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Structured clinical breast examination (CBE) training results in objective improvement in CBE skills
John T Vetto1, John K Petty, Nancy Dunn
1Department of Surgery, OHSU Cancer Institute, Oregon Health and Science University, Portland 97201-3098, USA. vettoj@ohsu.edu
Background:
A statewide breast cancer care provider needs assessment had identified CBE training as a target educational need. Accordingly, the authors implemented a one-on-one skills-based course for primary care providers (PCPs) across the state.
Method:
The course had two components: a prerequisite self-study manual, followed by a 1 1/2-hour skills-based practicum. As part of the practicum, pre- and post-course testing were performed on standardized silicone breast models.
Results:
Pre- and post-testing data were available for 205 PCPs who completed the course. In the pre-test period, 59% of PCPs examined could detect 60-100% of the lumps. In the post-test, that rose to 94% of PCPs detecting 60-100% of the lumps. This improvement reached statistical significance. Further, false-positive lump detection declined in the post-test period to 59% of the pre-test rate (236 to 139).
Conclusion:
Formal CBE training for PCPs significantly improves the sensitivity of lump detection and concurrently reduces false-positive detection. The program is currently being extended to a greater number of providers across the state.