Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.
University of Florida College of Medicine, Gainesville, Florida, USA.
Clin Dermatol. 2022 Nov-Dec;40(6):782-787. doi: 10.1016/j.clindermatol.2022.08.003. Epub 2022 Aug 7.
Lack of standardized dermatoscopy training limits confidence and accuracy. We assessed the effect of a dermatoscopy lecture series on the diagnostic accuracy of dermatology residents' biopsies. Additionally, we evaluated resident comfort with and knowledge of dermatoscopy before and after the curriculum. Twelve dermatology residents were enrolled in a 5-month dedicated dermatoscopy curriculum. To assess knowledge of and comfort with dermatoscopy, residents were given a 50-question assessment and 21-question survey before and after the curriculum. Change in diagnostic accuracy was assessed by comparing the suspected clinical diagnosis to the final histopathologic diagnosis of lesions biopsied by residents before and after the course. Upon completion of the curriculum, residents felt significantly more comfortable performing dermatoscopy (P = .002) and using dermatoscopy to identify melanocytic nevi (P = .037) and melanomas (invasive and in situ) (P = .012). Postgraduate year 2 residents also showed significantly improved diagnostic accuracy after the training course (odds ratio, 1.33; 95% confidence interval, 1.06-1.67; P = .013). Our study was limited by a small sample size of 12 residents from a single academic institution. A formal dermatoscopy course can effectively improve dermatology residents' knowledge, confidence, and diagnostic accuracy when using dermatoscopy.
缺乏标准化的皮肤镜检查培训限制了信心和准确性。我们评估了皮肤镜讲座系列对皮肤科住院医师活检诊断准确性的影响。此外,我们还在课程前后评估了住院医师对皮肤镜的舒适度和了解程度。12 名皮肤科住院医师参加了为期 5 个月的专门皮肤镜课程。为了评估对皮肤镜的了解程度和舒适度,住院医师在课程前后接受了 50 题的评估和 21 题的调查。通过比较居民活检的病变的可疑临床诊断和最终组织病理学诊断,评估诊断准确性的变化。在完成课程后,住院医师在进行皮肤镜检查时明显感到更舒适(P=0.002),并且使用皮肤镜检查来识别黑素细胞痣(P=0.037)和黑色素瘤(侵袭性和原位)(P=0.012)的能力也有所提高。在接受培训课程后,第二年住院医师的诊断准确性也有显著提高(优势比,1.33;95%置信区间,1.06-1.67;P=0.013)。我们的研究受到来自单一学术机构的 12 名住院医师的小样本量的限制。正式的皮肤镜课程可以有效提高皮肤科住院医师在使用皮肤镜时的知识、信心和诊断准确性。