Digital Rectal Exam Workshop 



This 15 minute workshop will be held in conjunction with the Best Practices in Primary Care program. The workshops will be available during the breaks in between sessions of the program.
Who Should Attend:  All physicians, nurse practitioners, and physician assistants who want to learn more about performing a digital rectal exam.

Overview:

A key diagnostic tool for chronic constipation is the digital rectal exam (DRE) which is recommended by the American Gastroenterological Association (AGA) and the American College of Gastroenterology.  They suggest this tool be used as a part of the physical exam that is performed on patients.  Often times the procedure is not done consistently or properly.  Chronic constipation is a multi-symptom gastrointestinal motility disorder that negatively impacts the lives of those affected. Chronic constipation is a problem for approximately 33 million Americans and spans all age groups, but tends to have a higher prevalence in women and the elderly. 

Performing a DRE should be a routine procedure in assessing patients in the primary care setting, often times it is not done though, thus a diagnosis of chronic constipation or other functional bowel disorders may be missed.  Frequently, this procedure is not performed because the physician may not have been trained properly or have had the experience while in medical school.  As many as two-thirds of patients presenting with rectal or urogenital symptoms do not undergo a DRE before a diagnosis of chronic constipation is made or they are referred to a specialist.  The ACG states that a patient first presents with constipation symptoms, that the clinician should complete a DRE as part of a thorough physical exam. 
The training of medical students and residents over the years has changed dramatically.  Often times the DRE procedures may be illustrated in a text book but, actual practice sessions may be infrequent.  The lack of training may continue throughout their practices and careers, as few DRE’s are actually performed during a routine physical exam.  Training and practice in performing a DRE is of utmost importance in the physical exam procedure that assists clinicians in making appropriate diagnoses and treatments for certain anomalies.

Research has been done to examine whether proper training in performing a comprehensive physical exam, including a DRE is part of the curriculum in medical schools.  The results were astounding, showing that training and practice was very low during there clinical experiences while in medical school.  The studies show that many times, it is the primary care physician that does not perform a DRE as part of their patient treatments.  Therefore, many renowned experts in the field of Gastroenterology have stated there is a need for proper training and practice for performing DRE’s. 

Learning Objectives:

1. Increase practical knowledge and techniques when performing a digital rectal exam to assist in forming an accurate diagnosis on a patient
2. Identify the signs and symptoms of the patient from the DRE that would necessitate a referral to a specialist

Accreditation: ACCME

Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Primary Care Network designates this educational activity for a maximum of .25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Commercial Supporter:  This program is supported through an educational grant from Takeda Pharmaceuticals North America, Inc. and Sucampo Pharmaceuticals, Inc.