Provider confidence in breast examination.

Many physicians have reported interest in further training in clinical breast examination, and it has been speculated that health care providers may lack confidence in their breast examination skills. At a multisite family practice residency, we surveyed a group of physicians and nurse practitioners about confidence in clinical breast examination. Forty-three percent of respondents reported impairment of the clinical breast examination by lack of confidence in skills, and 50% reported feeling only "somewhat" or "moderately" confident in their clinical breast examination skills. Residents often reported encountering few patients with breast lumps; experience with breast lumps was associated with reported confidence in the clinical breast examination. To improve and maintain breast palpation confidence and skills, residents and practicing physicians need longitudinal educational programs.