Teaching Dermatology to Canadian Undergraduate Medical Students

Kirshen, Carly; Shoimer, Ilya; Wismer, Judy; DesGroseilliers, Jean-Pierre; Lui, Harvey

doi:10.2310/7750.2011.10021

Cited by 21 publications

(28 citation statements)

References 15 publications

(22 reference statements)

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“…The recently introduced GP guidelines recommend cryotherapy for five or fewer AKs, which is comparable with international guidelines . The limited treatment modalities used by GPs may be a reflection of limited familiarity of GPs with different treatment modalities for AK, possibly because of the undersupply of dermatology training in both GP specialist training and continuing medical education programmes in many countries . Effective and successful implementation of the primary care guidelines has the potential to fill this educational gap in the short term, and may result in the decreased use of nonindicated treatments (such as antibiotics) and structuring the use of suitable treatments by GPs.…”

Section: Discussionmentioning

confidence: 91%

“…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%

“…2,19,[28][29][30] The limited treatment modalities used by GPs may be a reflection of limited familiarity of GPs with different treatment modalities for AK, possibly because of the undersupply of dermatology training in both GP specialist training and continuing medical education programmes in many countries. [31][32][33][34][35][36][37][38][39][40] Effective and successful implementation of the primary care guidelines has the potential to fill this educational gap in the short term, and may result in the decreased use of nonindicated treatments (such as antibiotics) and structuring the use of suitable treatments by GPs. However, without proper dermatology training for GPs, clinical guidelines are not sufficient to improve patient care.…”

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: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Various methods of teaching dermatology have been tried around the world. 2,3,4,5 Skin diseases are usually taught in specialist clinics in many countries. ese cases tend to be quite di erent from that in primary care.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Hybrid Undergraduate Dermatology Training workshop during Family Medicine clerkship

Mitesh¹

2019

SFP

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IntroductionDermatological conditions constitute 5 percent of primary care consultations. Effective undergraduate medical training in skin diseases inducts students to this important field of general practice. Aim:This study determined the acceptability and perceived effectiveness of the Hybrid Model of dermatology training during Family Medicine (FM) clerkship in a Singapore primary care institution. Method: This is a retrospective study based on the feedback responses of NUS third year medical undergraduates after attending a Hybrid dermatology workshop conducted during their FM clerkship. The 4-hour HybridModel covered description of cutaneous morphologies, photo illustrations of common diseases by the faculty, student presentations and a slide quiz. This new teaching model was conducted by a unique faculty. The students gauged the acceptability (how well it was received) and perceived effectiveness using Likert-scale scores in de-identified questionnaires. Results:The feedback responses from 994 medical students from 2010 to 2016 were analysed. Comprising of multi-ethnic Asian groups, slightly over half of them were females. The response rates ranged from 84 percent to 98 percent. Students' ratings on its usefulness had risen from 85.8 percent in 2010 to 94.0 percent in 2016. Conclusion:The Hybrid dermatological training model was well accepted and has been integrated into the clerkship program since 2013. SFP2018; 44(1): 39-45

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Contenidos fundamentales de la Dermatología en el grado de medicina en España. Recomendaciones del grupo de profesores de la Academia Española de Dermatología y Venereología

Casanova

Pujol

Ferrándiz

et al. 2016

Actas Dermo-Sifiliográficas

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Teaching Dermatology to Canadian Undergraduate Medical Students

Cited by 21 publications

References 15 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

Evaluation of a Hybrid Undergraduate Dermatology Training workshop during Family Medicine clerkship

Contenidos fundamentales de la Dermatología en el grado de medicina en España. Recomendaciones del grupo de profesores de la Academia Española de Dermatología y Venereología

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