DaRE to Approach Differently: Teaching the Digital Anorectal Examination Through a Trauma-Informed Framework.

Kera Kwan, Amanda Labora, Formosa Chen, Walter Solorzano, Daniel Gonzalez, Whitney Orji, Tara Russell

Abstract read

In one paragraph

Article in Journal of graduate medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kera Kwanis a PGY-4 Resident, Department of Surgery, David Geffen School of Medicine, and Fellow, National Clinician Scholars Program, University of California, Los Angeles (UCLA), Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-3651-8915

Amanda Laborais a PGY-7 Resident, Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California, USA.ORCID https://orcid.org/0000-0001-6273-0939

Formosa Chenis an Assistant Professor of Surgery and Associate Program Director of General Surgery, UCLA David Geffen School of Medicine, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-3303-8377

Walter Solorzanois a Fellow, Department of Medicine, Division of General Internal Medicine & Health Services Research, UCLA David Geffen School of Medicine, National Clinician Scholars Program, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-7824-4342

Daniel Gonzalezis a Fellow, Department of Medicine, Division of General Internal Medicine & Health Services Research, UCLA David Geffen School of Medicine, National Clinician Scholars Program, Los Angeles, California, USA.ORCID https://orcid.org/0009-0000-9917-9589

Whitney Orjiis a PGY-5 Resident, Department of Surgery, David Geffen School of Medicine, and Fellow, National Clinician Scholars Program, UCLA, Los Angeles, California, USA.ORCID https://orcid.org/0009-0005-2527-087X

Tara Russellis an Assistant Professor-in-Residence of Surgery, David Geffen School of Medicine, and Fellow, National Clinician Scholars Program, UCLA, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-3912-3601

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The digital anorectal examination (DRE) is a valuable clinical tool but is often underutilized due to provider discomfort, lack of confidence, and concerns about patient experience. Trauma-informed care (TIC) frameworks have improved education for other sensitive examinations, but their application to DRE instruction remains limited. Objective: To evaluate whether a TIC-focused educational intervention improved resident physician comfort, confidence, and knowledge related to the DRE. Methods: From October 2024 to February 2025, a prospective study was conducted among family medicine, internal medicine, and surgery residents at a large academic medical center. Residents attended a 30-minute TIC-focused DRE didactic session. Surveys were administered at baseline, immediately after the session, and at 6 weeks. Outcomes included confidence using TIC principles and identifying pathology, changes in comfort performing the DRE, and frequency of deferring examinations. Results: A total of 136 residents participated; 99 (73%) had paired post-session responses, and 45 (33%) completed all 3 surveys. Six weeks after the session, participants reported higher average confidence employing TIC (5.09 to 6.79, scale 1-10), greater comfort performing the DRE (4.63 to 6.36), and improved confidence identifying anal (4.07 to 6.00) and rectal pathology (3.65 to 5.47), with all comparisons Conclusions: A brief, low-resource educational session incorporating TIC principles significantly improved resident confidence and comfort employing TIC and performing the DRE.

Indexed as

Digital Rectal ExaminationInternship and ResidencyClinical CompetenceEducation, Medical, GraduateFamily PracticeHumansProspective StudiesSurveys and Questionnaires

Identifiers

PMID41694791

DOI10.4300/JGME-D-25-00553.1

PMCPMC12903381

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.