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皮肤镜学习之莲:基层医疗多模式皮肤镜课程的实施与推广

Dermoscopic Lotus of Learning: Implementation and Dissemination of a Multimodal Dermoscopy Curriculum for Primary Care.

作者信息

Seiverling Elizabeth, Ahrns Hadjh, Stevens Kathryn, Ayers Lindsay, Nussinow Tyler, Dorr Gregory, Cyr Peggy

机构信息

Maine Medical Center, Portland, ME, USA.

Maine Medical Partners Primary Care, Westbrook, ME, USA.

出版信息

J Med Educ Curric Dev. 2021 Feb 1;8:2382120521989983. doi: 10.1177/2382120521989983. eCollection 2021 Jan-Dec.

Abstract

Dermoscopy is a cost-effective tool for detection of skin cancers yet there is limited training available for primary care. The goal of this project was to develop, implement, and disseminate a multimodal curriculum for primary care across a health system based on a previously validated algorithm (Triage Amalgamated Dermoscopic Algorithm; TADA). This cross-sectional study analyzes the dermoscopy workshop intervention of a dermoscopy multimodal curriculum. Volunteers attended one 120-minute dermoscopy workshop on benign and malignant growths using a validated algorithm. Participants took a 30-image pre- and posttest. Survey questions on dermoscopy use, preferences for learning, and skin biopsy performance were included to enhance curriculum development. About 96 participants completed both pre- and postintervention tests. The mean preintervention score (out of 30) was 18.6 and increased to 24.4 on the postintervention evaluation. There was a statistically significant improvement in scores for both benign and malignant skin growths after the intervention ( < .05). Short dermoscopy workshops have a positive intervention effect when training primary care providers to identify images of benign and malignant dermoscopic skin lesions. A multimodal dermoscopy curriculum allows learners to build on initial training using spaced review and blended learning strategies. The "Dermoscopic Lotus of Learning" has the potential to be a model for other primary care residency programs. A healthy partnership between dermatologists and primary care is essential.

摘要

皮肤镜检查是一种检测皮肤癌的经济高效工具,但初级保健方面的培训有限。本项目的目标是基于先前验证的算法(分诊综合皮肤镜算法;TADA),在一个卫生系统中开发、实施并推广针对初级保健的多模式课程。这项横断面研究分析了皮肤镜多模式课程中的皮肤镜检查工作坊干预措施。志愿者参加了一次120分钟的使用经过验证算法的关于良性和恶性皮肤病变的皮肤镜检查工作坊。参与者进行了一次30张图片的前后测试。还纳入了关于皮肤镜检查使用、学习偏好和皮肤活检操作的调查问卷,以促进课程开发。约96名参与者完成了干预前后的测试。干预前的平均得分(满分30分)为18.6分,干预后的评估中提高到了24.4分。干预后良性和恶性皮肤病变的得分均有统计学上的显著提高(<0.05)。简短的皮肤镜检查工作坊在培训初级保健提供者识别良性和恶性皮肤镜下皮肤病变图像时具有积极的干预效果。多模式皮肤镜课程允许学习者利用间隔复习和混合学习策略在初始培训的基础上进一步学习。“皮肤镜学习莲花模式”有潜力成为其他初级保健住院医师培训项目的典范。皮肤科医生和初级保健之间建立健康的合作关系至关重要。

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