Distance Learning and Spaced Review to Complement Dermoscopy Training for Primary Care
Keywords:
dermoscopy, primary care, skin cancer, distance learning, resident educationAbstract
Background: Dermoscopy aids in skin cancer identification. For family physicians who use dermoscopy, there is higher sensitivity for melanoma detection than naked-eye examination. There is a shortage of dermoscopy training for primary care providers. The Triage Amalgamated Dermoscopic Algorithm (TADA) is designed for novice dermoscopists. While TADA can be taught in a short dermoscopy workshop, spaced review and blended learning strategies improve knowledge retention.
Objectives: This study determined the impact that the addition of a distance learning platform has on clinical dermoscopy use. Moreover, it evaluated dermoscopic image identification (knowledge retention) following the addition of distance learning via Extension for Community Health Outcomes (ECHO) to a traditional TADA dermoscopy workshop.
Methods: Primary care providers voluntarily attended a 120-minute TADA dermoscopy workshop. Participants completed pre-intervention, post-TADA, and post-ECHO tests of 30 dermoscopic images of benign and malignant skin lesions. A survey was also administered to analyze clinical dermoscopy use and prior dermoscopy training.
Results: Twenty-seven residents, faculty, and advanced practice providers participated in this longitudinal observational cohort study. Mean test scores (out of 30) for images of benign and malignant lesions improved from 20.29 pre-intervention to 24.62 post-TADA and 27.63 post-ECHO (P < .001). On average, participants attended 4 ECHO sessions (out of 7 total) and there was a positive correlation (r = 0.77) between the number of ECHOs attended and post-ECHO scores. Dermoscope use increased from 37.0% to 96.3% (P < .001).
Conclusion: Distance learning and spaced review complement dermoscopy workshop training for primary care.
References
Kerr OA, Tidman MJ, Walker JJ, Aldridge RD, Benton EC. The profile of dermatological problems in primary care. Clin Exp Dermatol. 2010;35(4):380-383. DOI: 10.1111/j.1365-2230.2009.03586.x. PMID: 19874334
Cancer facts & figures 2017. American Cancer Society. Published 2017. Accessed July 8, 2020. https://www.cancer.org/content/ dam/cancer-org/research/cancer-facts-and- statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf.
Rate of new cancers in the United States, melanomas of the skin. Center for Disease Control and Prevention. Accessed July 10, 2020. https://gis.cdc.gov/Cancer/USCS/DataViz.html.
Glazer AM, Farberg AS, Winklemann RR, Rigel DS. Analysis of trends in geographic distribution and density of US dermatologists. JAMA Dermatol. 2017;153(4):322-325. DOI: 10.1001/jamadermatol.2016.5411. PMID: 28146246
Perera E, Xu C, Manoharan S. Real-life teledermatology cases. In: Soyer HP, Binder M, Smith A, Wurm E, eds. Telemedicine in Dermatology. Berlin: Springer Science & Business Media; 2011:123-129.
Verhoeven EW, Kraaimaat FW, van Weel C, et al. Skin diseases in family medicine: prevalence and health care use. Ann Fam Med. 2008;6(4):349-354. DOI: 10.1370/afm.861./ PMID: 18626035.
Herschorn A. Dermoscopy for melanoma detection in family practice. Can Fam Physician. 2012;58(7):740-745, e372-748. PMID: 22859635.
Seiverling EV, Ahrns HT, Greene A, et al. Teaching benign skin lesions as a strategy to improve the triage amalgamated dermoscopic algorithm (TADA). J Am Board Fam Med. 2019;32(1):96-102. DOI: 10.3122/jabfm.2019.01.180049. PMID: 30610147.
Susong JR, Ahrns HT, Daugherty A, Marghoob AA, Seiverling EV. Evaluation of a virtual basic dermatology curriculum for dermoscopy by using the triage amalgamated dermoscopic algorithm for novice dermoscopists. J Am Acad Dermatol. 2020;83(2):590-592. DOI: 10.1016/j.jaad.2019.05.097. PMID: 32331797.
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. J Am Acad Dermatol. 2013;68(6):1000-1005. DOI: 10.1016/j.jaad.2012.11.032. PMID: 23374231.
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. DOI: 10.5826/dpc.0703a08. PMID: 29085718.
Ruiz JG, Mintzer MJ, Leipzig RM. The impact of E-learning in medical education. Acad Med. 2006;81(3):207-212. DOI: 10.1097/00001888-200603000-00002. PMID: 16501260.
Augustin M. How to learn effectively in medical school: Test yourself, learn actively, and repeat in intervals. Yale J Biol Med. 2014;87(2):207-212. PMID: 24910566.
Khajah MM, Lindsey RV, Mozer MC. Maximizing students' retention via spaced review: practical guidance from computational models of memory. Top Cogn Sci. 2014;6(1):157-169. DOI 10.111/tops.12077. PMID: 24482341.
Distance education. National Education Association. Accessed August 13, 2020. http://www.nea.org/home/34765.htm.
Family medicine residency curriculum guidelines: Conditions of the skin. American Academy of Family Physicians. Accessed June 3, 2019. https://www.aafp.org/medical-school-residency/program-directors/ curriculum.html.
Nelson KC, Gershenwald JE, Savory SA, et al. Telementoring and smartphone-based answering systems to optimize dermatology resident dermoscopy education. J Am Acad Dermatol. 2019;81(2):e27-e28. DOI: 10.1016/j.jaad.2019.01.045. PMID: 30703459.
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