Dermoscopic Lotus of Learning: Implementation and Dissemination of a Multimodal Dermoscopy Curriculum for Primary Care

Abstract

Dermoscopy is a cost-effective tool for detection of skin cancers yet there is limited training available for primary care. The goal of this project was to develop, implement, and disseminate a multimodal curriculum for primary care across a health system based on a previously validated algorithm (Triage Amalgamated Dermoscopic Algorithm; TADA). This cross-sectional study analyzes the dermoscopy workshop intervention of a dermoscopy multimodal curriculum. Volunteers attended one 120-minute dermoscopy workshop on benign and malignant growths using a validated algorithm. Participants took a 30-image pre- and posttest. Survey questions on dermoscopy use, preferences for learning, and skin biopsy performance were included to enhance curriculum development. About 96 participants completed both pre- and postintervention tests. The mean preintervention score (out of 30) was 18.6 and increased to 24.4 on the postintervention evaluation. There was a statistically significant improvement in scores for both benign and malignant skin growths after the intervention ( P < .05). Short dermoscopy workshops have a positive intervention effect when training primary care providers to identify images of benign and malignant dermoscopic skin lesions. A multimodal dermoscopy curriculum allows learners to build on initial training using spaced review and blended learning strategies. The “Dermoscopic Lotus of Learning” has the potential to be a model for other primary care residency programs. A healthy partnership between dermatologists and primary care is essential.

Evaluation of primary care physicians' competence in selective skin tumour triage after short versus long dermoscopy training: a randomized non‐inferiority trial

“…Several ST courses in dermoscopy have already shown to improve diagnostic accuracy for skin tumours in inexperienced users. 36,[38][39][40][41][42] However, the present study is the first to compare the skills acquired after a short dermoscopy training program and after a long training program. Hence, ST was shown to provide acceptable short-and medium-term competence in skin tumour triage with significant benefits.…”

Educational Interventions to Support Primary Care Provider Performance of Diagnostic Skin Cancer Examinations: A Systematic Literature Review

“…If programs were reported as lasting a “day,” we extrapolated this to equal 8 h. In general, PCPs have indicated they often prefer live and interactive educational modalities (Fig. 2 ) [ 78 ]. However, schedule constraints have been cited as barriers to effectively implementing live formats [ 78 ].…”

“…2 ) [ 78 ]. However, schedule constraints have been cited as barriers to effectively implementing live formats [ 78 ]. Virtual or web-based formats diminish this constraint by eliminating travel time and lecture schedules.…”

Expert Consensus Statement on Proficiency Standards for Dermoscopy Education in Primary Care

“…31 Training programs based on TADA have been shown to improve the sensitivity for skin cancer detection compared with baseline. [29][30][31][32] Given the proven effectiveness of TADA in training PCPs and novices, 33 diagnoses in level 2 are mostly considered less common in the general population and/or more challenging to discern (eg, pigmented actinic keratosis, lichen planus-like keratosis). Level 2 also incorporates different types of melanoma (eg, lentigo maligna melanoma, amelanotic/hypomelanotic melanoma) and benign nevi (eg, blue nevi, acral nevi) and demonstrates a broader utility of dermoscopy in the identification of other diagnoses frequently encountered by PCPs (eg, molluscum contagiosum, psoriasis).…”