Direct observation of procedural skills to improve validity ofstudents' measurement of prostate volume in predicting treatmentoutcomes

Objective: To evaluate whether using the direct observation of procedural skills (DOPS) tool improves the accuracy of students' performance for clinical skill assessment. Materials and Methods: Outcome- and clinical-based evidence results were analyzed for prostate size measurement for benign prostatic hyperplasia (BPH), including digital rectal examination (DRE) and transrectal ultrasonography (TRUS). Patients were stratified into three clinical groups based on the results of DRE and TRUS. Clinical outcomes were correlated between DRE and TRUS for prostate size. We designed a DOPS study in a clinical setting with actual patients in which DRE and TRUS results for prostate volume measurement were compared in order to determine their correlation. Results: The DRE of patients with mild, moderate, and severe BPH showed prostate size variations. The correlation between DRE and TRUS showed that DRE underestimated prostate size in the severe hyperplasia group (>60mL) and was more accurate in the moderate hyperplasia group (40-60mL). The implementation of DOPS for prostate size measurement improved students' self-assessed communication and counseling skills. The study results show that the DOPS tool improved students' prostate measurement techniques and skills (Cronbach's α>0.70). Conclusion: We demonstrated that students' clinical skills for the measurement of prostate size improved after the implementation of the DOPS tool in DRE to determine prostate size accurately in the clinical teaching program. Clinicians can enhance clinical skills education in certain circumstances with strategic incorporation of tools for direct observation into medical student training programs. By using the DOPS scoring system and reviewing faculty feedback, trainees can improve their accuracy of prostate size measurements.