Teaching the testicular exam: a model curriculum from "A" to "Zack"

The testicular exam was not explicitly taught at our medical schools before 2002. In this article, we explore different phases of curriculum development, implementation, and evaluation of a method for teaching the testicular exam. Medical students participated in surveys and focus groups, and male patients participated in focus groups. From the results of the focus groups, we developed a comprehensive testicular exam module that includes (1) a PowerPoint lecture, (2) a video, (3) reading materials, and (4) an artificial male model ("Zack"). These materials were then incorporated into family medicine clerkships. Students and faculty have evaluated the project. Initially, students expressed discomfort discussing sexual issues with patients, especially those of the opposite gender, and knew little about testicular cancer. Male patients had limited knowledge of the testicular self-exam and felt that their physical exam training had not been ideal. Faculty and students agreed that a lecture on the testicular exam and practice with Zack were useful in improving their exam skills, while the video and readings were less so. To address curricular deficits, a self-contained module on the testicular exam has been successfully incorporated into family medicine clerkships at two different medical schools. This module is easily adaptable to other settings and institutions.