Men's health: it is imperative to teach scrotal and rectal examination

Men's health has been a neglected area. Both their general health and their sexual health impact on morbidity and mortality. To improve this situation we need to educate men to attend their doctor and discuss their concerns. But, we also need medical professionals who are both competent and confident in initiating discussions and dealing with men's concerns.

Studies of graduating students in both Australia and Ireland show that they have had little experience in performing rectal examinations, and have little confidence in their findings when they do perform them.

We decided to implement a pilot study of a Urological Teaching Associate (UTA) Programme, aiming to teach students during their urological rotation the technique and communication skills of hernia, genital and rectal examinations. We recruited men from the community, trained them in these skills, and in feedback skills, and the UTAs then teach the students whilst being examined themselves. Each tutorial begins with an introduction followed by a demonstration by the UTAs, where one plays the role of the doctor and the other plays the patient. The students then have a turn at examining a UTA, obtaining feedback from UTAs on their performance. The students complete an evaluation form before and after the tutorial. Part of this is to assess their confidence in performing these examinations. The results show a dramatic increase in confidence in performing these examinations after the tutorial.

If these results are confirmed by a larger study then consideration needs to be given to these programmes becoming a standard part of the curriculum.