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Am J Surg. 2007 Jun;193(6):766-70.

Fear of missing a lesion: use of simulated breast models to decrease student anxiety when learning clinical breast examinations.

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  • 1Department of Surgery, Northwestern University Feinberg School of Medicine, 201 East Huron Street, Galter 10-105, Chicago, IL 60611-2908, USA. drpugh@northwestern.edu



Medical students experience a considerable amount of discomfort during their training. The purpose of the current study was to identify sources of student anxiety when learning clinical breast examinations (CBEs) and to evaluate the effects of simulated breast models on student comfort.


Simulated breast models were introduced into the curriculum for 175 second-year medical students. Using surveys, students identified sources of anxiety and rated their comfort levels when learning CBE skills.


"Fear of missing a lesion" and the "Intimate/personal nature of the exam" accounted for 73.8% of student anxiety when learning CBEs. In addition, there were significant improvements (P < .05) in student comfort levels when using simulated breast models to learn CBE skills.


We have identified 2 of the top causes of anxiety for second-year medical students learning CBE. In addition, we found simulated breast models to be effective in increasing student comfort levels when learning CBEs.

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