The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York.
Department of Dermatology and Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon.
JAMA Dermatol. 2021 Feb 1;157(2):189-197. doi: 10.1001/jamadermatol.2020.5213.
Dermoscopy education in US dermatology residency programs varies widely, and there is currently no existing expert consensus identifying what is most important for resident physicians to know.
To identify consensus-based learning constructs representing an appropriate foundational proficiency in dermoscopic image interpretation for dermatology resident physicians, including dermoscopic diagnoses, associated features, and representative teaching images. Defining these foundational proficiency learning constructs will facilitate further skill development in dermoscopic image interpretation to help residents achieve clinical proficiency.
DESIGN, SETTING, AND PARTICIPANTS: A 2-phase modified Delphi surveying technique was used to identify resident learning constructs in 3 sequential sets of surveys-diagnoses, features, and images. Expert panelists were recruited through an email distributed to the 32 members of the Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group. Twenty-six (81%) opted to participate. Surveys were distributed using RedCAP software.
Consensus on diagnoses, associated dermoscopic features, and representative teaching images reflective of a foundational proficiency in dermoscopic image interpretation for US dermatology resident physicians.
Twenty-six pigmented lesion and dermoscopy specialists completed 8 rounds of surveys, with 100% (26/26) response rate in all rounds. A final list of 32 diagnoses and 116 associated dermoscopic features was generated. Three hundred seventy-eight representative teaching images reached consensus with panelists.
Consensus achieved in this modified Delphi process identified common dermoscopic diagnoses, associated features, and representative teaching images reflective of a foundational proficiency in dermoscopic image interpretation for dermatology residency training. This list of validated objectives provides a consensus-based foundation of key learning points in dermoscopy to help resident physicians achieve clinical proficiency in dermoscopic image interpretation.
美国皮肤科住院医师培训计划中的皮肤镜教学差异很大，目前尚无现有专家共识确定住院医师最需要了解哪些内容。
确定基于共识的学习结构，代表皮肤科住院医师进行皮肤镜图像解释的适当基础能力，包括皮肤镜诊断、相关特征和代表性教学图像。定义这些基础能力学习结构将有助于进一步发展皮肤镜图像解释技能，帮助住院医师达到临床熟练程度。
设计、设置和参与者：使用 2 阶段改良 Delphi 调查技术，在 3 个连续的调查系列中确定住院医师的学习结构-诊断、特征和图像。通过向黑色素瘤预防工作组色素性病变小组委员会的 32 名成员发送电子邮件来招募专家小组成员。26 人（81%）选择参与。使用 RedCAP 软件分发调查。
对诊断、相关皮肤镜特征和代表美国皮肤科住院医师皮肤镜图像解释基础能力的教学图像达成共识。
26 名色素性病变和皮肤镜专家完成了 8 轮调查，所有轮次的回复率均为 100%（26/26）。最终生成了 32 个诊断和 116 个相关皮肤镜特征列表。与小组成员达成共识的 378 张代表性教学图像。
在这项改良 Delphi 过程中达成的共识确定了常见的皮肤镜诊断、相关特征和代表性教学图像，反映了皮肤科住院医师培训中皮肤镜图像解释的基础能力。这份经过验证的目标清单提供了皮肤镜中关键学习要点的基于共识的基础，有助于住院医师在皮肤镜图像解释方面达到临床熟练程度。
