Creation of a Novel Digital Rectal Examination Evaluation Instrument to Teach and Assess Prostate Examination Proficiency.


Journal Article

OBJECTIVE: To create a validated tool to measure digital rectal examination proficiency and aid with teaching of the examination. DESIGN: The Digital Rectal Examination Clinical Tool was created using a modified Delphi method with 5 urologists and 5 radiation oncologists. The instrument was then validated in a population of preclinical medical students examining male urological teaching associates, and clinical trainees (third- and fourth-year medical students and urology resident physicians) examining prospectively enrolled subjects. Trainees completed paired examinations with an attending urologist, and responses were scored with reference to the attending responses. SETTING: The instrument was validated at the University of Virginia in the urology clinic, endoscopic operating room, and main operating room settings. PARTICIPANTS: We tested the instrument on consenting subjects consisting of male urologic teaching associates (n = 12), clinic patients (n = 4), and operating room patients (n = 64). The participants were undergraduate (n = 302) and graduate (n = 9) medical trainees. RESULTS: In preclerkship trainees, improved scores in subjects without abnormal compared to those with abnormal findings demonstrated validity. In clinical trainees, scores on the Digital Rectal Examination Clinical Tool increased by 2% for each additional year of training, demonstrating construct validity. CONCLUSIONS: We used an expert panel to create a novel instrument for measuring digital rectal examination proficiency and validated it with preclinical and clinical trainee cohorts at our institution.

Full Text

Duke Authors

Cited Authors

  • Clements, MB; Schmidt, KM; Canfield, SE; Gilbert, SM; Khandelwal, SR; Koontz, BF; Lallas, CD; Liauw, S; Nguyen, PL; Showalter, TN; Trabulsi, EJ; Cathro, HP; Schenkman, NS; Krupski, TL

Published Date

  • March 2018

Published In

Volume / Issue

  • 75 / 2

Start / End Page

  • 434 - 441

PubMed ID

  • 28923535

Pubmed Central ID

  • 28923535

Electronic International Standard Serial Number (EISSN)

  • 1878-7452

Digital Object Identifier (DOI)

  • 10.1016/j.jsurg.2017.08.012


  • eng

Conference Location

  • United States