A Survey of Digital Rectal Examination Training in Canadian Medical Schools

Abstract

BACKGROUND: The digital rectal examination (DRE) is important for the diagnosis of a variety of gastrointestinal, urological and gynecological disorders. However, it appears that Canadian medical students may not be adequately taught nor provided the opportunity to practice their skills often enough. The present study was an analysis of the current practices in DRE teaching and evaluation in undergraduate medicine programs across Canada.METHODS: Clinical skills coordinators from the 14 English-speaking medical schools in Canada were invited to participate in the survey and to respond to questions regarding DRE teaching at their respective schools.RESULTS: Thirteen of the 14 schools (93%) responded to the survey. The DRE is taught in various ways: 69% of schools use anatomical rectal models, 62% use video tutorials and 62% involve physician instruction. Most schools (85%) offer one formal teaching session before clerkship. Generally, there is no formal DRE teaching session during clerkship. Preclerkship students in 62% of the schools perform ≤1 DRE during their training, and clinical skills coordinators in 85% of the schools expected that clerkship students perform ≤2. The training is evaluated in a variety of ways, with most schools (77%) only requiring mandatory attendance.DISCUSSION: Although a variety of techniques are used to teach and evaluate DRE training in Canadian medical schools, students are performing very few DREs before graduation. Medical schools should objectively evaluate proficiency to give meaningful feedback and improve competence in their students as well as provide more opportunities for students to obtain the necessary experience performing DREs during their clinical training.