35126 Education to improve general medical doctors’ dermatology referrals

Abstract

General hospital doctors often find it challenging to correctly diagnose and appropriately refer common benign and malignant skin lesions. A series of dermatology images of melanoma, nonmelanoma malignancies, actinic keratosis and benign lesions was presented in a quiz format to general medical doctors in a model 3 hospital. Dermatology experience, confidence in lesion recognition and decision for dermatology referral was surveyed pre-teaching. A teaching session with follow-up quiz and self-assessed confidence of lesion recognition and diagnosis was surveyed. Comparison pre and post quiz scores were analyzed. Twenty-four medical doctors ranging from intern to consultant participated in this study. 96% (n = 23) had no prior dermatology experience. Following teaching, 61% (n = 14) expressed feeling confident in their diagnosis of presented images, compared with 17% (n = 4) preteaching. The follow-up quiz showed a global 24% increase in lesion recognition. Correct referral of actinic keratosis improved from 79% to 100%, acral melanoma improved from 75% to 90%, melanoma referral improved from 77% to 93% and BCC referral improved from 88% to 100%. 91% (n = 21) found the teaching session helpful for future practice. The teaching session improved the ability to correctly identify features of common benign, premalignant and malignant skin lesions. The follow-up quiz demonstrated improvement in appropriate referrals for premalignant and malignant lesions. Regular dermatology teaching with images and self-assessment quizzes should improve the confidence of general hospital doctors to correctly recognize and refer to dermatology services. This study demonstrates the need for dermatology teaching to general medical doctors to improve the accurate diagnosis and referral of common skin lesions.