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

Abstract

Background: Primary care providers (PCPs) frequently address dermatologic concerns and perform skin examinations during clinical encounters. For PCPs who evaluate concerning skin lesions, dermoscopy (a noninvasive skin visualization technique) has been shown to increase the sensitivity for skin cancer diagnosis compared with unassisted clinical examinations. Because no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy for skin cancer detection, the objective of this study was to develop an expert consensus statement on proficiency standards for PCPs learning or using dermoscopy.Methods: A 2-phase modified Delphi method was used to develop 2 proficiency standards. In the study's first phase, a focus group of PCPs and dermatologists generated a list of dermoscopic diagnoses and associated features. In the second phase, a larger panel evaluated the proposed list and determined whether each diagnosis was reflective of a foundational or intermediate proficiency or neither.Results: Of the 35 initial panelists, 5 PCPs were lost to follow-up or withdrew; 30 completed the fifth and last round. The final consensus-based list contained 39 dermoscopic diagnoses and associated features.Conclusions: This consensus statement will inform the development of PCP-targeted dermoscopy training initiatives designed to support early cancer detection.

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

“…Recently, Tran et al proposed an expert‐approved list of key dermoscopic features of skin tumours to be taught in training programs for PCPs 57 . We found that all of the core dermoscopic features proposed in their fundamental list of basic skills required to selectively triage benign and malignant skin lesions are taught in the ST.…”

“…-28% margin of non-inferiority programs for PCPs. 57 We found that all of the core dermoscopic features proposed in their fundamental list of basic skills required to selectively triage benign and malignant skin lesions are taught in the ST. In the same line of thought, we deliberately excluded from the ST skin tumours that do not present specific dermoscopic features or that are difficult to diagnose using dermoscopy, such as adnexal tumours.…”