“Teaching the Digital Rectal Examination to Third-Year Medical Students: A Flipped-Classroom Pre–Post Study”

Background: The digital rectal exam (DRE) is an important yet underutilized clinical exam that needs reinforcement in medical education. Methods: We conducted a class-wide, single-group pre–post evaluation of a flipped-classroom DRE curriculum for third-year medical students; no separate control group was included. The intervention included a 10-minute asynchronous instructional video followed by a 20-minute supervised hands-on session using DRE manikins. Pre- and post-intervention surveys assessed knowledge using multiple-choice questions and self-reported attitudes and confidence using five-point Likert-scale items. Pre- and post-intervention surveys were successfully matched for 123 participants; 109 had complete paired knowledge assessments. Results: Medical students showed improvements in mean self-reported Likert scores regarding knowledge of DRE indications (2.7 vs 4.6, p< 0.001), contraindications (1.9 vs 4.5, p< 0.001), complications (2.0 vs 4.5, p< 0.001), and findings (3.0 vs 4.7, p< 0.001). Self-reported comfort (1.6 vs 4.3, p< 0.001) and confidence (1.6 vs 4.4, p< 0.001) also improved. The mean multiple-choice knowledge score increased from 1.5 to 4.5 out of 5 (p< 0.001). Conclusion: A class-wide flipped-classroom approach was feasible for teaching the DRE and was associated with immediate improvements in DRE-related knowledge and self-reported confidence. Further study is needed to determine whether these improvements translate into increased DRE performance during clinical rotations.