DEMONSTRATION
"Prostate Practicum" -- Meeting the Challenge of Teaching Examination of the Male Genitalia and Digital Examination of the Rectum and Prostate
Richard A. Watson, M.D., Associate Professor of Surgery, Division of Urology
UMDNJ New Jersey Medical School< Newark, NJ, USA
ABSTRACT:
Second-year medical students find examination of the male genitalia and digital examination of the rectum and prostate a challenging -- and for several, even a threatening aspect of their introduction to the complete physical examination. Providing, to 175+ students each year, a learning experience that is thorough, meaningful, non-threatening and one which, while standardized, is responsive to each student's individual needs and abilities has proven no easy task. At NJMS, we are meeting this challenge with a multifaceted, interactive "Prostate Practicum."
The centerpiece of this Practicum is the opportunity that each student is given to perform a hands-on examination with a live "patient" - a professional Urology Training Associate. Aspects of this process, which validate the experience, are:
Solid preparation and motivation have been the 'sine-qua-non' of our success to date. Students are required to read in advance the appropriate chapter in their standard text. In addition, they must view a videotape, which details the particulars of this exam. Our two innovative additions to this preparation are:
1) A Syllabus, which clearly defines the goals and objectives of this Practicum and, step by step, takes the student through entire experience. Points made in the syllabus are reinforced during the 30-minute, small-group lecture, which precedes the UTA encounter. Beyond the mechanical details and the diagnostic relevance of the exam, we deal with sensitive issues not frequently addressed elsewhere, which are yet of great concern to many of our student-doctors. For example: What do you say and do, if your patient develops an erection during this exam? Should a woman physician have a chaperone present during her examination of a male patient's genitalia?
2) The pride of our Practicum is the computer-based, multimedia, interactive, instructional program that we are currently developing. This program provides dramatic, three-dimensional displays of the complex anatomy of the prostate and highlights dynamically the physiology of the prostate. Illustrations are linked to relevant text. Students are invited to dis- and re-assemble the anatomy. Key vocabulary terms are hot-text linked to their definitions in the glossary. The student is able to self-pace learning, to cross-reference information, to vary learning algorithms, and to take individualized advantage of visual, auditory and psychomotor stimuli for learning. Further refinements are even now in process. We envision expanding the concept, to incorporate instruction in abnormal findings, such as in prostatitis, prostatic hypertrophy, and cancer. Our hope is to develop an exportable CD-ROM package that would enable home-based learning and facilitate our sharing with other medical schools. Access via the Internet would expedite dissemination of this information and offer opportunities for real-time interactive feedback.
BENEFIT TO PARTICIPANTS ATTENDING SESSION:
While our Practicum, in general, and our computer-based program in particular, are still very much works-in-progress, we are excited about our achievements to date. Our program is now in its third year of implementation. We look forward to sharing our experience with interested others, to improving our own program and, through networking, to our promoting effective instruction in Urology to medical students everywhere.
Richard A. Watson, M.D., F.A.C.S.
Division of Urology
UMDNJ New Jersey Medical School
Medical Sciences Building / G-536
185 South Orange Avenue
Newark, NJ 07103-2757, USA
Phone: (973) 972-4439
Fax: (973) 972-3892
Email: watsonra@umdnj.edu