Prepubescent Female Genital Examination Images: Evidence-Informed Learning Opportunities.
J Pediatr Adolesc Gynecol
; 34(2): 117-123, 2021 Apr.
Article
in En
| MEDLINE
| ID: mdl-33189899
ABSTRACT
OBJECTIVES:
To determine diagnoses and image features that are associated with difficult prepubescent female genital image interpretations. DESIGN ANDSETTING:
This was a mixed-methods study conducted at a tertiary care pediatric center using images from a previously developed education platform.PARTICIPANTS:
Participants comprised 107 medical students, residents, fellows, and attendings who interpreted 158 cases to derive case difficulty estimates.INTERVENTIONS:
This was a planned secondary analysis of participant performance data obtained from a prospective multi-center cross-sectional study. An expert panel also performed a descriptive review of images with the highest frequency of diagnostic error. MAIN OUTCOMEMEASURES:
We derived the proportion of participants who interpreted an image correctly, and features that were common in images with the most frequent diagnostic errors.RESULTS:
We obtained 16,906 image interpretations. The mean proportion correct scores for each diagnosis were as follows normal/normal variants 0.84 (95% confidence interval [CI] 0.82, 0.87); infectious/dermatology pathology 0.59 (95% CI 0.45, 0.73); anatomic pathology 0.61 (95% CI 0.41, 0.81); and, traumatic pathology 0.64 (95% CI 0.49, 0.79). The mean proportion correct scores varied by diagnosis (P < .001). The descriptive review demonstrated that poor image quality, infant genitalia, normal variant anatomy, external material (eg, diaper cream) in the genital area, and nonspecific erythema were common features in images with lower accuracy scores.CONCLUSIONS:
A quantitative and qualitative examination of prepubescent female genital examination image interpretations provided insight into diagnostic challenges for this complex examination. These data can be used to inform the design of teaching interventions to improve skill in this area.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Gynecological Examination
/
Genital Diseases, Female
/
Genitalia, Female
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Qualitative_research
/
Risk_factors_studies
Limits:
Child
/
Child, preschool
/
Female
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
J Pediatr Adolesc Gynecol
Journal subject:
GINECOLOGIA
/
PEDIATRIA
Year:
2021
Document type:
Article
Affiliation country:
Canada