Hybrid Simulation in Teaching Clinical Breast Examination to Medical Students. 2019

Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.

Clinical breast examination (CBE) is traditionally taught to third-year medical students using a lecture and a tabletop breast model. The opportunity to clinically practice CBE depends on patient availability and willingness to be examined by students, especially in culturally sensitive environments. We propose the use of a hybrid simulation model consisting of a standardized patient (SP) wearing a silicone breast simulator jacket and hypothesize that this, compared to traditional teaching methods, would result in improved learning. Consenting third-year medical students (N = 82) at a university-affiliated tertiary care center were cluster-randomized into two groups: hybrid simulation (breast jacket + SP) and control (tabletop breast model). Students received the standard lecture by instructors blinded to the randomization, followed by randomization group-based learning and practice sessions. Two weeks later, participants were assessed in an Objective Structured Clinical Examination (OSCE), which included three stations with SPs blinded to the intervention. The SPs graded the students on CBE completeness, and students completed a self-assessment of their performance and confidence during the examination. CBE completeness scores did not differ between the two groups (p = 0.889). Hybrid simulation improved lesion identification grades (p < 0.001) without increasing false positives. Hybrid simulation relieved the fear of missing a lesion on CBE (p = 0.043) and increased satisfaction with the teaching method among students (p = 0.002). As a novel educational tool, hybrid simulation improves the sensitivity of CBE performed by medical students without affecting its specificity. Hybrid simulation may play a role in increasing the confidence of medical students during CBE.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010808 Physical Examination Systematic and thorough inspection of the patient for physical signs of disease or abnormality. Physical Exam,Examination, Physical,Physical Examinations and Diagnoses,Exam, Physical,Examinations, Physical,Exams, Physical,Physical Examinations,Physical Exams
D001941 Breast Diseases Pathological processes of the BREAST. Endocrine Breast Diseases,Breast Disease,Breast Disease, Endocrine,Breast Diseases, Endocrine,Disease, Breast,Disease, Endocrine Breast,Diseases, Breast,Diseases, Endocrine Breast,Endocrine Breast Disease
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D004504 Education, Medical, Undergraduate The period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D. Medical Education, Undergraduate,Education, Undergraduate Medical,Undergraduate Medical Education
D004521 Educational Measurement The assessing of academic or educational achievement. It includes all aspects of testing and test construction. Assessment, Educational,Graduate Records Examination,Educational Assessment,Examination, Graduate Records,Measurement, Educational,Assessments, Educational,Educational Assessments,Educational Measurements,Examinations, Graduate Records,Graduate Records Examinations,Measurements, Educational
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000066908 Simulation Training A highly customized interactive medium or program that allows individuals to learn and practice real world activities in an accurate, realistic, safe and secure environment. Interactive Learning,Learning, Interactive,Training, Simulation

Related Publications

Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
December 1994, Academic medicine : journal of the Association of American Medical Colleges,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
January 2019, BMJ simulation & technology enhanced learning,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
April 1986, The Journal of reproductive medicine,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
January 2012, Journal of surgical education,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
January 2012, Medical teacher,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
August 1979, Journal of medical education,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
March 2022, European journal of pediatrics,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
November 2009, Medical education,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
January 1968, Journal of medical education,
Joseph Nassif, and Abdul-Karim Sleiman, and Anwar H Nassar, and Sima Naamani, and Rana Sharara-Chami
July 1993, Medical education,
Copied contents to your clipboard!