Breast Cancer Research and Treatment

, Volume 173, Issue 2, pp 439–445 | Cite as

Improving the competency of medical students in clinical breast examination through a standardized simulation and multimedia-based curriculum

  • Fernando A. Angarita
  • Benjamin Price
  • Matthew Castelo
  • Mauricio Tawil
  • Juan Carlos Ayala
  • Lilian TorregrossaEmail author



Clinical breast examination (CBE) is an important step in the assessment of patients with breast-related complaints. We developed a standardized simulation and multimedia-based (SSMBI) curriculum using current evidenced-based recommendations. This study aimed to determine if SSMBI training resulted in better performance (examination scores and detection of abnormal findings) than the traditional teaching method.


Novice fourth-year medical students were exposed to the SSMBI curriculum (n = 68) or traditional (n = 52) training. The traditional group was taught by a lecture and attending weekly clinics where they had hands-on experience. The SSMBI group underwent a structured lecture followed by an instructional video and dedicated simulated teaching. Both groups were assessed through a written knowledge exam and an objective structured clinical examination (OSCE). Student’s t test and χ2 tests were used to assess differences in CBE technique and knoweldge.


Students who underwent SSMBI training had significantly higher numbers of correct answers describing the different steps and justifications of CBE. OSCE performance was significantly higher in the SSMBI group. SSMBI-trained students were more likely to complete all the necessary CBE steps compared to traditionally-trained students (88.2% vs. 28.2%, p < 0.00001). The SSMBI group was also more systematic and more likely to perform adequate inspection, palpation, examination of the nipple-areolar complex, and identify and characterize a palpable lesion (p < 0.05).


Formal SSMBI training is an important asset when teaching medical students how to perform a CBE. Real clinical experience is still necessary to refine this skill and the physician–patient interaction.


Clinical breast examination Breast disease Breast cancer Breast 



Clinical breast examination


Objective structured clinical examinations


Standardized simulation and multimedia-based


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

Ethics approval was obtained by the review board from the Pontificia Universidad Javeriana School of Medicine in Bogota, Colombia.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Fernando A. Angarita
    • 1
  • Benjamin Price
    • 2
  • Matthew Castelo
    • 1
  • Mauricio Tawil
    • 3
    • 4
  • Juan Carlos Ayala
    • 3
  • Lilian Torregrossa
    • 3
    • 4
    Email author
  1. 1.Division of General Surgery, Department of SurgeryUniversity of TorontoTorontoCanada
  2. 2.Melbourne Medical SchoolThe University of MelbourneMelbourneAustralia
  3. 3.Department of SurgeryPontificia Universidad JaverianaBogotaColombia
  4. 4.Department of SurgeryHospital Universitario San IgnacioBogotáColombia

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