Acquisition of skills in digital rectal examination through supervised patient examination with real-time feedback in transrectal sonography room

Objective: To assess the acquisition digital rectal examination (DRE) skills by medical students through an alternative teaching method. Materials and methods: Medical students at the National Cheng-Kung University Hospital, Tainan, Taiwan in 2009 were assigned to receive training through supervised rectal examination (DRE) with real-time feedback in a transrectal sonography room during their standard urologic rotation. Students completed a questionnaire (before and after the training) regarding their experiences in performing DRE to assess their confidence levels. Direct observation of practical skills (DOPS) was used to assess the students' competence in performing DRE at the end of urologic rotation. Results: A total of 75 students received the questionnaire, of which 72 (96%) responded. On average, every student had an experience of 6.6 supervised patient examinations with real-time feedback in a transrectal sonography room. Following the training, students were more confident in their ability to give an opinion based on their findings related to DRE. The overall rate of the students' ability to interpret the DRE findings after urologic rotation improved from 69% to 100% for identification of the prostate, from 14% to 60% for assessment of prostate size, from 32% to 95% to describe prostate consistency accurately, and from 9.8% to 64% to identify overt prostate cancer from benign prostate hyperplasia. All students met expectations or were above expectations according to the grading scale of performing DOPS. Conclusion: Students' skills and confidence with regard to performing DRE were improved significantly through supervised examination with real-time feedback in a transrectal sonography room.