learning module viewed immediately prior to a simulated class session [16]. …”