Improving the competency of medical students in clinical breast examination through a standardized simulation and multimedia-based curriculum

Fernando A. Angarita, Benjamin Price, Matthew Castelo, Mauricio Tawil, Juan Carlos Ayala, Lilian Torregrossa

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: Clinical breast examination (CBE) is an important step in the assessment of patients with breast-related complaints. We developed a standardized simulation and multimedia-based (SSMBI) curriculum using current evidenced-based recommendations. This study aimed to determine if SSMBI training resulted in better performance (examination scores and detection of abnormal findings) than the traditional teaching method. Methods: Novice fourth-year medical students were exposed to the SSMBI curriculum (n = 68) or traditional (n = 52) training. The traditional group was taught by a lecture and attending weekly clinics where they had hands-on experience. The SSMBI group underwent a structured lecture followed by an instructional video and dedicated simulated teaching. Both groups were assessed through a written knowledge exam and an objective structured clinical examination (OSCE). Student’s t test and χ 2 tests were used to assess differences in CBE technique and knoweldge. Results: Students who underwent SSMBI training had significantly higher numbers of correct answers describing the different steps and justifications of CBE. OSCE performance was significantly higher in the SSMBI group. SSMBI-trained students were more likely to complete all the necessary CBE steps compared to traditionally-trained students (88.2% vs. 28.2%, p < 0.00001). The SSMBI group was also more systematic and more likely to perform adequate inspection, palpation, examination of the nipple-areolar complex, and identify and characterize a palpable lesion (p < 0.05). Conclusions: Formal SSMBI training is an important asset when teaching medical students how to perform a CBE. Real clinical experience is still necessary to refine this skill and the physician–patient interaction.

Original languageEnglish (US)
Pages (from-to)439-445
Number of pages7
JournalBreast Cancer Research and Treatment
Issue number2
StatePublished - Jan 30 2019


  • Breast
  • Breast cancer
  • Breast disease
  • Clinical breast examination

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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