Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. R. Wayne Fuqua


Maintenance of breast self-examination (BSE) skills is crucial to the effectiveness of self-exams in early detection of breast tumors. While researchers have developed an effective technology for training these skills, the maintenance of BSE proficiency is questionable (Pennypacker et al., 1982). The objective of this study was to evaluate the effects of reassessment (and retraining) on the maintenance of BSE skills. Twenty-nine women (ages 25-64) were trained to criterion using the MammaCare training package. Experimental subjects were required to demonstrate their skills at a 2 month reassessment and received retraining if their skills had declined below criterion. Control subjects were not required to demonstrate their skills until a 4 month follow-up. Measures of proficiency were obtained by requiring all subjects to demonstrate their skills by examining breast models at pretraining, posttraining, and at two follow-ups (4 month and one year). Measures of BSE frequency and knowledge were also obtained at pretraining and at the 4 month follow-up.

There were no significant differences between groups on outcome measures. However, in the control group, there were significant decreases in lump detection rates between posttraining and each follow-up. In the experimental group, although detection rates declined between posttraining and the 4 month follow-up, such declines were not statistically significant. At the one year follow-up, experimental subjects' detection rates were similar to those at posttraining. We suggest that training to criterion on simulated breast models can produce acquisition of proficient BSE skills, and periodic reevaluation can prevent significant deterioration of these skills.

Access Setting

Dissertation-Open Access