Background: This study hypothesized that an office-based training program in clinical breast examination (CBE) would improve the lump-detection skills of primary care physicians.
Methods: A one-group pretest-posttest design was utilized, without outcome measurements taken prior to instruction, immediately afterwards, and six months later. Fifty physicians from 117 practices that had been randomly selected and met program eligibility criteria elected to participate. The intervention was a one-hour office-based CBE training program based on the MammaCare method, a standardized approach to teaching the detection of breast lumps using silicone breast models.
Results: There were five lumps in the silicone model. The mean number of correct lump detections increased significantly, from 0.66 before to 3.2 after instruction, and this gain was maintained at six-month follow-up. The mean number of false positives decreased from 2.9 before to 1.16 after instruction, increasing slightly to 1.6 at six-month follow-up. Ninety-six percent of the physicians reported that they had modified their methods of CBE as a result of the training.
Conclusions: This office-based instruction using an academic detailing model improved the participating physicians' abilities to correctly detect lumps in a silicone breast model and was received favorably.