Online learning in a dermatology clerkship: Piloting the new American Academy of Dermatology Medical Student Core Curriculum

Cipriano, Sarah D.; Dybbro, Eric; Boscardin, Christy; Shinkai, Kanade; Berger, Timothy G.

doi:10.1016/j.jaad.2013.04.025

Cited by 52 publications

(37 citation statements)

References 8 publications

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“…Many countries including the Netherlands, have some level of gatekeeping in access to specialists, although the extent varies widely between countries . However, with skin cancer GP education being side‐lined in both a national and an international perspective, successful AK management (and thus efficient gatekeeping) is compromised . Increasing the familiarity of GPs with AK management by extending dermatology training for GPs may increase the likelihood of treating the condition themselves, reducing the use of nonindicated treatments (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…[42][43][44][45] However, with skin cancer GP education being side-lined in both a national and an international perspective, successful AK management (and thus efficient gatekeeping) is compromised. [32][33][34][37][38][39]46,47 Increasing the familiarity of GPs with AK management by extending dermatology training for GPs may increase the likelihood of treating the condition themselves, reducing the use of nonindicated treatments (e.g. antibiotics) and limiting patients entering secondary care.…”

Section: Discussionmentioning

confidence: 99%

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Healthcare utilization and management of actinic keratosis in primary and secondary care: a complementary database analysis

Noels¹,

Hollestein²,

Egmond

et al. 2019

Br J Dermatol

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Summary Background The high prevalence of actinic keratosis (AK) requires the optimal use of healthcare resources. Objectives To gain insight in to the healthcare utilization of people with AK in a population‐based cohort, and the management of AK in a primary and secondary care setting. Methods A retrospective cohort study using three complementary data sources was conducted to describe the use of care, diagnosis, treatment and follow‐up of patients with AK in the Netherlands. Data sources consisted of a population‐based cohort study (Rotterdam Study), routine general practitioner (GP) records (Integrated Primary Care Information) and nationwide claims data (DRG Information System). Results In the population‐based cohort (Rotterdam Study), 69% (918 of 1322) of participants diagnosed with AK during a skin‐screening visit had no previous AK‐related visit in their GP record. This proportion was 50% for participants with extensive AK (i.e. ≥ 10 AKs; n = 270). Cryotherapy was the most used AK treatment by both GPs (78%) and dermatologists (41–56%). Topical agents were the second most used treatment by dermatologists (13–21%) but were rarely applied in primary care (2%). During the first AK‐related GP visit, 31% (171 of 554) were referred to a dermatologist, and the likelihood of being referred was comparable between low‐ and high‐risk patients, which is inconsistent with the Dutch general practitioner guidelines for ‘suspicious skin lesions’ from 2017. Annually, 40 000 new claims representing 13% of all dermatology claims were labelled as cutaneous premalignancy. Extensive follow‐up rates (56%) in secondary care were registered, while only 18% received a claim for a subsequent cutaneous malignancy in 5 years. Conclusions AK management seems to diverge from guidelines in both primary and secondary care. Underutilization of field treatments, inappropriate treatments and high referral rates without proper risk stratification in primary care, combined with extensive follow‐up in secondary care result in the inefficient use of healthcare resources and overburdening in secondary care. Efforts directed to better risk differentiation and guideline adherence may prove useful in increasing the efficiency in AK management. What's already known about this topic? The prevalence of actinic keratosis (AK) is high and, in particular, multiple AKs are a strong skin cancer predictor. The high prevalence of AK requires optimal use of healthcare resources. Nevertheless, (population based) AK healthcare utilization and management data are very rare. What does this study add? Although AK‐related care already consumes substantial resources, about 70% of the AK population has never received care. Primary care AK management demonstrated underutilization of topical therapies and high referral rates without proper risk stratification, while in secondary care the extensive follow‐up schedules were applied. This inefficient use of healthcare resources highlights the need for better harmonization and risk stratification to increase the ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Healthcare utilization and management of actinic keratosis in primary and secondary care: a complementary database analysis

Noels¹,

Hollestein²,

Egmond

et al. 2019

Br J Dermatol

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“…Regardless of the method of assessment, almost all studies reported high satisfaction and increased knowledge after intervention. Student self-assessment typically revealed positive attitudes toward online lectures as a teaching modality [7,8,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Moreover, students showed increased knowledge in the subject material at hand, as evaluated by pre-and post-lecture knowledge assessment [11,[13][14][15]17,19,21,22,24,25,27,[29][30][31][32].…”

Section: Assessment Of Learning Outcomesmentioning

confidence: 99%

Online Lectures in Undergraduate Medical Education: Scoping Review (Preprint)

Tang¹,

Coret²,

Qureshi³

et al. 2017

Preprint

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Background: The adoption of the flipped classroom in undergraduate medical education (UME) calls on students to learn from various self-paced tools -including online lectures -before attending in-class sessions. Hence, the design of online lectures merits special attention, given that applying multimedia design principles has been shown to enhance learning outcomes. Objective: To understand how online lectures have been integrated into medical school curricula, and whether published literature employs well-accepted principles of multimedia design. Methods: This scoping review followed the methodology outlined by Arksey and O'Malley (2005). MEDLINE, PsycINFO, Education Source, Francis, and ProQuest were searched to find articles from 2006 to 2016 related to online lecture use in UME. Results: 45 articles met inclusion criteria. Online lectures are used in preclinical and clinical years, covering basic sciences, clinical medicine, and clinical skills. The use of multimedia design principles is seldom reported. Almost all studies describe high student satisfaction and improvement on knowledge tests following online lecture use. Conclusions: Integration of online lectures into UME is well-received by students and appears to improve learning outcomes. Future studies should apply established multimedia design principles to the development of online lectures to maximize their educational potential.

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“…Online learning modules are an effective, preferred method of learning for providers of all educational levels . The American Academy of Dermatology has developed 18 online learning modules focused on core competency and needs assessments of primary care physicians . These modules have been effective in increasing knowledge; however, the impact upon clinical practice has not been studied.…”

Section: Introductionmentioning

confidence: 99%

Impact of standardized templates and skin cancer learning modules for teledermatology consultations

et al. 2019

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Background Little research has been done in teledermatology to examine the effects of standardized templates and subject‐specific learning modules. Methods We performed a prospective study examining the effects of standardized templates and standardized cutaneous oncology learning modules on teledermatology referrals at Mayo Clinic. This data was then compared to previous teledermatology referrals before standardized templates were adopted. Results A total of 42 teledermatology consultations were performed during the 4‐month study period. The use of standardized templates resulted in an absolute reduction in face‐to‐face referrals. Teledermatology consultation increased the absolute diagnostic and management concordance by 26.2% (P = 0.02) and 33.3% (P < 0.01), respectively, and decreased the absolute diagnostic and management discordance by 19.1% (P = 0.03) and 31.0% (P < 0.01), respectively. The largest knowledge gaps were identified in cutaneous oncology. Educational intervention improved theoretical referral rates and confidence in diagnosis and management overall. Conclusion The implementation of standardized intake templates reduces the rate of face‐to‐face referrals. Teledermatology improves primary care‐based dermatological care and reduces theoretical referral rates.

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Online learning in a dermatology clerkship: Piloting the new American Academy of Dermatology Medical Student Core Curriculum

Cited by 52 publications

References 8 publications

Healthcare utilization and management of actinic keratosis in primary and secondary care: a complementary database analysis

Healthcare utilization and management of actinic keratosis in primary and secondary care: a complementary database analysis

Online Lectures in Undergraduate Medical Education: Scoping Review (Preprint)

Impact of standardized templates and skin cancer learning modules for teledermatology consultations

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