Teaching digital rectal examination to medical students using a structured workshop-a point in the right direction?

Background: Digital rectal examination (DRE) is an important skill in the investigation of rectal symptoms. This frequently performed examination is poorly taught and while students agree it is an important skill, their experience is often limited. Studies have suggested that structured teaching can improve confidence, knowledge, and ability of DRE.

Method: Medical students from the University of Leicester attended a teaching program in DRE. It consisted of a lecture followed by objective structured clinical examination stations. These stations included the teaching of communication skills, utilized interactive scenarios, and DRE training with mannequins. Students were asked to complete an evaluation questionnaire that assessed their skill level both prior to and following the workshop.

Results: A total of 377 students completed the workshop and all completed our questionnaire; 228 students (63.5%) had not previously performed a DRE. Before the workshop, 55% (199/360) were not confident in performing a DRE at all. Following the workshop, 19% (68/358) of students felt confident to perform a DRE independently, and the majority, 68% (223/358) felt confident to perform a DRE on a patient under supervision. The mean score following the workshop was 4.87, improving from 2.22 before the workshop. A Student t-test showed this improvement was statistically significant (p < 0.0001, 95% CI 2.65-2.64).

Conclusions: The overwhelming feedback to our program is extremely favorable and demonstrates that medical students clearly benefit from a structured, interactive, and hands-on educational workshop in DRE.