Effectiveness of technology-enhanced simulation in teaching digital rectal examination: a systematic review narrative synthesis
File(s)
Author(s)
Type
Journal Article
Abstract
Background Digital rectal examination (DRE) is a challenging examination to learn.
Objective To synthesise evidence regarding the effectiveness of technology-enhanced simulation (TES) for acquiring DRE skills.
Study selection EMBASE, Medline, CINAHL, Cochrane, Web of Knowledge (Science and Social Science), Scopus and IEEE Xplore were searched; the last search was performed on 3 April 2019. Included were original research studies evaluating TES to teach DRE. Data were abstracted on methodological quality, participants, instructional design and outcomes; a descriptive synthesis was performed. Quality was assessed using a modified Medical Education Research Study Quality Instrument. The study design domain was modified by scoring the papers based on (1) evaluation of risk of bias for randomised controlled trials, (2) description of participants and (3) assessment of robustness and degree of simulation fidelity of the assessments used to evaluate learning.
Findings 863 articles were screened; 12 were eligible, enrolling 1507 prequalified medical/clinical students and 20 qualified doctors. For skill acquisition, role player was statistically significantly superior to a static manikin (2 studies). For knowledge acquisition, manikin use was significantly superior to role player (1 study); 2 studies showed no difference. For confidence, manikin use was significantly superior to no manikin (4 studies). For comfort, manikin use was significantly superior to no manikin (2 studies). For anxiety, role player was significantly superior to manikin (1 study).
Median overall quality score (QS) was 48% (27–62). Highest median QS was 73% (33–80) for data analysis; lowest median QS was 20% (7–40) for the validity of instrument. Six papers scored over 50% of the maximum score for overall quality.
Conclusions TES training is associated with improved DRE skills and should be used more widely.
Objective To synthesise evidence regarding the effectiveness of technology-enhanced simulation (TES) for acquiring DRE skills.
Study selection EMBASE, Medline, CINAHL, Cochrane, Web of Knowledge (Science and Social Science), Scopus and IEEE Xplore were searched; the last search was performed on 3 April 2019. Included were original research studies evaluating TES to teach DRE. Data were abstracted on methodological quality, participants, instructional design and outcomes; a descriptive synthesis was performed. Quality was assessed using a modified Medical Education Research Study Quality Instrument. The study design domain was modified by scoring the papers based on (1) evaluation of risk of bias for randomised controlled trials, (2) description of participants and (3) assessment of robustness and degree of simulation fidelity of the assessments used to evaluate learning.
Findings 863 articles were screened; 12 were eligible, enrolling 1507 prequalified medical/clinical students and 20 qualified doctors. For skill acquisition, role player was statistically significantly superior to a static manikin (2 studies). For knowledge acquisition, manikin use was significantly superior to role player (1 study); 2 studies showed no difference. For confidence, manikin use was significantly superior to no manikin (4 studies). For comfort, manikin use was significantly superior to no manikin (2 studies). For anxiety, role player was significantly superior to manikin (1 study).
Median overall quality score (QS) was 48% (27–62). Highest median QS was 73% (33–80) for data analysis; lowest median QS was 20% (7–40) for the validity of instrument. Six papers scored over 50% of the maximum score for overall quality.
Conclusions TES training is associated with improved DRE skills and should be used more widely.
Date Issued
2021-07-06
Date Acceptance
2020-09-01
Citation
BMJ Simulation & Technology Enhanced Learning, 2021, 7 (5), pp.414-421
ISSN
2056-6697
Publisher
BMJ Publishing Group
Start Page
414
End Page
421
Journal / Book Title
BMJ Simulation & Technology Enhanced Learning
Volume
7
Issue
5
Copyright Statement
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. This article has been accepted for publication in Systematic review following peer review. The definitive copyedited, typeset version Al Asmri MA, Ennis J, Stone RJ, et alEffectiveness of technology-enhanced simulation in teaching digital rectal examination: a systematic review narrative synthesisBMJ Simulation and Technology Enhanced Learning Published Online First: 01 September 2020 is available online at: http://dx.doi.org/10.1136/bmjstel-2020-000587
Identifier
https://stel.bmj.com/content/early/2020/08/31/bmjstel-2020-000587
Publication Status
Published
Date Publish Online
2020-09-01