MP35-16 A RANDOMISED STUDY OF SIMULATED VERSUS VOLUNTEER DIGITAL RECTAL EXAM FOR MEDICAL STUDENT TEACHING

Abstract

INTRODUCTION AND OBJECTIVES: Digital rectal examination (DRE) is an important skill required of all graduating doctors. It identifies pathologies of the prostate as well as colorectal and gynaecological conditions. It is poorly taught in medical schools and the number of DREs performed by medical students by the end of training has fallen to 3‐5 in the UK and 2 in Australia. At our university traditional DRE teaching is composed of lectures and simulation on models. We hypothesised that teaching students DRE on human volunteers would increase their confidence in performing future DREs. METHODS: Second year medical students underwent computer generated randomisation into one of two groups. Control: Standard teaching and intervention: Standard teaching plus further tuition with a volunteer. Standard teaching involved a 30‐minute lecture outlining anatomy, palpable organs, indications, variations in pathology and performing a DRE on a simulation model. The intervention group were then divided into groups of approximately 5 students. They observed a tutor demonstrating a DRE on a volunteer and each student performed a DRE under supervision. Before and after teaching, both groups completed two 3 question surveys (Table 1). The primary end‐point was confidence in performing a DRE, which was the sum of the scores from these 3 questions. This study was approved by the University of Sydney Human Research Ethics Committee (2018/525). RESULTS: In total 48 students were randomised, 22 to control and 26 to intervention. The groups were well matched prior to teaching DRE. After the DRE teaching, students in the intervention group were more confident in the indications for DRE (p=0.001), more confident in their technique for performing DRE (p<0.001) and more confident in their ability to accurately assess findings at DRE (p<0.001) (Table 1). The primary outcome measure, overall confidence for performing DRE, was significantly better in the intervention group (10 vs 14, p<0.001). CONCLUSIONS: This study shows the use of volunteers for teaching significantly improves student confidence in performing DRE. Whether that translates into improved ability to detect pathology in the future is beyond the scope of this study. We would recommend medical student DRE teaching which includes volunteers. (Table Presented).