Effect of dermoscopy education on the ability of medical students to detect skin cancer

Abstract

Objectives: 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 intention to perform SCE on patients (P = .55). Overall, cohort 2 exhibited improvement (P < .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 (P < .001) in the diagnosis of the superficial spreading melanoma, cohort 2 improved in the diagnosis of the basal cell carcinoma (P < .001) and cohort 1 displayed deterioration in identifying the malignant nature of this lesion (P < .001). For the nodular melanoma, correct diagnosis decreased significantly in cohort 1 (P < .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.