New prostate exam training

Someone had posted this in FB, and I thought it was interesting and a great teaching tool. (Too bad they can't get the medfetters in for practice ...)

http://www.medicaldaily.com/robotic-butt-offers-prostate-exam-training-medical-students-how-patrick-teaches-empathy-proper

It took a minute to realize the Sears refrigerator ad was not part of the presentation.

I've discussed this with real students and medical school faculty who've used it. If you have a Male Urogenital Training Assistant team, this is crap. If it's all you have, it's better than nothing.

I was hoping someone had experience with it and would weigh in. I wondered about how often schools used humans with the comment about this being good because students didn't get feedback on technique. And if students are NOT getting feedback from humans, they should be.

The mannequin is a fixed cost - buy it, use it. Human staff costs money. In NJ, made $150 for a 75 minute session for up to 4 students, additional for more students. Of course I taught the techniques personally and provided immediate guidance and feedback.

I think jds4mds is right- it really takes a real person to practice on that can provide feedback when they are feeling the prostate. Eventually the robot trained med student will have to do the procedure on a real patient and their point of reference will have been a fake doll. I would imagine getting real training like what jds4mds does would enable the student to get the aha light going off in their head moment when the teacher tells them they are doing it right. I just can't see them getting that with a robot.

Using the torso robot is used with interchangeable reproductive organs (F and M) and has a rectal hole for enema training. I'm unsure it a more realistic rectum is used, or just the very well made videos I have observed showing proper prostate examination procedure. Other videos are used for both male and female genital procedures. Imagine High Def.!

This system does provide feedback, although obviously not as good as practicing on a human: "Patrick is a simulated patient that talks to medical students while offering real-time feedback about the virtual prostate exam he’s receiving." "Personally, he comes equipped with software that enables him to interact emotionally with the student and voice any concerns he has about the procedure. Dr. Benjamin Lok, one of the program’s designers, says the interpersonal relationship Patrick helps foster is invaluable from a practicing perspective. 'This virtual human patient can talk to the learner, expresses fears and concerns about the prostate exam, and presents a realistic patient encounter,' Lok told Geekosystem." And "Patrick is endowed with force sensors, which can alert the student when he or she is being too aggressive, and can report how thorough the student was in his or her examination."

Not sure about the emotional interaction software provides, though ...

That's two separate issues that I believe should be taught separately. Master the physical techniques before the patient interactions.

Learning to do prostate exams on a robot trainer? What a joke. Such exams should be done on a learning assistant such as Jds or on a real patient. We had to do our first pelvic exams on a plastic model and it was ridiculous. Both the instructors and the students thought it was totally bogus.

I agree with several of the posters: use a live GU teaching aide or just a live model, and kill several birds with one stone. First, the students are already nervous about a new intimate procedure in general. Doing a new procedure on a dummy, and when you already don't feel comfortable having mastered it because it wasn't a real subject, trying the same sorta-new procedure on a real subject keeps the stress level up. Cut it way back and go to the source.) They can take as long as they need to get it right, with suggestions and coaching from in front (me) and behind (instructor) to get some degree of skill and a smooth, professional procedure, all wrapped into one lesson. And feedback given is human and immediate, as in "almost there, push in a little further, slightly to the right now - Bullseye! Light pressure while you palpate it - ok, a little more pressure, test the elasticity and the surfaces for lumps and general symmetry. You missed the right side, go back and try again, sweep from left to right completely."

(I had one NP who started exclaiming "I FOUND IT! I FOUND IT! THERE IT IS" and laughing excitedly, which broke the ice and the ones following her were pretty much at ease and stress-free in doing their own exploration.) They have to practice on a live subject to get it right, no point in an expensive doll unless there's no other way to get started. Arizona school had the only one I'd seen, guess I can see some benefit to it like training wheels on a bike; most of the students thought it was lame, most of the instructors considered it a stop-gap at best, until a live GTA was available to learn the real thing on.

Wow, very interesting, did not know something like this even existed.