Structured clinical breast examination (CBE) training results in objective improvement in CBE skills

Background. A statewide breast cancer care provider needs assessment had identified CBE training as a target educational need. Accordingly, the authors implemented a one-on-one skills-based course for primary care providers (PCPs) across the state. Method. The course had two components: a prerequisite self-study manual, followed by a 1 1/2-hour skills-based practicum. As part of the practicum, pre- and post-course testing were performed on standardized silicone breast models. Results. Pre- and post-testing data were available for 205 PCPs who completed the course. In the pre-test period, 59% of PCPs examined could detect 60-100% of the lumps. In the posttest, that rose to 94% of PCPs detecting 60-100% of the lumps. This improvement reached statistical significance. Further, false-positive lump detection declined in the post-test period to 59% of the pre-test rate (236 to 139). Conclusion. Formal CBE training for PCPs significantly improves the sensitivity of lump detection and concurrently reduces false-positive detection. The program is currently being extended to a greater number of providers across the state.