Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10022, USA.
J Am Acad Dermatol. 2012 Oct;67(4):606-11. doi: 10.1016/j.jaad.2011.12.007. Epub 2012 Jan 24.
Non-dermatologist physicians are well positioned for opportunistic melanoma detection; however, education in the skin cancer examination is limited during medical school and traditionally lecture-based. Simulating melanoma cases provides a means to demonstrate whether proficiency in knowledge and recognition of melanoma images translates into improved clinical skill.
To evaluate medical student recognition and appropriate response to a prosthetic melanoma placed on a standardized patient (SP) during a simulated clinical encounter.
In this pilot study, prosthetic mimics of melanoma were placed on the backs of SPs unbeknownst to a convenience sample of 59 second-year medical students. The study took place during clinical skills practice sessions with SPs conducted from February to April 2010 at Mount Sinai School of Medicine (New York, NY). SPs presented with non-dermatologic chief complaints typical for an acute office visit. All students had the opportunity to attend a lecture on the clinical signs of melanoma 2 to 4 months earlier, for which pre-test and post-test data were collected.
Recognition and evaluation of a prosthetic melanoma as determined by querying the SPs and reviewing the students' examination notes. During the SP encounter, 37 students (63%) asked about the melanoma moulage; of those, 25 (68%) made recommendations for further evaluation. The moulage was documented in 17 examination notes (43%). Thirty-three students (56%) asked about the skin on review of systems, although this did not predict moulage detection.
Prosthetic mimics of melanoma are useful tools for assessing skin cancer awareness and detection skills among medical students.
非皮肤科医生在机会性黑色素瘤检测方面具有优势；然而，在医学院期间，皮肤癌检查的教育是有限的，传统上以讲座为基础。模拟黑色素瘤病例提供了一种方法，可以证明在黑色素瘤知识和识别方面的熟练程度是否转化为临床技能的提高。
评估医学生在模拟临床就诊中对放置在标准化患者（SP）上的假体黑色素瘤的识别和适当反应。
在这项初步研究中，假体黑色素瘤模拟物被放置在 SP 的背部，而 59 名二年级医学生是随机抽取的，对他们来说是未知的。该研究在 2010 年 2 月至 4 月期间在西奈山医学院（纽约，NY）进行的 SP 临床技能实践课程中进行。SP 出现了非皮肤科的主要投诉，这些投诉是典型的急性门诊就诊。所有学生都有机会参加 2 到 4 个月前关于黑色素瘤临床体征的讲座，为此收集了预测试和后测试数据。
通过询问 SP 和审查学生的检查记录来确定对假体黑色素瘤的识别和评估。在 SP 就诊期间，有 37 名学生（63%）询问了黑色素瘤模塑；其中 25 名（68%）建议进一步评估。在 17 份检查记录（43%）中记录了模塑。在回顾系统皮肤时，有 33 名学生（56%）询问了皮肤，但这并不能预测模塑检测。
假体黑色素瘤模拟物是评估医学生皮肤癌意识和检测技能的有用工具。
