Dermoscopy in Selected Latin American Countries: A Preliminary Look into Current Trends and Future Opportunities Among Dermatology Residency Programs

Citation: Perez M, Williams NM, Avila AM, et al. Dermoscopy in Selected Latin American Countries: A Preliminary Look into Current Trends and Future Opportunities among Dermatology Residency Programs. Dermatol Pract Concept. 2023;13(2):e2023093. DOI: https://doi.org/10.5826/dpc.1302a93

Accepted: October 19, 2022; Published: April 2023

Copyright: ©2023 Perez et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Natalia Jaimes, MD, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Sylvester Comprehensive Cancer Center, Miami, FL. University of Miami Miller School of Medicine, Dermatology Research Clinic 1600 NW 10^th Ave. RSMB 2023A, Miami, FL 33136 Phone: 305-243-6735 Email: njaimes@med.miami.edu

Abstract

Introduction: Dermoscopy is a useful technique that aids in early detection of skin cancer by increasing diagnostic accuracy with adequate training. However, dermoscopy is not uniformly taught to residents worldwide. Dermoscopy training in Latin American dermatology residency programs has not been explored.

Objectives: To assess current dermoscopy training among dermatology residency programs in Latin America (e.g. training modalities, preferred/most effective modalities per residents, diseases/pathologies taught).

Methods: Cross-sectional survey distributed via email between March and May 2021. Chief residents from Argentina, Brazil, Colombia, Costa Rica, Chile, Ecuador, Guatemala, Mexico, Panama, and Uruguay were invited to participate.

Results: 81 chief residents completed the questionnaire (81/126, 64.2%). 72% of programs had an established dermoscopy curriculum, with dedicated hours of training varying greatly by program. Institutions commonly utilized sessions with “unknown” dermoscopy images and direct teaching by experts in the clinical setting as supplements to lectures, also described by residents as most effective. The most commonly taught methods included pattern analysis (74.1%), the two-step algorithm (61.7%), and the ABCD rule (59.3%). Almost all respondents reported desiring additional training during residency and believe that dermoscopy training should be a requirement to graduate from residency.

Conclusion: This study highlights the current landscape in dermoscopy training among dermatology residency programs in Latin America, demonstrating room for improvement and standardization in dermoscopic education and training. Our results serve as a baseline reference and provide valuable information to guide future educational initiatives incorporating successful teaching strategies (e.g. spaced education/repetition, flipped classroom model) used in dermatology and other fields.

Keywords : Dermoscopy, Dermatology Residency, Latin America, Medical Education

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

References

1. Elliott TM, Whiteman DC, Olsen CM, Gordon LG. Estimated Healthcare Costs of Melanoma in Australia Over 3 Years Post-Diagnosis. Applied Health Economics and Health Policy. 2017;15(6):805-816. 2. Guy GP, Jr., Thomas CC, Thompson T, et al. Vital signs: melanoma incidence and mortality trends and projections - United States, 1982-2030. MMWR Morb Mortal Wkly Rep. 2015;64(21):591-596. 3. Hanson JL, Kingsley-Loso JL, Grey KR, et al. Incidental melanomas detected in veterans referred to dermatology. Journal of the American Academy of Dermatology. 2016;74(3):462-469. 4. Argenziano G, Ferrara G, Francione S, Di Nola K, Martino A, Zalaudek I. Dermoscopy--the ultimate tool for melanoma diagnosis. Semin Cutan Med Surg. 2009;28(3):142-148. 5. Menzies SW, Ingvar C, McCarthy WH. A sensitivity and specificity analysis of the surface microscopy features of invasive melanoma. Melanoma Res. 1996;6(1):55-62. 6. Vestergaard ME, Macaskill P, Holt PE, Menzies SW. Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol. 2008;159(3):669-676. 7. Kittler H, Pehamberger H, Wolff K, Binder M. Diagnostic accuracy of dermoscopy. Lancet Oncol. 2002;3(3):159-165. 8. Blum A, Kreusch J, Stolz W, et al. The status of dermoscopy in Germany - results of the cross-sectional Pan-Euro-Dermoscopy Study. J Dtsch Dermatol Ges. 2018;16(2):174-181. 9. Forsea AM, Tschandl P, Del Marmol V, et al. Factors driving the use of dermoscopy in Europe: a pan-European survey. Br J Dermatol. 2016;175(6):1329-1337. 10. Piliouras P, Buettner P, Soyer HP. Dermoscopy use in the next generation: a survey of Australian dermatology trainees. Australas J Dermatol. 2014;55(1):49-52. 11. Chen YA, Rill J, Seiverling EV. Analysis of dermoscopy teaching modalities in United States dermatology residency programs. Dermatol Pract Concept. 2017;7(3):38-43. 12. Freeman SR, Greene RE, Kimball AB, et al. US dermatology residents' satisfaction with training and mentoring: survey results from the 2005 and 2006 Las Vegas Dermatology Seminars. Arch Dermatol. 2008;144(7):896-900. 13. Patel P, Khanna S, McLellan B, Krishnamurthy K. The need for improved dermoscopy training in residency: a survey of US dermatology residents and program directors. Dermatol Pract Concept. 2017;7(2):17-22. 14. Wu TP, Newlove T, Smith L, Vuong CH, Stein JA, Polsky D. The importance of dedicated dermoscopy training during residency: A survey of US dermatology chief residents. Journal of the American Academy of Dermatology. 2013;68(6):1000-1005. 15. Forsea AM, Tschandl P, Zalaudek I, et al. Inequalities in the patterns of dermoscopy use and training across Europe: conclusions of the Eurodermoscopy pan-European survey. Eur J Dermatol. 2020. 16. Piliouras P, Buettner P, Soyer HP. Dermoscopy use in the next generation: A survey of Australian dermatology trainees. Australasian Journal of Dermatology. 2014;55(1):49-52. 17. Muzumdar S, Waldman RA, Grant-Kels JM, Kerr P. Implementing the flipped classroom approach to dermatopathology and dermoscopy resident education: A single-institution experience. Journal of Cutaneous Pathology. 2019;46(10):753-755. 18. Boespflug A, Guerra J, Dalle S, Thomas L. Enhancement of Customary Dermoscopy Education With Spaced Education e-Learning: A Prospective Controlled Trial. JAMA Dermatology. 2015;151(8):847-853. 19. Chevolet I, Hoorens I, Janssens A, et al. A short dermoscopy training increases diagnostic performance in both inexperienced and experienced dermatologists. Australasian Journal of Dermatology. 2015;56(1):52-55. 20. Kerfoot BP. Learning Benefits of On-Line Spaced Education Persist for 2 Years. Journal of Urology. 2009;181(6):2671-2673. 21. Kerfoot BP, Turchin A, Breydo E, Gagnon D, Conlin PR. An online spaced-education game among clinicians improves their patients' time to blood pressure control: a randomized controlled trial. Circ Cardiovasc Qual Outcomes. 2014;7(3):468-474. 22. Kuperstock JE, Horný M, Platt MP. Mobile app technology is associated with improved otolaryngology resident in-service performance. The Laryngoscope. 2019;129(1):E15-E20.