Dakum K, Ramyil V M, Agbo S, Ogwuche E, Makama B S, Kidmas A T
Urology Unit, Department of Surgery, Jos University Teaching Hospital, PMB 2076, Jos, Nigeria.
Niger J Clin Pract. 2007 Mar;10(1):5-9.
Prostate cancer which tends to take an aggressive course in black populations can be detected by digital rectal examination (DRE). There are concerns however that medical students are not acquiring the necessary DRE skills. We therefore studied their experience and attitude towards DRE for prostate cancer to assist us make any necessary adjustments in training.
This was a self-administered questionnaire based study of final year medical students two months to graduation carried out at the Jos University Teaching Hospital, location for clinical studies of the Medical Faculty ofthe University of Jos.
There were 100 students in the study, with a male: female ratio of 3.6:1. The ages ranged from 24 to 35 with a mean of 28 years. Fifty-one percent and 94% agreed they had been taught DRE in class and on the ward/clinic respectively. Almost half (45%) had never performed a DRE and 43% performed it only 1-2 times. Sixty-two percent of the students had never confidently palpated a prostate; while 30% had palpated it 1 2 times. Eighty-six percent and 7% respectively have never felt a clinically malignant prostate or felt it 1 2 times. There was no statistically significant difference in the number of DREs performed by sex or age (p> 0.05). On supervision 43% were never supervised to do DRE while 23% were supervised all the time. Ninety-five percent believed DRE is an essential requirement for a medical practitioner and 96% believed they should have the skills before graduating. Only 36%, however, believed their teachers have been supportive, teaching them DRE (p value = .033). Ninety percent agreed that DRE is useful for screening for prostate cancer. The major reason for not performing DRE more than half the time was the student not feeling competent (54%).
Students have received adequate teaching on DRE, have the right attitude and perspective, have adequate knowledge on DRE findings suggestive of prostate cancer but have not translated this knowledge into practice. This is mainly due to the students not feeling competent. Teachers need to intensify practical supervision to enable medical students acquire the necessary experience during clinical training.
在黑人人群中往往呈侵袭性病程的前列腺癌可通过直肠指检（DRE）检测出来。然而，有人担心医学生没有掌握必要的直肠指检技能。因此，我们研究了他们对前列腺癌直肠指检的经验和态度，以帮助我们在培训中做出必要的调整。
这是一项基于问卷调查的研究，对象是乔斯大学教学医院即将毕业的最后一年医学生，该医院是乔斯大学医学院临床研究的地点。
该研究共有100名学生，男女比例为3.6:1。年龄在24岁至35岁之间，平均年龄为28岁。分别有51%和94%的学生表示他们在课堂上和病房/诊所接受过直肠指检的教学。近一半（45%）的学生从未进行过直肠指检，43%的学生仅进行过1至2次。62%的学生从未自信地触诊过前列腺；而30%的学生触诊过1至2次。分别有86%和7%的学生从未触摸过临床上恶性的前列腺或仅触摸过1至2次。按性别或年龄划分，进行直肠指检的次数没有统计学上的显著差异（p>0.05）。在监督方面，43%的学生从未接受过直肠指检的监督，而23%的学生一直受到监督。95%的学生认为直肠指检是医生的一项基本要求，96%的学生认为他们在毕业前应该掌握这项技能。然而，只有36%的学生认为他们的老师给予了支持，教授他们直肠指检（p值=0.033）。90%的学生同意直肠指检对前列腺癌筛查有用。超过一半的时间不进行直肠指检的主要原因是学生觉得自己没有能力（54%）。
学生们在直肠指检方面接受了充分的教学，有正确的态度和观点，对提示前列腺癌的直肠指检结果有足够的了解，但没有将这些知识转化为实践。这主要是因为学生觉得自己没有能力。教师需要加强实践监督，以使医学生在临床培训期间获得必要的经验。
