Effect of Dermoscopy Education on the Ability of Medical Students to Detect Skin Cancer

Abstract

To determine students' ability to discriminate benign vs malignant lesions and to assess attitudes regarding skin cancer examination (SCE).Design: Second-year medical students at 1 institution participated in an SCE intervention for 2 consecutive years.Intervention: Cohort 1 received intervention A, consisting of SCE teaching without a dermoscopy tutorial. Cohort 2 received intervention B, consisting of SCE teaching with a dermoscopy tutorial, access to online dermoscopy resources, and a dermoscope.Main Outcome Measure: Surveys before and after the lecture included an image-based test of 10 lesions to assess ability to differentiate benign from malignant lesions.Results: There were 130 participants from cohort 1 and 131 participants from cohort 2 at the postintervention survey. At baseline, students in both groups reported similar attitudes regarding the value of SCE (P= .05) and in-tention to perform SCE on patients (P=.55). Overall, cohort 2 exhibited improvement (P Ͻ .001) from preintervention (52.0% correct) to postintervention assessments (63.0% correct), whereas cohort 1 did not (47.0% and 46.0% correct, respectively; P = .50). Although both groups improved (PϽ .001) in the diagnosis of the superficial spreading melanoma, cohort 2 improved in the diagnosis of the basal cell carcinoma (PϽ .001) and cohort 1 displayed deterioration in identifying the malignant nature of this lesion (PϽ.001). For the nodular melanoma, correct diagnosis decreased significantly in cohort 1 (P Ͻ .001) and negligibly in cohort 2 (P =.90). Conclusions:Students receiving the dermoscopy tutorial improve in diagnosis of cutaneous lesions compared with those not receiving the dermoscopy intervention. Teaching SCE with inclusion of dermoscopy may be an effective means of enhancing skin cancer knowledge.

Dermoscopy Improves the Diagnostic Accuracy of Melanomas Clinically Resembling Seborrheic Keratosis: Cross-Sectional Study of the Ability to Detect Seborrheic Keratosis-Like Melanomas by a Group of Dermatologists with Varying Degrees of Experience

“…In contrast, specificity depends on experience, and it only increased for the most expert users, while dermoscopy led to a decrease in specificity in the group of novices (from 58.6 to 45.6%, p = 0.02). The data demonstrated in the present study support previously published prospective studies where dermoscopy has been shown to improve diagnostic accuracy among well-trained dermatologists [5], and improve detection of skin cancer even among nondermatologists and novices [6][7][8].…”

Teaching dermatoscopy of pigmented skin tumours to novices: comparison of analytic vs. heuristic approach

“…namely the heuristic method based on the overall gestalt of a given lesion and the analytic approach based on the description of patterns and specific criteria (clues). It has been shown previously that a short time teaching of dermatoscopy to medical students in general has beneficiary effects to diagnostic accuracy and is superior to mere clinical teaching . In our study, we could reproduce an equal diagnostic improvement compared to the pretest performance status irrespective of the method used for teaching.…”

One-Year Follow-Up of Dermoscopy Education on the Ability of Medical Students to Detect Skin Cancer

“…Pre- and post-test assessments were accomplished with in-class surveys and image-based tests of 10 lesions immediately prior to the lecture and immediately after delivery of the lecture. The results of these outcomes are discussed elsewhere [5. ]…”

“…The continued use of dermoscopy can reduce the number of benign lesions being excised compared to clinical examination alone [3,4]. We have previously shown that incorporating dermoscopy teaching into a medical school curriculum can improve skin cancer detection between two cohorts of second-year medical students; one cohort received dermoscopy training and the other did not [5]. To our knowledge, our study was the first to examine the use of dermoscopy to enhance SCE instruction in the preclinical setting.…”