Perceptual learning modules in undergraduate dermatology teaching

Abstract

Background. Dermatological diagnosis depends highly on visual skills, and implicit nonanalytical proficiency plays a key role. To correctly diagnose skin diseases, the clinician needs visual skills, and intuitive recognition plays a key role. Aim. To investigate the effectiveness of digital perceptual learning modules (PLMs) in undergraduate teaching, and how these affect medical students' learning about skin diseases. Methods. This was a study performed in Finland, which enrolled 39 students of an undergraduate dermatology course. Online PLMs designed for dermatology, using different pictures of skin diseases were performed three times: before, during and at the end of the course. The modules provided four outcome measures: diagnostic accuracy (percentage of correct responses), a rating of confidence about the decision, fluency (response/decision time) and a list of features on which the decision was based.Results. As the number of PLMs and the course duration increased, there were also improvements in the four measures, with a significant increase in diagnostic accuracy [from 66% to 94%; P < 0.001; partial g 2 (g 2 p ) = 0.92], fluency (as measured by a decrease in response time (from 10 to 6 s; P < 0 0.001; g 2 p = 0.69) and self-perceived confidence (2.5 to 4.3; P < 0 0.001, g 2 p = 0.86) with subsequent PLMs and course duration. There was a diversification of recognized features, an increase in pattern recognition, and better attention to localization and contextual association. Based on student feedback, the PLMs functioned well online, and enhanced motivation and learning. Conclusion. PLMs increased diagnostic accuracy, had a positive effect on learning outcomes and were easily integrated alongside clinical teaching. Considering the current era of digital technologies, we believe that there is potential for wider use of PLMs to improve visual skills and strengthen implicit learning in dermatology.

Perceptual learning in dermatology—A Finnish cohort study of undergraduate medical students

“…1,48,49 Roads et al 50 observed no differences in easy-to-hard and hard-to-easy image recognition of melanoma. We did not predict prior difficulty, but because of high baseline accuracy in our former study, 26 we decided to increase task difficulty by adding images to the first display of the PLMs (from four to eight) and shortening response time (from 15 to 10 s). Based on accuracy the student recognized the easiest quartile of diagnoses in initial tests and the second and third quartile during the course duration.…”

“…52,53 We used a 10 s response time (images disappeared after 10s, but participants had 30s time to respond), which was shorter than in our previous study on PLMs. 26 Champagne et al 54 examined PLMs on postgraduate training of echocardiography with short-time improvements, but no sustainment of learning effects. In our posttests on learning retention 6-12 months subsequent to the initial PLMs, we could show lasting effects regarding performance and confidence which were similar to the initial three paired PLMs.…”

“…Perceptual learning modules were designed for online teaching and access was limited to university students (JavaScript and jsPsych, 27 run on Jatos‐server 28 ). Details on the structure and function of PLMs, a PLM example with patient images (demo version) and instructions on building own PLMs are included in Data S1 and have been described formerly 26 . The PLMs contained clinical pictures selected by an experienced dermatologist from the teaching pictures of the university.…”

“…Details on the structure and function of PLMs, a PLM example with patient images (demo version) and instructions on building own PLMs are included in Data S1 and have been described formerly. 26 The PLMs contained clinical pictures selected by an experienced dermatologist from the teaching pictures of the university. They contained typical clinical entities that had been confirmed with appropriate laboratory, histological and additional tests, where there had been a clinical indication.…”

“…25,26 Recently, we conducted a pilot study on digital PLMs in undergraduate dermatology and observed significant improvements in learning outcomes. 26 Methods of perceptual learning may thus have substantial potential in teaching dermatology. In this study, our aim was to investigate modified PLMs and widen our understanding of visual perceptual learning (PL) in dermatology.…”