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