gms | German Medical Science

Research in Medical Education – Chances and Challenges International Conference

20.05. - 22.05.2009, Heidelberg

Learning with Simulations – Teaching the Rectal Exam with Standardised Patients

Meeting Abstract

Research in Medical Education - Chances and Challenges 2009. Heidelberg, 20.-22.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09rmeK5

doi: 10.3205/09rme63, urn:nbn:de:0183-09rme631

Published: May 5, 2009

© 2009 Siebeck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Undergraduate medical curricula are often deficient in teaching physical examinations in taboo zones, particularly the rectal exam. Here, students' inhibition is assumed to hamper the performance of the rectal exam in daily practice as well as the learning process. Simulation-based learning has proven effective to teach the physical exam. Complexity of simulations can be variable, depending on whether a part task (PT) or the whole task (WT) is simulated.

In 2 studies we have addressed 2 research questions:

does the complexity of the simulations (PT vs. WT) affect inhibition and acquisition of procedural knowledge?
does the sequence of the simulation (WT-PT vs. PT-WT) affect inhibition and acquisition of procedural knowledge?

The study populations consisted of 41 (study 1) and 188 (study 2) female and male undergraduate medical students. Each student participated in two sessions (1 PT and 1 WT), the order of which was randomised. For the PT we used a mannequin, for the WT standardised patients trained to give feedback.

In both studies we found that the complexity of the simulation had a strong positive effect on the reduction of inhibition: The reduction of inhibition was significantly stronger after the WT than after the PT. Both types of simulations facilitated acquisition of knowledge.

Our results show that simulations of different complexity are capable of facilitating both acquisition of knowledge and affective variables such as the reduction of inhibition.