Effectiveness of a dynamic breast examination training model to improve clinical breast examination (CBE) skills

Abstract

Despite the potential utility of clinical breast examination (CBE), doctors’ palpation skills are often inadequate and difficult to train. CBE sensitivity ranges from 39–59%, in part because current training does not effectively teach tactile skills. To address CBE training limitations, we developed a breast examination training model with 15 dynamically controlled lumps, set to desired hardness within underlying rib and muscle structures, in a silicone breast. In an experiment of 48 medical students, training with the dynamic model increased lump detection by 1.35 lumps compared to 0.60 lumps for a traditional breast model ( P=0.008), reduced false positives by −0.70 lumps compared to +0.42 lumps ( P=0.0277), and demonstrated skill transfer with a 1.17 lump detection improvement on the traditional device compared to only a 0.17 lump detection improvement by traditional device trainees on the dynamic device ( P<0.001). Findings demonstrate the advantage of the dynamic model over conventional models in training CBE tactile skills.