A computerized physical simulator for training clinical prostate palpation skills

Cancer of the prostate is diagnosed at a high rate in American men and leads to a high number of deaths annually. Each of the three separate prostate diseases (benign prostatic hypertrophy, prostatitis, and cancer) has different palpable characteristics and requires different treatment. Therefore healthcare professionals must learn to correctly detect and diagnose each prostate abnormality. The digital rectal examination is a commonly employed method to detect prostate abnormalities. However, medical and nurse practitioner students often receive little to no training for this exam and trained clinicians often exhibit low agreement on findings. Both may be due, in part, to inadequacies of current training practices, particularly those involving simulation. The purpose of this work is to improve the current training. In particular, current simulators might more adequately prepare trainees if they included design characteristics such as basic elements of lifelike anatomy, multiple and reconfigurable scenarios with graded levels of difficulty, and feedback on trainee technique and performance. Also, the simulator must train practitioners to detect prostate cancer and other diseases of the prostate. This work presents the implementation of these design characteristics. The Virginia prostate examination simulator includes a freestanding torso structure, six instrumented prostates with embedded pressure sensors and controllable balloons, custom-built electronics to record sensor data and control balloon water pressure, and a user-interface display that presents technique and performance information to trainees.