Undescended testis? How best to teach the physical examination

• Published in: Journal of pediatric urology 2016-12, Vol.12 (6), p.406.e1-406.e6
• Main Authors: Zundel, S, Blumenstock, G, Herrmann-Werner, A, Trueck, M, Schmidt, A, Wiechers, S
• Format: Article
• Language: English
• Subjects: Cryptorchidism - diagnosis; Education, Medical - methods; Humans; Infant, Newborn; Male; Medical students; Pediatrics; Pediatrics - education; Physical Examination; Teaching; Undescended testicle; Urology
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2016.07.003

Summary Background Undescended testis in boys is common. To lower the risks of subfertility and testicular carcinoma, international guidelines recommend surgical treatment between the ages of 6 months and 2 years; nevertheless, orchidopexy is frequently performed at later ages. One reason is the belated diagnosis due to a perceived difficulty in the physical examination and correct localization of the testis. Objectives The present study aimed to find an alternate method for teaching the physical examination of the testis in a child, as using pediatric standardized patients or patient volunteers presents an ethical challenge. Study design A curriculum was designed using Kern’s recommendations. An interdisciplinary team developed the teaching sessions, including an educational video and a simulator. Year-3 medical students from the University of Tuebingen, Germany ( n =133) were randomized into three groups: self-study only, video, and video and simulator. The sessions were carried out and quantitative feedback was collected from the teachers and students. The learning achievements of the different groups were assessed with an objective structured clinical examination (OSCE). The differences in mean OSCE results between all three groups were tested using one-way analysis of variance (ANOVA). For multiple pairwise comparisons, a closed testing procedure was performed using unpaired t -tests. The level of statistical significance was set at P