Training using a simulation-based workshop reduces inaccuracies in estimations of testicular volume
-
Jessica N. Craig
Abstract
Objectives
Measuring testicular volume (TV) by orchidometer is routine in the clinic when staging male puberty. We have developed a simulation model for TV estimation and investigated whether training medical students, using a workshop with simulation models, could improve the accuracy and reliability of TV estimation.
Methods
All participating medical students watched a video representing standard undergraduate training in male pubertal assessment. Volunteers were then randomised directly to assessment or to attend a workshop consisting of a further video and four stations contextualising and practising the skills required for TV estimation, prior to assessment. Three child mannequins displaying testes of 3 mL, 4 mL (twice), 5, 10 and 20 mL were used for assessment. Participants were asked to return a fortnight later for repeat assessment to assess intra-observer reliability, the effect of repeated examinations on accuracy and time on skill retention.
Results
Ninety students participated (55F), 46 attended the workshop and were considered “trained”. There was no difference between the groups in numbers of correct estimations (29% trained, 27% untrained, p=0.593). However, the trained group’s estimations were closer to the true volume, with more from the trained group one bead away (p=0.002) and fewer more than three beads away from the true volume (p<0.001), compared to the untrained group. Trained participants were more accurate at the second assessment (n=80) (p<0.001) and had greater intra-observer reliability (p=0.004).
Conclusions
Overall TV estimation accuracy was poor. Workshop-style training improved accuracy, reliability and retention of skill acquisition and could be considered as a useful learning tool.
Research funding: None declared.
Author contributions: CJE and NPW had the original idea for the study. BW and EW designed the workshop and undertook the pilot study. JL and DW designed and produced simulation models. NPW provided educational material for the workshops. JC, MS and CF conducted the study, analysed the data and drafted the initial manuscript. CJE revised the manuscript. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Statement of Ethics: Ethical approval was not required for this study. All participants recruited were willing and consented prior to taking part.
References
1. Mbaeri, TU, Orakwe, JC, Nwofor, AM, Oranusi, KC, Mbonu, OO. Accuracy of Prader orchidometer in measuring testicular volume. Niger J Clin Pract 2013;16:348–51. https://doi.org/10.4103/1119-3077.113460.Suche in Google Scholar PubMed
2. Karaman, M, Kaya, C, Caskurlu, T, Guney, S, Ergenekon, E. Measurement of pediatric testicular volume with Prader orchidometer: comparison of different hands. Pediatr Surg Int 2005;21:517–20. https://doi.org/10.1007/s00383-005-1470-1.Suche in Google Scholar PubMed
3. Chamberlain, EN. Symptoms and signs in clinical medicine: an introduction to medical diagnosis. Baltimore: Williams and Wilkins; 1961.Suche in Google Scholar
4. Brunner, H, Otten, B. Precocious puberty in boys. N Engl J Med 1999;341:1763–5. https://doi.org/10.1056/nejm199912023412311.Suche in Google Scholar PubMed
5. Elder, CJ, Langley, J, Stanton, A, De Silva, S, Akbarian-Tefaghi, L, Wales, JKH, et al.. A simulation study assessing the accuracy and reliability of orchidometer estimation of testicular volume. Clin Endocrinol 2019;90:623–9. https://doi.org/10.1111/cen.13923.Suche in Google Scholar PubMed
6. Lofty-John, CA, Oludayo, AS, Christianah, MA, Mohammed, KS, Aminu, MM, Mayomi, O, et al.. Testicular volume: correlation of ultrasonography, orchidometer and caliper measurements in children. Afr J Urol 2020;26:1–6. https://doi.org/10.1186/s12301-020-0016-z.Suche in Google Scholar
7. Good, M. Patient simulation for training basic and advanced clinical skills. Med Educ 2003;37:14–21. https://doi.org/10.1046/j.1365-2923.37.s1.6.x.Suche in Google Scholar PubMed
8. Khan, K, Pattison, T, Sherwood, M. Simulation in medical education. Med Teach 2011;33:1–3. https://doi.org/10.3109/0142159x.2010.519412.Suche in Google Scholar
9. Elder, CJ, De Silva, S, Akbarian-Tefaghi, L, Langley, J, Wright, NP. Inter and intra-rater reliability of accuracy of testicular volume evaluation: a simulation study. Endocr Abstr 2015;39:EP73 https://doi.org/10.1530/endoabs.39.EP73.Suche in Google Scholar
10. Harold, P, Mark, M, Doug, R, Robert, B. Learning styles: concepts and evidence. Psychol Sci Public Interest 2008;9:105–19. https://doi.org/10.1111/j.1539-6053.2009.01038.x.Suche in Google Scholar PubMed
11. Rohrer, D, Pashler, H. Learning styles: where’s the evidence? Med Educ 2012;46:634–5. https://doi.org/10.1111/j.1365-2923.2012.04273.x.Suche in Google Scholar PubMed
12. Lujan, HL, Dicarlo, SE. First-year medical students prefer multiple learning styles. Adv Physiol Educ 2006;30:13–6. https://doi.org/10.1152/advan.00045.2005.Suche in Google Scholar PubMed
13. Kolb, DA, Boyatzis, RE, Mainemelis, C. Experiential learning theory: previous research and new directions. In: Sternberg, RJ, Zhang, LF, editors. Perspectives on Thinking, Learning, and Cognitive Styles. New York: Routledge; 2001:227–48 pp.10.4324/9781410605986-9Suche in Google Scholar
14. Garner, MS, Gusberg, RJ, Kim, AW. The positive effect of immediate feedback on medical student education during the surgical clerkship. J Surg Educ 2014. https://doi.org/10.1016/j.jsurg.2013.10.009.Suche in Google Scholar PubMed
15. Abrahamson, SS, Denson, MJ, Wolf, MR. Effectiveness of a simulator in training anesthesiology residents. Acad Med 1969;44:515–9. https://doi.org/10.1097/00001888-196906000-00006.Suche in Google Scholar PubMed
16. Anders Ericsson, K. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med 2008;15:988–94. https://doi.org/10.1111/j.1553-2712.2008.00227.x.Suche in Google Scholar PubMed
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review Articles
- Association between muscle strength and risk factors for metabolic syndrome in children and adolescents: a systematic review
- Adverse effects of metabolic disorders in childhood on adult reproductive function and fertility in the male
- Original Articles
- Female adolescents and young women previously treated for pediatric malignancies: assessment of ovarian reserve and gonadotoxicity risk stratification for early identification of patients at increased infertility risk
- Anthropometric indices and cardiometabolic risk factors in a Ghanaian adolescent population
- Effectiveness of basal LH in monitoring central precocious puberty treatment in girls
- Combination of sleep duration, TV time and body mass index is associated with cardiometabolic risk moderated by age in youth
- Serum level of NPTX1 is independent of serum MKRN3 in central precocious puberty
- Training using a simulation-based workshop reduces inaccuracies in estimations of testicular volume
- Longitudinal 15-year follow-up of women with former early puberty: abnormal metabolic profiles not associated with earlier age at onset of puberty, but associated with obesity
- Prenatal smoke exposure is associated with increased anogenital distance in female infants: a prospective case–control study
- Evaluation of the efficiency of serum biotinidase activity as a newborn screening test in Turkey
- Characterization and outcome of 11 children with non-diabetic ketoacidosis
- Challenges of following patients with inherited metabolic diseases during the COVID-19 outbreak. A cross-sectional online survey study
- The utility of 68Ga-DOTATATE PET/CT in localizing primary/metastatic pheochromocytoma and paraganglioma in children and adolescents – a single-center experience
- Impact of sodium phenylbutyrate treatment in acute management of maple syrup urine disease attacks: a single-center experience
- Case Reports
- Delayed phenylketonuria diagnosis: a challenging case in child psychiatry
- Late diagnosis of 3β-Hydroxysteroid dehydrogenase deficiency: the pivotal role of gas chromatography-mass spectrometry urinary steroid metabolome analysis and a novel homozygous nonsense mutation in the HSD3B2 gene
- Differentiating syndrome of inappropriate ADH, reset osmostat, cerebral/renal salt wasting using fractional urate excretion
- Ectopic ACTH production by thymic and appendiceal neuroendocrine tumors – two case reports
- New onset diabetes with diabetic ketoacidosis in a child with multisystem inflammatory syndrome due to COVID-19
Artikel in diesem Heft
- Frontmatter
- Review Articles
- Association between muscle strength and risk factors for metabolic syndrome in children and adolescents: a systematic review
- Adverse effects of metabolic disorders in childhood on adult reproductive function and fertility in the male
- Original Articles
- Female adolescents and young women previously treated for pediatric malignancies: assessment of ovarian reserve and gonadotoxicity risk stratification for early identification of patients at increased infertility risk
- Anthropometric indices and cardiometabolic risk factors in a Ghanaian adolescent population
- Effectiveness of basal LH in monitoring central precocious puberty treatment in girls
- Combination of sleep duration, TV time and body mass index is associated with cardiometabolic risk moderated by age in youth
- Serum level of NPTX1 is independent of serum MKRN3 in central precocious puberty
- Training using a simulation-based workshop reduces inaccuracies in estimations of testicular volume
- Longitudinal 15-year follow-up of women with former early puberty: abnormal metabolic profiles not associated with earlier age at onset of puberty, but associated with obesity
- Prenatal smoke exposure is associated with increased anogenital distance in female infants: a prospective case–control study
- Evaluation of the efficiency of serum biotinidase activity as a newborn screening test in Turkey
- Characterization and outcome of 11 children with non-diabetic ketoacidosis
- Challenges of following patients with inherited metabolic diseases during the COVID-19 outbreak. A cross-sectional online survey study
- The utility of 68Ga-DOTATATE PET/CT in localizing primary/metastatic pheochromocytoma and paraganglioma in children and adolescents – a single-center experience
- Impact of sodium phenylbutyrate treatment in acute management of maple syrup urine disease attacks: a single-center experience
- Case Reports
- Delayed phenylketonuria diagnosis: a challenging case in child psychiatry
- Late diagnosis of 3β-Hydroxysteroid dehydrogenase deficiency: the pivotal role of gas chromatography-mass spectrometry urinary steroid metabolome analysis and a novel homozygous nonsense mutation in the HSD3B2 gene
- Differentiating syndrome of inappropriate ADH, reset osmostat, cerebral/renal salt wasting using fractional urate excretion
- Ectopic ACTH production by thymic and appendiceal neuroendocrine tumors – two case reports
- New onset diabetes with diabetic ketoacidosis in a child with multisystem inflammatory syndrome due to COVID-19