The development of prostate palpation skills through simulation training may impact early detection of prostate abnormalities and early management PRINCIPAL INVESTIGATOR:

for paper in IEEE Transactions on Information Technology in Biomedicine This work seeks to quantify finger palpation techniques in the prostate clinical exam, determine their relationship with performance in detecting abnormalities, and differentiate the tendencies of nurse practitioner students and resident physicians. One issue with the digital rectal examination (DRE) is that performance in detecting abnormalities varies greatly and agreement between-examiners is low. The utilization of particular palpation techniques may be one way to improve clinician ability. Based on past qualitative instruction, this work algorithmically defines a set of palpation techniques for the DRE, i.e., global finger movement, local finger movement, and average intentional finger pressure, and utilizes a custom-built simulator to analyze finger movements in an experiment with two groups: 18 nurse practitioner students and 16 resident physicians. Although technique utilization varied, some elements clearly impacted performance. For example, those utilizing the local finger movement of vibration were significantly better at detecting abnormalities. Also, the V global finger movement led to greater success, but finger pressure played a lesser role. Interestingly, while the residents were clearly the superior performers, their techniques differed only subtly from the students. In summary, the quantified palpation techniques appear to account for examination ability at some level but not entirely for differences between groups. Abstract for paper in Journal of Simulation in Healthcarefor paper in Journal of Simulation in Healthcare Introduction: Prostate carcinoma (and other prostate irregularities and abnormalities) are detected in part via the digital rectal exam. Training clinicians to use particular palpation techniques may be one way to improve rates of detection. Methods: In an experiment of