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一项支持初级保健提供者进行皮肤癌检查的试点教育干预措施。

A Pilot Educational Intervention to Support Primary Care Provider Performance of Skin Cancer Examinations.

作者信息

Nelson Kelly C, Seiverling Elizabeth V, Gonna Nadeen, Berry Elizabeth, Stoos Elizabeth, Dorsey Chloe N, Sepulveda Sarah, Vazquez Gerardo, Doan Hung Q, Haydu Lauren E

机构信息

Department of Dermatology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1452, Houston, TX, 77030, USA.

Division of Dermatology, Maine Medical Center, Portland, ME and Tufts University School of Medicine, Boston, MA, USA.

出版信息

J Cancer Educ. 2023 Feb;38(1):364-369. doi: 10.1007/s13187-021-02126-8. Epub 2022 Jan 10.

Abstract

Educational interventions to support Primary Care Provider (PCP) performance of skin cancer examinations typically train PCPs to "triage and refer," an approach that may result in diagnostic delays in regions without appropriate access to dermatology care. To address the needs of PCPs and patients in regions without appropriate access to dermatology care, we developed a multi-faceted pilot intervention, including a curriculum and telementoring, designed to support PCP performance of skin cancer detection examinations. Our intervention offers two levels of proficiency: "triage and refer" and "diagnose and manage." The pilot intervention was conducted in collaboration with the Texas Tech University of Health Sciences Center El Paso, TX Family and Community Medicine Department (TTUHSC-El Paso). Participation in the intervention was voluntary, and 18-22 family medicine resident physicians completed the intervention tests. The participating family medicine resident physicians demonstrated statistically significant gains in knowledge and self-efficacy at the immediate post-intervention time points. Further adaption of the pilot intervention is needed to meet the needs of practicing PCPs. The pilot tests require further adaption and validation. Translating education delivery from live/synchronous to interactive virtual/asynchronous modules will support greater educational dissemination, and telementoring support is essential to address challenging cases encountered during patient care.

摘要

支持初级保健提供者(PCP)进行皮肤癌检查的教育干预措施通常会培训PCP进行“分诊和转诊”,这种方法可能会导致在无法获得适当皮肤科护理的地区出现诊断延迟。为了满足在无法获得适当皮肤科护理地区的PCP和患者的需求,我们开发了一种多方面的试点干预措施,包括一门课程和远程指导,旨在支持PCP进行皮肤癌检测检查。我们的干预措施提供两种熟练水平:“分诊和转诊”以及“诊断和管理”。该试点干预措施是与德克萨斯理工大学健康科学中心埃尔帕索分校、德克萨斯州家庭与社区医学系(TTUHSC - 埃尔帕索)合作开展的。参与干预是自愿的,18 - 22名家庭医学住院医师完成了干预测试。参与的家庭医学住院医师在干预后即刻的时间点在知识和自我效能方面有统计学上的显著提高。需要对试点干预措施进行进一步调整以满足执业PCP的需求。试点测试需要进一步调整和验证。将教育交付从现场/同步转变为交互式虚拟/异步模块将有助于扩大教育传播,并且远程指导支持对于解决患者护理过程中遇到的具有挑战性的病例至关重要。

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