Via Research Recognition Day 2024 VCOM-Carolinas

Educational Reports

EVALUATING MEDICAL STUDENTS’ COMFORT AND PROFICIENCY USING A WEARABLE BREAST MODEL Rachel Daley, OMS-II 1 , Keagan James, OMS-II 1 , Michael Parks, MS, David Redden, PhD., Stacey Stokes, Lisa Worley, MSN, Tommy Lindsey, DO, FACOS,CHSE * . Edward Via College of Osteopathic Medicine, Spartanburg, SC. Abstract Results Conclusions

Background: One in eight women in the United States will receive a breast cancer diagnosis in her lifetime, marking it as the second most prevalent cancer among women. Despite a consistent decline in mortality rates from breast cancer over time, it still stands as the primary cause of cancer-related deaths in women 1 . Therefore, the imperative nature of screening asymptomatic women for breast cancer is an imperative part of women’s health exams, as it enables the detection of breast cancer in its early stages when it is more manageable. Notably, between 2013-2019, the five-year survival rate for women diagnosed with breast cancer was an encouraging 90.8%. The significance of early detection is highlighted by the fact that 99.3% of the survivors were diagnosed with localized disease, while only 31.0% battled distant metastatic disease 2 . This underscores the significance of early detection through breast examinations and mammography in enhancing overall survival rates. Introduction: Given the prevalence of breast cancer and the imperative nature of early detection, breast examinations constitute a critical element of women’s physical exams. However, traditional medical education often lacks hands-on, realistic experiences that adequately prepare medical students for sensitive and intimate clinical settings, particularly those involving breast examinations. In response, we have developed a lifelike, wearable breast model to bridge the gap between medical school education and direct patient interaction. This innovative model serves as a realistic simulation tool, offering medical students a comfortable environment to practice and refine breast palpation skills, thereby ensuring their comfort and proficiency before engaging in actual clinical settings where they may need to perform breast examinations on female patients. Methods: The wearable breast model is crafted using a foundation of quick drying, semi-rigid plastic, which is then duplicated through a silicone molding process (Figure 1). This method ensures the accurate replication of anatomically correct breasts and integrates tumor-like inserts to simulate malignancies. To evaluate the model’s efficacy, a cohort of 30 second -year medical students at VCOM Carolinas participated in a pre-survey, assessing their proficiency and comfort in conducting a breast exam after using the wearable breast model and before performing an exam on a female. Subsequently, the same cohort of students responded to a Introduction and Methods

Perceptions of the Wearable Breast Model: At both baseline and follow-up, we asked respondents if the wearable breast model increased understanding. Twenty respondents indicated Yes at both times for a sample proportion of 8.96% and a 95% Confidence Interval of (66.41%, 97.23%). From this, we can conclude greater than 50% believe the wearable breast model increased understanding at both time points. Similarly, at both baseline and follow-up, we asked if the respondent believed the wearable breast model increased their confidence in conducting a breast exam (Figure 3). Twenty-one respondents indicated Yes at both times for a sample proportion of 91.30% and a 95% Confidence Interval of (71.96%, 98.93%). From this confidence interval, we can conclude more than 50% believe that the wearable breast model increased confidence at both time points. We observed statistically significant increases on the ordinal scales for comfort in conducting breast exams (p < 0.0001) (Figure 2) and confidence (p = 0.0018), but we did not observe a significant change from baseline to follow-up in the likelihood a respondent would recommending the wearable breast model (p = 0.5078) (Figure 4). Conclusion: Our study aims to bridge the gap in traditional medical education through developing and evaluating the efficacy of a realistic, wearable breast model to aid in learning breast examinations. Our research involves a comprehensive statistical analysis, revealing a large proportion of respondents believe the wearable breast model significantly enhanced both their understanding and confidence in conducting breast exams. From this, we can conclude the model serves as an effective educational tool; enhancing students’ confidence and competence in performing breast examinations. Data also shows significant increases in ordinal scales for comfort in conducting breast exams and confidence after using the model. This highlights the practical impact of the model on medical students’ comfort and confidence levels during breast exams. To summarize, our research introduces an innovative approach to improve medical education, providing a tool that positively impacts medical students’ ability to conduct breast examinations. We hope to use this data and further studies to enhance medical education and breast cancer screening.

Figure 2. A. Change in comfort level conducting a breast exam from baseline to follow-up, B. Average ratings at baseline and follow-up for comfort conducting a breast exam.

Figure 3. A. Change in confidence identifying abnormal breast tissue from baseline to follow-up, B. Average rating for confidence in identifying abnormal breast tissue at baseline and follow-up.

Statistical Analysis and Interpretation: Descriptive statistics were computed for baseline and follow-up outcome measures. Sample proportions and 95% Confidence Intervals were calculated for Yes/No scale responses, while sample means and standard deviations gauged responses on ordinal scales. Change in the ordinal scores by subtracting the baseline values from the follow-up. Given the ordinal nature of the variables, we used the non-parametric sign test to evaluate statistically significant changes from baseline to follow-up. All analyses were conducted in SAS 9.4 and used a Type I error rate of 0.05. Figure 4. Average likelihood of recommending the wearable breast model from baseline to follow-up

post-survey to assess similar parameters after engaging in live female breast exams with the gynecologic teaching associates (GTA).

Figure 1. Wearable Breast Model

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2024 Research Recognition Day