Fourth-Year Medical Student, Northwestern University Feinberg School of Medicine.
Resident Physician, Department of Dermatology, Northwestern University Feinberg School of Medicine.
MedEdPORTAL. 2020 Dec 29;16:11049. doi: 10.15766/mep_2374-8265.11049.
While the incidence of skin cancers continues to rise, there remains a disproportionate lack of introductory training on skin cancer screening and identification of modifiable behaviors in medical curricula. Trainees and students have cited low confidence in their ability to counsel patients and lack of instruction as barriers.
To address this need, we created a 1-hour didactic lecture based on a cognitive teaching framework for third-year medical students during their core primary care clerkship. The session highlighted visual identification of different skin cancers, factors increasing individual risk, and photoprotective behaviors. Session content was based on American Academy of Dermatology recommendations for skin cancer prevention. An assessment of knowledge, behaviors, and attitudes given before, immediately following, and at 6 months after the session was used to determine efficacy.
One hundred eight students before and immediately after the session demonstrated significantly improved knowledge (mean correct: 71% presession vs. 99% postintervention, < .0001). Based on 39 participants completing 6-month follow-up, knowledge remained improved (mean answered correctly: 80%, < .0001). Confidence in patient counseling on preventive behaviors, risk assessment, and reported likelihood of counseling significantly increased across the three time points ( < .0001 for all attitude questions). Specific topics included appropriate referral to a dermatologist, sunscreen application, and dangers of indoor tanning bed usage.
Our session on skin cancer screening and prevention demonstrated improvements in medical student knowledge, confidence, and patient counseling likelihood. This introductory curriculum could be adapted for multiple core clerkships or specialties.
尽管皮肤癌的发病率持续上升，但医学课程中仍然缺乏关于皮肤癌筛查和可改变行为识别的入门培训，这一情况极不均衡。受训者和学生表示，他们对自己为患者提供咨询的能力缺乏信心，并且缺乏指导，这是他们面临的障碍。
为了解决这一需求，我们为三年级医学生在核心初级保健实习期间创建了一个基于认知教学框架的 1 小时讲座。该课程强调了不同皮肤癌的视觉识别、增加个体风险的因素和防晒行为。课程内容基于美国皮肤病学会关于皮肤癌预防的建议。在课程之前、之后立即以及之后 6 个月进行的知识、行为和态度评估用于确定效果。
在课程之前和之后，共有 108 名学生参加了测试，他们的知识显著提高（平均正确回答：课前 71%，课后 99%，<0.0001）。根据 39 名完成 6 个月随访的参与者的数据，知识仍然有所提高（平均正确回答：80%，<0.0001）。在三个时间点，对患者进行预防行为、风险评估和咨询的信心都显著提高（所有态度问题均<0.0001）。具体内容包括向皮肤科医生的适当转诊、防晒霜的使用以及室内晒黑床使用的危险。
我们的皮肤癌筛查和预防课程提高了医学生的知识、信心和患者咨询的可能性。这个入门课程可以适应多个核心实习或专业。
