Academic Primary Care Research Group, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, AB25 2ZD, Aberdeen, Scotland.
BMC Med Educ. 2024 Aug 5;24(1):839. doi: 10.1186/s12909-024-05840-1.
Melanoma is the 5th commonest cancer in the UK and survivors require frequent and thorough skin checks. During the Achieving Self-directed Integrated Cancer Aftercare (ASICA) trial, melanoma survivors used an app to submit images of concerning lesions for assessment by a dermatology nurse. In the past, online courses have been used to train non-specialist primary care practitioners (PCPs) in this skill.
This study aimed to determine whether an online course could increase knowledge, confidence, and attitudes towards skin image triage in PCPs in the Grampian area.
Preliminary discussions were held with PCPs to determine the need for an online course. The course was designed at the University of Aberdeen and included an introduction to the skin, case studies and quizzes on a variety of skin conditions based on melanoma survivors' submissions via the ASICA app. Two pre- and post-course questionnaires were administered to all participants to (1) assess knowledge gained and (2) assess any improvements in confidence and attitudes towards triaging skin lesions that could be indicative of skin cancer. All PCPs in the Grampian area were invited to participate with almost 70 medical practices contacted. Results were analysed using a paired sample T-test.
The course was advertised to all GP practices in the Grampian area and 38 PCPs completed all its stages. Undertaking the course improved all PCPs' confidence and attitudes towards triaging (p < 0.001). It also improved knowledge in all non-GP PCPs (p = 0.01). Most participants found the course useful; thought it was at the right level of difficulty, right format and thought the design was good.
Our online course in triaging skin lesions submitted digitally to PCPs was able to improve knowledge, confidence, and attitudes towards triaging. The course was acceptable in its design and was deemed useful and applicable to practice. Further research should investigate the effect the course has on secondary care referral numbers.
黑色素瘤是英国第五大常见癌症，幸存者需要频繁且彻底的皮肤检查。在 Achieving Self-directed Integrated Cancer Aftercare（ASICA）试验中，黑色素瘤幸存者使用一款应用程序提交可疑病变的图像，由皮肤科护士进行评估。过去，曾使用在线课程培训非专科初级保健医生（PCP）掌握这一技能。
本研究旨在确定在线课程是否能够提高格兰扁地区 PCP 对皮肤图像分诊的知识、信心和态度。
与 PCP 进行初步讨论，确定是否需要开设在线课程。该课程由阿伯丁大学设计，包括皮肤简介、基于 ASICA 应用程序中黑色素瘤幸存者提交的病例研究和各种皮肤状况的测验。所有参与者都在课前和课后完成了两份问卷，（1）评估所学知识，（2）评估对分诊皮肤病变的信心和态度的任何改善，这可能表明存在皮肤癌。邀请格兰扁地区的所有 PCP 参加，联系了近 70 个医疗实践。使用配对样本 T 检验分析结果。
该课程向格兰扁地区的所有全科医生诊所做了宣传，有 38 名 PCP 完成了所有课程。完成该课程后，所有 PCP 的信心和对分诊的态度都有所提高（p<0.001）。非全科医生 PCP 的知识也有所提高（p=0.01）。大多数参与者认为该课程有用；认为难度适中、格式正确、设计良好。
我们对 PCP 分诊的数字提交的皮肤病变的在线课程能够提高知识、信心和态度。该课程在设计上是可以接受的，被认为是有用的和适用于实践的。进一步的研究应该调查该课程对二级保健转诊数量的影响。
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