Hayden T. Middleton, DMSc, PA-C, is an instructor of Family Medicine and Family Medicine Physician Assistant at Mayo Clinic Rochester, Rochester, Minnesota.
David L. Swanson, MD, is a professor of Dermatology and Dermatologist, Mayo Clinic Arizona, Phoenix, Arizona.
J Physician Assist Educ. 2024 Mar 1;35(1):9-13. doi: 10.1097/JPA.0000000000000538. Epub 2023 Sep 1.
Patients often first present to their primary care provider for skin lesion concerns, and dermoscopy is a tool that enhances diagnostic acumen of both malignant and benign skin lesions. Physician assistants (PAs) frequently serve as primary care and dermatology providers, but to our knowledge, no current research on dermoscopy expertise with PAs exists. We hypothesize that PA students could be taught dermoscopy based on the triage amalgamated dermoscopic algorithm (TADA) to increase their diagnostic skill, as previously shown with medical students.
Dermoscopy was taught to first-year PA students at all 5 PA programs in the state of Minnesota. The training was 50 minutes in length and focused on the fundamentals of the TADA method. Physician assistant students participated in a pretraining and post-training test, consisting of 30 dermoscopic images.
A total of 139/151 (92%) PA students completed both the pretraining and post-training tests. Overall, mean scores for all students increased significantly ( P < .0001) after dermoscopy training was given (18.5 ± 7.1 vs. 23.8 ± 6.7).
Our study demonstrates that after TADA training, PA students improved their ability to assess dermoscopy images of both skin cancer and benign lesions accurately, suggesting that PAs can be trained as novice dermoscopists and provide better dermatologic care to patients. We strongly encourage integration of dermoscopy into didactic education across PA programs. Implementing a dermoscopy curriculum in established PA programs will enable future PAs to provide better clinical care when evaluating skin lesions.
患者通常首先向其初级保健医生咨询皮肤病变问题，而皮肤镜检查是一种可提高对良恶性皮肤病变诊断能力的工具。医师助理（PA）通常担任初级保健和皮肤科医生，但据我们所知，目前尚无关于 PA 皮肤镜检查专业知识的研究。我们假设可以根据分诊合并皮肤镜检查算法（TADA）向 PA 学生教授皮肤镜检查，以提高他们的诊断技能，正如之前在医学生中所展示的那样。
在明尼苏达州的所有 5 个 PA 项目中向一年级 PA 学生教授皮肤镜检查。培训时长为 50 分钟，重点是 TADA 方法的基础知识。PA 学生参加了培训前和培训后的测试，包括 30 张皮肤镜图像。
共有 139/151（92%）名 PA 学生完成了培训前和培训后的测试。总体而言，所有学生的平均分数在接受皮肤镜检查培训后均显著提高（P<0.0001）（18.5±7.1 与 23.8±6.7）。
我们的研究表明，在接受 TADA 培训后，PA 学生提高了准确评估皮肤癌和良性病变皮肤镜图像的能力，这表明 PA 可以接受皮肤镜检查的初步培训，并为患者提供更好的皮肤科护理。我们强烈鼓励将皮肤镜检查纳入 PA 课程的教学教育中。在已建立的 PA 项目中实施皮肤镜检查课程将使未来的 PA 能够在评估皮肤病变时提供更好的临床护理。
