Peer-to-Peer Interactive Breast Health Training With Simulation: Effect on Medical Student Anxiety and Exam Scores

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Changes in national screening guidelines have decreased student clinical experience with breast health, which may be ameliorated using a case-based simulation model in the curriculum.


A case-based interactive peer-to-peer didactic using a breast simulation model was introduced to the OB/GYN clerkship curriculum at the University of California, Davis School of Medicine during AY2013-2014. Students who underwent the didactic completed pre- and post-didactic surveys assessing anxiety regarding breast health. The post-didactic survey was compared to a survey of students from AY2012-2013 who did not experience this didactic, as were each group's OB/GYN shelf exam performance on breast health questions.


Fifty of 96 students (52%) from AY2012-13 and 63 of 97 students (65%) from AY2013-14 completed the survey. Among AY2013-14 students, there was no significant difference in anxiety before and after the didactic (P=.12), nor when compared with AY2012-13 students (P=.25). However, 26 of 63 (41%) of students from AY2013-14 reported anxiety about differentiating malignant versus benign disease, compared with 35 of 50 (70%) students from AY2012-13 (P=.002). On the OB/GYN shelf exam, AY2013-14 students collectively performed 13% higher than national average on breast health questions, while AY2012-13 students performed 3% higher than national average.


A case-based simulation model did not improve anxiety regarding breast health. However, students who experienced this didactic session had improved confidence in benign versus malignant differentiation and improved exam performance compared to students who did not.

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