CLINICAL BREAST EVALUATION SKILLS OF HOUSE OFFICERS AND STUDENTS

Current health care reform is placing primary care physicians in an in creasingly significant role as the front-line providers of women's hea lth care. It is critical that primary care physicians as well as surge ons develop the knowledge base, physical examination skills, and inter personal skills necessary to care for patients with breast cancer. Thi s study uses a standardized patient breast case in an Objective Struct ured Clinical Examination (OSCE) format to objectively assess clinical breast evaluation skill performance by house officers and medical stu dents. Performance of USC medical students, exposed to a uniform clini cal breast evaluation curriculum, were compared with MSIVs from four o ther medical schools, and postgraduate year I and II categorical surgi cal residents. USC medical students were found to maintain performance between an initial surgical OSCE breast station and a delayed clinica l practice exam (CPX) reexam as MSIVs (breast exam, P = 0.21; patient- physician interaction, P = 0.67). USC MSIVs had statistically signific antly higher performance on the CPX breast station when compared with other MSIVs (T = 11.701, two-tailed test, P = 0.0001). House officers demonstrated significantly poorer skills than medical students (P = 0. 03). An incoming housestaff group showed improvement with clinical bre ast evaluation checklists and orientation as part of their intern orie ntation program and ongoing curriculum.