Diehl Kyra, Stoos Elizabeth, Becker Alyssa, Orfaly Victoria E, Nelson Jacob, Gillespie Jordan, Ng Justin, Tobey Tayler, Latour Emile, Ludzik Joanna, Berry Elizabeth G, Geller Alan C, Jacobe Heidi, Leitenberger Justin, McClanahan Danielle, Tran Jessica, Prasad Smriti, Mengden-Koon Stephanie, Nelson Kelly C, Petering Ryan, Verdieck Alex, Savory Stephanie, Smith Emily H, Tofte Susan, Weinstock Martin A, White Kevin, Wisco Oliver, Curiel-Lewandrowski Clara, Swetter Susan M, Witkowski Alexander M, Ferris Laura, Black Samantha, Xu Rebecca, Xu Shuai, Leachman Sancy
Department of Dermatology, Oregon Health & Science University, Portland, OR, United States.
School of Medicine, Oregon Health & Science University, Portland, OR, United States.
Front Med (Lausanne). 2024 Dec 18;11:1500216. doi: 10.3389/fmed.2024.1500216. eCollection 2024.
Primary care providers or clinicians (PCPs) have the potential to assist dermatologists in screening patients at risk for skin cancer, but require training to appropriately identify higher-risk patients, perform skin checks, recognize and biopsy concerning lesions, interpret pathology results, document the exam, and bill for the service. Very few validated dermatology training programs exist for PCPs and those that are available focus primarily on one emphasis area, which results in variable efficacy and single-topic limited scope.
We have created a free, online, continuing education program (Melanoma Toolkit for Early Detection, MTED) that allows learners to choose from a variety of multimedia tools (image recognition, videos, written material, in-person seminars, self-tests, etc.) that suits their learning style and time availability. Here we present the toolkit, the development and validation of the curriculum, and report on 1-year outcomes of a nested survey study. Because the goal of the program is to maximize participation by allowing PCPs to tailor their experience to their own needs and interests, the majority of participants did not complete every element of the program.
A total of 8,683 PCPs have accessed at least one element of the toolkit from 2019-2024. Participants completed a pre-survey, online training module, and post-survey that included self-reported screening behaviors, changes in confidence, and malignant and benign lesion categorization based on clinical images. A total of 139 pre-surveys and 92 post-surveys were completed, including 55 matched participants that completed both the pre- and post-training surveys. There were significant improvements in PCP confidence ( < 0.001) and malignant ( < 0.001) and benign image ( = 0.029) identification respectively.
PCPs may serve as a valuable aid in skin cancer screening efforts, but additional studies are needed to evaluate the impact of these curricula in clinical practice.
初级保健提供者或临床医生有潜力协助皮肤科医生筛查皮肤癌高危患者,但需要接受培训,以便正确识别高危患者、进行皮肤检查、识别并对可疑病变进行活检、解读病理结果、记录检查情况以及为该服务计费。针对初级保健提供者的经过验证的皮肤科培训项目非常少,现有的项目主要侧重于一个重点领域,这导致效果参差不齐且范围局限于单一主题。
我们创建了一个免费的在线继续教育项目(早期检测黑色素瘤工具包,MTED),该项目允许学习者从各种多媒体工具(图像识别、视频、书面材料、现场研讨会、自我测试等)中进行选择,这些工具适合他们的学习风格和时间安排。在此,我们展示该工具包、课程的开发与验证,并报告一项嵌套式调查研究的一年期结果。由于该项目的目标是通过允许初级保健提供者根据自身需求和兴趣量身定制学习体验来最大限度地提高参与度,所以大多数参与者并未完成该项目的每个部分。
从2019年到2024年,共有8683名初级保健提供者访问了该工具包的至少一个部分。参与者完成了一项预调查、在线培训模块以及一项后调查,后调查包括自我报告的筛查行为、信心变化以及基于临床图像对恶性和良性病变的分类。总共完成了139份预调查和92份后调查,其中包括55名完成了培训前后两项调查的匹配参与者。初级保健提供者的信心(<0.001)以及对恶性(<0.001)和良性图像(=0.029)的识别能力均有显著提高。
初级保健提供者在皮肤癌筛查工作中可能是一项宝贵的助力,但还需要更多研究来评估这些课程在临床实践中的影响。