Teaching Digital Rectal Examinations to Medical Students

PURPOSE: The digital rectal examination (DRE) is a necessary part of a complete physical examination and evaluation of a patient, yet teaching of this examination to medical students is often inadequate. This study was a comparative evaluation of the effectiveness of the rectal teaching associate (RTA), lecture, role-playing, and simulated models as methods for teaching the DRE procedure to undergraduate medical students at Memorial University of Newfoundland Faculty of Medicine. METHOD: A total of 65 third-year medical students were randomly assigned to either an experimental or control group. Both groups received a lecture and practiced the DRE on a simulated model. The experimental group received further training from an RTA. Students completed a pre- and post-intervention knowledge assessment, an objective structured clinical exam (OSCE) measuring performance of the DRE, and a satisfaction survey. RESULTS: Mean knowledge scores increased significantly for both groups (18.73 to 22.32, p <.0001). The control group scored significantly higher on the post-intervention assessment than did the experimental group (23.11 versus 21.47, p =.025) The experimental group scored higher on the OSCE (27.52 versus 23.80, p =.001) and rated the RTA as a more effective method for learning the DRE. CONCLUSIONS: This first study using RTAs to teach the DRE as a global skill for evaluating the rectum suggests that the RTA method is effective for increasing skills and students' confidence in the procedure.