Dermatology Course Research Articles

Blended learning: An innovative teaching strategy to teach dermatology to the family medicine residents of a teaching hospital.

Medical educators face different challenges in this digital era with the pressure for clinical practice as well as teaching. In blended learning Internet technologies are used along with face-to-face teaching to deliver learning methodologies. To assess the efficacy of the blended learning dermatology course on Family Medicine residents at a teaching hospital. Methodology: It was interventional (pre and post) study with purposive sampling. All the Family Medicine residents enrolled at The Aga Khan University Hospital participated in the study after giving consents. The course covered most common skin conditions. Multiple slide sessions, online lectures, clinical presentations, case-based scenarios, and quizzes were included in the course. Knowledge was assessed through pre- test by multiple choice questions. Post tests were taken after completion of the modules to assess the improvement in the knowledge of residents about basic dermatological conditions by multiple choice questions. After completion of sessions a survey questionnaire was administered to evaluate the perception of participants about blended learning strategy. The tests scores were significantly higher in the post test. The majority of the residents were satisfied with the course delivery. A statistically significant difference was found between pre and post test results with a P value 0.000. Blended learning is an effective and innovative teaching strategy that helped family medicine residents to enhance their learning more effectively. We recommend that this method of teaching strategy should be used in other clinical disciplines in different contexts.didifferent contexts.

Diagnostic errors during perceptual learning in dermatology: a prospective cohort study of Finnish undergraduate students.

Perceptual learning modules (PLMs) have been shown to significantly improve learning outcomes in teaching dermatology. To investigate the quantity and quality of diagnostic errors made during undergraduate PLMs and their potential implications. The study data were acquired from 8 successive dermatology courses (2021-23) from 142 undergraduate medical students. Digital PLMs were held before, during and after the courses. We investigated the number and distribution of diagnostic errors, differences between specific skin conditions and classified the errors based on type. Diagnostic errors were not randomly distributed. Some skin conditions were almost always correctly identified, whereas a significant number of errors were made for other diagnoses. Errors were classified into one of three groups: mostly systematic errors of relevant differential diagnoses ('similarity' errors); partly systematic errors ('mixed' errors); and 'random' errors. While a significant learning effect during the repeated measures was found in accuracy (P < 0.001, η²P = 0.64), confidence (P < 0.001, η²P = 0.60) and fluency (P < 0.001, η²P = 0.16), the three categories differed in all outcome measures (all P < 0.001, all η²P > 0.47). Visual learning was more difficult for diagnoses in the similarity category (all P < 0.001, all η²P > 0.12) than for those in the mixed and random categories. Error analysis of PLMs provided relevant information about learning efficacy and progression, and systematic errors in tasks and more difficult-to-learn conditions. This information could be used in the development of adaptive, individual error-based PLMs to improve learning outcomes, both in dermatology and medical education in general.

Challenges of fully online learning for dermatology education: a retrospective study.

Blended learning has proven to be an effective teaching strategy. During the COVID-19 pandemic in 2019, educational institutions worldwide switched to online learning. However, there is limited research on the effectiveness of blended learning and fully online learning. This study aims to evaluate and compare whether pure online learning is as effective as traditional blended learning by taking the example of dermatology education. The researchers compared traditional blended learning and fully online learning by evaluating the achievement scores of undergraduate students in a dermatology course in the academic years 2019 and 2020, respectively, at the Shandong First Medical University, China. In 2019, students undertook small private online courses (SPOCs) combined with face-to-face teacher-led learning. In 2020, live teacher-led learning replaced face-to-face teacher-led learning. The researchers also conducted a questionnaire survey in 2020. The scores of students in 2019 were significantly higher than in 2020 (p = 0.002). There was no significant difference in the distribution of achievement variance in the scores between the two academic years. In the questionnaire survey, the majority of the students rated highly the fully online education mode and responded that pure online learning enhanced their self-study ability. The present study shows that fully online learning currently does not perform as well as traditional blended learning in terms of examination scores due to some limitations. However, pure online education has several advantages over traditional blended education. Online courses should be improved to ignite students' interest and increase their learning efficiency.

Answering the call to diversify the dermatology curriculum in undergraduate medical education.

Limited exposure to dermatological diseases across a range of skin tones can lead to diagnostic inaccuracies and lower diagnostic self-confidence. This study demonstrates that a short-term dermatology course is feasible and beneficial for increasing diagnostic skills across a range of skin tones, especially when skin of colour education is intentional.

Visual Learning Equity: A Course Auditing System of Skin Color in Preclinical Medical Education.

Visual learning equity is a health justice effort in response to the lack of representation of brown and black skin images in medical education. This paucity creates a knowledge gap and decreases providers' competence in managing skin disease in minoritized populations. Herein, we aimed to create a standardized course auditing system to assess the use of brown and black skin images in medical education. We performed a cross-sectional analysis of the 2020-2021 preclinical curriculum at one US medical school. All human images in the learning material were analyzed. Skin color was categorized as light/white, medium/brown, and dark/black using the Massey-Martin New Immigrant Survey Skin Color Scale. We included 1,660 unique images in our analysis; 71.3%, (n=1,183) were light/white, 16.1% (n=267) were medium/brown and 12.7% (n=210) were dark/black. Dermatologic images of skin, hair, nails, or mucosal disease made up 62.1% (n=1,031) of the images and 68.1% (n=702) were light/white. The pulmonary course presented the highest proportion of light/white skin (88.0%, n=44/50) and the dermatology course presented the lowest proportion of light/white skin (59.0%, n=301/510). Images of infectious diseases were more frequently presented in darker skin colors (χ2 [2]=15.46, P&lt;.001). Light/white skin was the standard used for visual learning images in the medical school curriculum at this institution. The authors outline steps to perform a curriculum audit and diversify medical curricula to ensure the next generation of physicians are educated to care for all patients.

Perceptual learning in dermatology-A Finnish cohort study of undergraduate medical students.

Implicit visual skills play an important role in the recognition of skin-related conditions. We aimed to evaluate effectiveness and practicability of digital perceptual learning modules (PLMs) during undergraduate teaching of dermatology. The study consisted of four subsequent dermatology courses including 105 medical students. PLMs designed for an online setting were carried out before, during and at course ends, as well as 6-12 months after the courses (N = 33). We investigated four important outcome measures regarding perceptual learning: diagnostic accuracy (%-percentage of correct responses), decision duration (response time), recognized features (decision basis) and student-perceived confidence. Diagnostic accuracy (p < 0.001, effect size = 0.82), fluency (p < 0.001, = 0.23) and confidence (p < 0.001, = 0.74) increased significantly with successive PLMs during courses. Students classified more visual features and based the diagnosis more on primary lesion. Accuracy increased in all tasks during the courses and reached over 90% in diagnoses of the first to third task difficulty quartile. In the most difficult quartile accuracy reached to 60%. In the follow-up, students' performance remained at high level. Analysis of diagnostic errors showed that there were specific conditions which were systematically confused with each other. Digital PLMs improved high rates of diagnostic accuracy, fluency and student-perceived confidence in recognition of skin-related conditions. There was a long-term consistency in high performance suggesting effective learning retention. In the digital setting, PLMs were practicable and easily integrated into traditional teachings. We believe that there is extensive potential for a wider use of perceptual learning to improve nonanalytical visual skills in dermatology and medical education in general.

Pioneers in Dermatology and Venereology: An Interview with Professor An Goossens.

Following my education as a pharmacist at KU Leuven, I obtained a ‘Certificate of Cosmetopharmacy at Nantes University’ (France), which included a course in Dermatology given by very inspiring teachers H. Barrière and P. Litoux. Back in Belgium, I spent 4 months in the department of Dermatology in Leuven with Prof. H. Degreef, after which I had the opportunity to spend 9 months in Prof. A.A. Fisher's office in NY to specialize in contact allergy. Prof. A.A. Fisher from New York University and Professor S. Fregert from Lund University, Sweden. Professors A.A. Fisher and H. Degreef. Dooms-Goossens A et al. Computer-assisted monitoring of contact dermatitis. Contact Dermatitis 1980; 6: 123–7. Dooms-Goossens A et al. Contact dermatitis caused by airborne agents. A review and case reports. J Am Acad. Dermatol. 1986; 15: 1–10. Coopman S, Degreef H, Dooms-Goossens A. Identification of cross-reaction patterns in allergic contact dermatitis from topical corticosteroids. Br J Dermatol 1989; 121: 27–34. Lepoittevin JP, Drieghe J, Dooms-Goossens A. Studies in patients with corticosteroid contact allergy. Understanding cross-reactivity among different steroids. Arch Dermatol. 1995; 131: 31–7. Gilissen L, Goossens A. Frequency and trends of contact allergy to and iatrogenic contact dermatitis caused by topical drugs over a 25-year period; Contact allergy to Contact Dermatitis 2016; 75: 290–302. President of the European Society of Contact Dermatitis (ESCD) 2010–2012, of the European Environmental Contact Dermatitis Research Group (EECDRG) 1999–2002, and the Belgian Contact Dermatitis Group (BCEDG) 1993–1996, and 2004–2007. Being a pharmacist working as a scientific researcher and head of the Contact-allergy unit at the University dermatological department KU Leuven, having trained hundreds of dermatological residents in contact allergy, both nationally and internationally. None. Meeting so many kind colleagues and friends worldwide sharing the same interest. A.A. Fisher. Arts, music, learning languages, sports and cooking. All the good ones… Far too much interest in cosmetic dermatology, hence, shortage of interest in dermatological diseases, including contact dermatitis. Further research in biologics. Be involved with the patients! *Note: The Pioneers in Dermatology and Venereology interview was conceived and conducted by Johannes Ring. None Declared. The authors have no conflict of interest to declare.

Translated article] Analysis of Undergraduate Dermatology Syllabi at Spanish Universities: Does the Weight of Theoretical Content Match the Skin Conditions Seen in Primary Care and General Dermatology Practices?

IntroductionUndergraduate dermatology courses vary in the nearly 50 Spanish medical faculties that teach the subject. This study aimed to describe the characteristics of these courses and to analyze whether the weight assigned to dermatology topics reflects the caseloads of primary care physicians and general dermatologists in the Spanish national health system. Material and methodsCross-sectional study of syllabi used in Spanish medical faculties during the 2021–2022 academic year. We determined the number of teaching hours in public and private university curricula and compared the weight of dermatology topics covered to the dermatology caseloads of primary care physicians and general dermatologists as reported in published studies. ResultsMost medical faculties taught dermatology for one semester. The median number of credits offered was 4.5. On average, lectures covered 24 theoretical topics, and seminars and workshops covered 9 topics. We identified a clear disparity between the percentage of time devoted to dermatology topics in course lectures and the skin conditions usually managed in primary care and general dermatology practices. DiscussionThe skin diseases most commonly treated by primary care physicians and general dermatologists are underrepresented in the curricula of Spanish medical faculties. The topics that should be given more weight in syllabi, or recovered for inclusion in dermatology courses, should be re-examined. Our findings show that the topics that ideally should be emphasized more are types of dermatitis, infectious skin diseases, acne, psoriasis, rashes, and the differential diagnosis of benign and malignant neoplasms. There should be additional support for the theoretical teaching of these topics.

Dermatology Core Curriculum in Medical School and its Association in the Selection of Dermatology as a Future Career: A Nationwide Cross-sectional Study

Abstract Background: The shortfall of dermatology curricula during medical school greatly impacts the knowledge about common skin diseases and clinical skills. The lack of exposure to dermatology hampers the decision for students to consider pursuing dermatology and their preparation for matching. Purpose: The aims of this study were to assess the current state of dermatology curricula in medical school and to determine the relation of those factors to the selection of dermatology as a career. Methods: A nationwide cross-sectional study was conducted between September 2020 and May 2021 using a previously published questionnaire distributed to 25 universities across all regions of the Kingdom of Saudi Arabia. Results: Out of 1411 participants, around half reported having only 1–4 h of basic and clinical dermatology lectures. Forty-four percent were required to rotate in dermatology. Half of the respondents were expected to treat acne, sexually transmitted diseases, herpes, and candidiasis after finishing the dermatology course. Students in clinical years (odds ratio [OR] = 0.6 and confidence interval [CI] = 0.39–0.92) and interns (OR = 0.54 and CI = 0.30–0.94) were more likely to consider dermatology as their future career. Having a dermatology program in their university tended to generate interest in dermatology as a career choice (OR = 2.24 and CI = 1.55–3.24). Compared to students who did not complete a core dermatology course, students who completed core dermatology courses were twice as likely to be interested in dermatology as a future career (OR = 1.91 and CI = 1.35–2.70). Conclusion: Including core dermatology topics in the medical curriculum can help address community health needs and give students needed clinical experience and a basis for considering dermatology as a career path.

Evaluation of Clinical Knowledge Regarding Geriatric Skin Conditions among Thai Physicians

Objective: Assess the knowledge of common geriatric skin conditions in Thai physicians.Materials and Methods: This retrospective study was conducted among Thai physicians attending annual dermatology courses by the Dermatological Society of Thailand from 2016 to 2019. Data was assessed based on knowledge of diagnosis and management of common geriatric skin conditions.Results: A total of 197 participants, mainly general practitioners, were included. The highest percentage of correct diagnoses were benign erythematous, eczematous lesions (35.5%, senile purpura; 36.0%, xerotic eczema), and malignant diseases (35.5%, basal cell carcinoma; 27.4%, squamous cell carcinoma; 11.7%, subungual melanoma; 24.4%, acral lentiginous melanoma). In contrasts, the lowest percentage of correct diagnosis were premalignant diseases (0.5%, arsenical keratosis; 4.6%, actinic keratosis; 1.0% Bowen’s disease) and benign hypopigmented lesion (0.5%, stellate pseudoscar; 7.6%, idiopathic guttate hypomelanosis). Harmful treatment with systemic antifungal therapy was used in subungual melanoma (58.0%). Harmful management of senile comedone, subungual melanoma and acral lentiginous melanoma was significantly found in physicians given the incorrect diagnosis. (p = 0.027, p &lt;0.001, p = 0.014, respectively).Conclusion: Most physicians recognized malignant lesions, benign erythematous or eczematous diseases in elderly skin. Surprisingly, almost all physicians couldn’t diagnose premalignant lesions and benign hypopigmented lesions.

Perceptual learning modules in undergraduate dermatology teaching.

Dermatological diagnosis depends highly on visual skills, and implicit nonanalytical proficiency plays a key role. To correctly diagnose skin diseases, the clinician needs visual skills, and intuitive recognition plays a key role. To investigate the effectiveness of digital perceptual learning modules (PLMs) in undergraduate teaching, and how these affect medical students' learning about skin diseases. This was a study performed in Finland, which enrolled 39 students of an undergraduate dermatology course. Online PLMs designed for dermatology, using different pictures of skin diseases were performed three times: before, during and at the end of the course. The modules provided four outcome measures: diagnostic accuracy (percentage of correct responses), a rating of confidence about the decision, fluency (response/decision time) and a list of features on which the decision was based. As the number of PLMs and the course duration increased, there were also improvements in the four measures, with a significant increase in diagnostic accuracy [from 66% to 94%; P < 0.001; partial η2 (η2 p ) = 0.92], fluency (as measured by a decrease in response time (from 10 to 6 s; P < 0 0.001; η2 p = 0.69) and self-perceived confidence (2.5 to 4.3; P < 0 0.001, η2 p = 0.86) with subsequent PLMs and course duration. There was a diversification of recognized features, an increase in pattern recognition, and better attention to localization and contextual association. Based on student feedback, the PLMs functioned well online, and enhanced motivation and learning. PLMs increased diagnostic accuracy, had a positive effect on learning outcomes and were easily integrated alongside clinical teaching. Considering the current era of digital technologies, we believe that there is potential for wider use of PLMs to improve visual skills and strengthen implicit learning in dermatology.

Análisis de las características de la docencia de pregrado de Dermatología en las universidades españolas. ¿Los contenidos teóricos se aproximan a la casuística de los médicos de Atención Primaria y dermatólogos generales?

IntroductionUndergraduate dermatology courses vary in the nearly 50 Spanish medical faculties that teach the subject. This study aimed to describe the characteristics of these courses and to analyze whether the weight assigned to dermatology topics reflect the caseloads of primary care physicians and general dermatologists in the Spanish national health system. Material and methodsCross-sectional study of syllabi used in Spanish medical faculties during the 2021-2022 academic year. We determined the number of teaching hours in public and private university curricula and compared the weight of dermatology topics covered to the dermatology caseloads of primary care physicians and general dermatologists as reported in published studies. ResultsMost medical faculties taught dermatology for one semester. The median number of credits offered was 4.5. On average, lectures covered 24 theoretical topics, and seminars and workshops covered 9 topics. We identified a clear disparity between the percentage of time devoted to dermatology topics in course lectures and the skin conditions usually managed in primary care and general dermatology practices. DiscussionThe skin diseases most commonly treated by primary care physicians and general dermatologists are underrepresented in the curricula of Spanish medical faculties. The topics that should be given more weight in syllabi, or recovered for inclusion in dermatology courses, should be re-examined. Our findings show that the topics that ideally should be emphasized more are types of dermatitis, infectious skin diseases, acne, psoriasis, rashes, and the differential diagnosis of benign and malignant neoplasms. There should be additional support for the theoretical teaching of these topics.

Developing a virtual global dermatology curriculum: Qualitative analysis based on a pilot study in Ethiopia

Developing a virtual global dermatology curriculum: Qualitative analysis based on a pilot study in Ethiopia

Increasing skin of color representation in a medical school dermatology course through student and faculty engagement: The Dermatology IDD Image Verification Ensuring Representation of Skin of Color initiative

To the Editor: The skin of color (SOC) has been underrepresented in dermatology study materials and academic publications1-3; nearly half of dermatologists report inadequate training on SOC.4 In addition, few studies have evaluated interventions addressing SOC representation in medical education, which have the potential to mitigate race-based disparities in dermatology. Therefore, we aimed to quantify and enhance the representation of diverse skin tones in a first-year medical school course and assess student and faculty experiences in an intervention-modified course.

Developing and Measuring Effectiveness of a Distance Learning Dermatology Course: A Prospective Observational Study.

As a response to the COVID-19 pandemic, many institutions transitioned to online learning or participation in telehealth as a substitute for clinical rotations. The Uniformed Services University of the Health Sciences (Bethesda, Maryland) relied heavily on e-learning during this time as an alternative means for meeting educational objectives. We report the positive results of a prospective study evaluating short-term information recall and comprehension as well as students' confidence in their ability to apply course objectives over 3 months of an online distance learning (DL) dermatology course.

Application of blended teaching model based on SPOC and TBL in dermatology and venereology

BackgroundIn this study, we applied the small private online course (SPOC) and team-based learning (TBL) blended teaching model to dermatology and venereology to ensure a higher quality learning experience for clinical medical students.MethodsA total of 52 fifth-grade clinical undergraduates from Xiangya School of Medicine of Central South University were randomly divided into an experimental (n = 26) and a control group (n = 26). In March 2018, we used the SPOC and TBL blended teaching model in the experimental group and explored the effects of innovative teaching in the dermatology and venereology course, compared with the control group receiving the conventional teaching method. We analyzed the two groups’ theoretical assessment scores and questionnaire results to evaluate the efficiency of the new pedagogy.ResultsStudents in the experimental group had a better understanding than the control group of the dermatology and venereology content and higher scores on the case analysis questions in the final theoretical examination. The results revealed that the majority of the experimental group students agreed that the novel teaching model blended with SPOC&TBL helped them significantly stimulate motivation and develop their ability in self-directed learning, independent thinking, literature retrieval, presentation board, teamwork, communication, and systematic clinical thinking. The teaching satisfaction survey of the two groups showed that the students’ satisfaction in the experimental group was significantly higher than in the control group (p < 0.05).ConclusionsThe SPOC&TBL teaching model is better than the traditional one in enriching students’ professional knowledge and cultivating their comprehensive ability. It can effectively promote educational quality, improve students’ learning effects, and enhance their satisfaction. This method has broad application prospects.

Free online dermatology course for medical trainees in Ethiopia: A pilot study

BackgroundThe effectiveness of virtual dermatology curricula in developing countries remains unclear despite an urgent need due to the pandemic and other factors.ObjectiveTo compare a virtual dermatology curriculum deployed in Gondar, Ethiopia with a traditional in-person course.MethodsWe developed a free, on-line dermatology course. 104 trainees from the University of Gondar, Ethiopia, completed the course. Pre- and post-course surveys measuring self-reported proficiency were administered. End-of-Course surveys were distributed to elicit feedback on the course. Performance on final examinations was compared to a historical control group, which did not participate in the course but received standard in-person training.ResultsCompared to historical controls (n = 236), the pilot cohort (n = 104) averaged over 4 points higher on the final exam (P < .0001). Most participants were satisfied with all aspects of the on-line course and desire at least a component of virtual learning in the future.LimitationsThis pilot study was performed at a single institution, and the participants were not randomized. Further studies in demographically diverse cohorts are needed to validate the results.ConclusionThis dermatology curriculum is a free, innovative platform that can be adapted for dermatology trainees in resource-limited settings.

Critical evaluation of the undergraduate curriculum-are we asking the right questions?

The curricular content in medical education needs continuous development and therefore must regularly undergo a critical evaluation. Here, the author describes an implemented shift in the teaching substance of an undergraduate dermatology course aimed to focus on relevance and practicability for general practitioners. The changes were based on a comprehensive nationwide database analysis of the spectrum of skin‐related conditions seen in primary care.

Community pharmacists' perceptions and role in the management of common dermatological problems in Lebanon: a cross-sectional study.

To explore the types and frequency of dermatologic disorders routinely encountered by community pharmacists in Lebanon, identify their educational preparedness and confidence, reasons for referrals to dermatologists and their attitude toward the potential pharmacist role in the treatment of dermatologic disorders. A cross-sectional descriptive study was conducted between June and October 2017. It involved the use of a self-administered questionnaire, distributed to a randomly selected sample of 500 community pharmacists from all Lebanese districts. A total of 456 pharmacists completed the questionnaire. Sixty-four per cent of participants had received a dermatology course at university and 38.7% had undertaken some form of postgraduate education in dermatology. Pharmacists believed that the most commonly encountered disorders were sunburn (22.6%) and acne (15.6%) during spring/summer and skin dryness (18.8%) followed by head lice (13.1%) during autumn/winter. Additionally, more than half of respondents reported that skin-related advice requests were 6-15% of the total advice offered to patients. Sixty-four per cent were confident or extremely confident in advising patients with dermatological complaints. Pharmacists ranked 'unsure of diagnosis' as the most common reason for patient referral to dermatologists. Pharmacists who received postgraduate dermatology training had higher self-reported confidence in tackling skin diseases and their treatments (P < 0.05). Our study revealed that community pharmacists in Lebanon commonly encounter a limited number of dermatologic disorders and the majority believed that they can confidently advise and manage patients. Nonetheless, they admitted a gap in their dermatology education at both undergraduate and postgraduate levels.

Access to a dermatoscope during dermatology courses motivates students’ towards thorough skin examination

Introduction. Dermatoscope is a tool for a skin examination, used especially in early detection of malignant skin lesions. Non-dermatologists are being trained for opportunistic melanoma detection with the usage of dermatoscopy, however, still non-satisfactory. This study was aimed to determine whether practical dermoscopy adjunct to traditional, lecture and seminar-based medical school curriculum would improve the perceived relevance of regular skin examination and basic skin lesions differentiation. Material and method. Fourth-year medical students participating in a 3-week-long dermatology course were randomly assigned to two groups: the first one called A with limited access to a dermatoscope and the second one called B, with unlimited access to dermatoscopes throughout the course. All participants answered surveys concerning their attitude towards skin examination, with a rating scale from 1 to 5, before and after the course. Also, all participants completed an image-based dermoscopy test for distinguishing benign from malignant skin lesions. Results. Students assigned to group B significantly improved their perceived importance of routine skin examination (mean scores before 4.38; after 4.57, P = 0.03). No such tendency was observed in group A — before 4.40, after 4.49 (P = 0.29). Students in the group with higher dermatoscope availability considered buying a dermatoscope more often (61%) than those without (44%) (P = 0.037). No significant score difference was observed when testing skin lesions identification, mean for extended access 7.84 vs. normal 7.64 points (P = 0.69). Conclusions. Higher availability of dermatoscopy during dermatology rotations may encourage students to use this tool in future clinical practice and improve early detection of malignant skin lesions.