Development of a Program to Educate Physician Assistant Students on Performance of a Comprehensive Breast Exam

ABSTRACT Purpose: The purpose of this study was to develop a new program to educate physician assistant (PA) students on the performance of a comprehensive breast exam and to test its effectiveness as compared to the previous program. Methods: The preexisting educational program for the performance of a clinical breast exam was evaluated during the term prior to the start of clinical rotations for the class of 2015. Baseline data were obtained from this control group by evaluation of student competency using a skills examination, utilizing a Nasco Advanced Breast Exam Simulator, and using a female standardized patient. An innovative program educating the PA class of 2016 on the performance and interpretation of a comprehensive breast exam was instituted, incorporating a new palpation technique, new models, and simulated patients. Both classes were directly compared in terms of their breast examination skills at 5 months post-training by administering the same skills examination. Nested, mixed, generalized, and linear models were created to look for differences between the two classes. Each model was adjusted by covariates to account for variation in student ability. Results: The PA class of 2016 showed statistically better performance in breast inspection, lymph node palpation, breast palpation, breast mass detection, and documentation of findings compared to the PA class of 2015. Conclusion: The new educational program on the clinical breast exam using a well-organized laboratory session with subsequent skills testing was found to be very efficacious