Dermatology Resident Education Research Articles

Top DEI Topics to Incorporate Into Dermatology Residency Training: An Electronic Delphi Consensus Study.

Current dermatology residency education may be deficient in curricular topics and training related to diversity, equity, and inclusion (DEI). Integrating more DEI topics within residency curricula may improve clinical care delivered to diverse populations and improve cultural humility among trainees. The objective of this electronic Delphi (e-Delphi) study was to reach a consensus on the most important DEI topics for inclusion in dermatology residency program curricula nationwide. Sixty-one DEI-related topics were proposed by an expert panel consisting of dermatologists from the Association of Professors of Dermatology DEI subcommittee and the American Academy of Dermatology Diversity Task Force. Two rounds of anonymous electronic surveys based on a 5-point Likert scale were administered using a modified e-Delphi design. Voluntary participants including residents and academic dermatologists were self-selected after an email was sent to the Association of Professors of Dermatology listserve.

Positive perceptions of virtual didactics during the COVID-19 pandemic: a survey of dermatology residents' satisfaction, perception of efficacy and preferences.

During the COVID-19 pandemic, resident didactics at many institutions, including ours, were transitioned from in-person to virtual. We aimed to examine dermatology residents' attitudes towards virtual didactics, assessing their satisfaction, impression of effectiveness and preference, along with factors correlating with these responses. An online questionnaire was administered to dermatology residents at our institution 3-6 months following the transition to virtual didactics. The response rate was 26 of 31 residents (84%). Of the 26 respondents, 20 (77%) expressed satisfaction, 15 (58%) effectiveness and 12 (46%) a preference towards virtual didactics. Factors associated with satisfaction included feeling that virtual didactics positively impacted learning retention, represented time well spent and utilized high-quality images. Perception of effectiveness correlated with using high-quality images, baseline preference for online instruction and feeling engaged. Factors associated with preference for virtual didactics included having opportunities for critical thinking, using high-quality images and utilizing images applicable to teledermatology care. Advantages of virtual didactics included convenience, decreased commuting and easily hosting guest lecturers. Disadvantages included distractions/decreased focus, reduced social interaction and difficulty with communication. Residents expressed satisfaction with, effectiveness of and some preference towards virtual didactics, which correlated with numerous factors relating to the learning environment, prior educational experiences and technology. Our findings suggest that it is reasonable to maintain a virtual didactic component as part of dermatology resident education. Furthermore, our data provide insights into strategies that residency programme directors and educators may consider when/if integrating virtual didactics into future educational curricula.

Impact of the COVID-19 pandemic on dermatology residency education in the United States: A cross-sectional survey

To the Editor: The COVID-19 pandemic has resulted in unprecedented disruptions to dermatology residency education.1,2 Following the novel disruptions of COVID-19 on medical training, it is imperative to support residents. However, there has been limited research evaluating the impact of the COVID-19 pandemic on US dermatology training as perceived by dermatology residents.3 This survey analyzes the impact of the COVID-19 pandemic on dermatology trainees. With new SARS-CoV-2 variants arising and the possibility of future public health crises, these reflections are of particular importance.

The Importance of Service Learning in Dermatology Residency: An Actionable Approach to Improve Resident Education and Skin Health Equity.

Accessing specialty care such as dermatology is a challenge for patients residing in marginalized communities. In 2019, there were nearly 30 million individuals without health insurance in the United States; furthermore, those from minority backgrounds are less likely to be insured than their White counterparts. Service learning is an educational approach that combines learning objectives with community service to provide a comprehensive scholastic experience, meet societal needs, and fulfill Accreditation Council for Graduate Medical Education requirements. A commitment to service learning in dermatology residency programs will improve skin health equity as well as dermatology residency education relating to cultural competency and socioeconomic determinants of health.

A virtual faculty exchange program enhances dermatology resident education in the COVID-19 era: a survey study

One of the many consequences of the COVID-19 pandemic was the cancelation of the 2020 American Academy of Dermatology Annual Meeting. This conference historically features lectures from world-renowned experts in all areas of dermatology, thus providing an important educational experience for dermatology residents. We hypothesized that the cancellation of this meeting produced a substantial educational loss for dermatology residents. To mitigate this impact, we developed a virtual faculty exchange program and surveyed dermatology residents' perspectives on its implementation. All participating residents found the virtual faculty exchange useful and would recommend it to other residents/programs. Moreover, all residents wanted to participate in more faculty exchange sessions as well as incorporate them throughout the academic year. Additionally, this educational program eliminated the potential cost of >$15,000 in flights and >24 metric tons of carbon emissions. This virtual faculty exchange program is a viable tool to enhance dermatology resident education in the COVID-19 era.

Inspired by COVID-19 isolation: Evolving educational techniques in dermatology residency programs

The coronavirus disease 2019 (COVID-19) global pandemic has required dermatology residency programs to convert their learning environment largely to a virtual setting. The impromptu reliance on online lectures, videoconference didactics, and other digital educational resources during this time is welcomed by today's millennial generation of medical trainees and coincides with their learning preferences. Although hands-on direct patient care experiences are currently limited due to reservation of in-office visits for urgent care only, resident participation in teledermatology has permitted them to continue gaining valuable clinical training and may allow for enhanced evaluation of their performance in the future. Given the shown benefits of telemedicine and student preferences for online learning, incorporating these virtual technologies into the curriculum will be essential to advancing dermatology residency education.

Rethinking dermatology resident education in the age of COVID-19.

International Journal of DermatologyVolume 59, Issue 12 p. 1539-1540 Commentary Rethinking dermatology resident education in the age of COVID-19 Lauren N. Ko MD, MEd, Lauren N. Ko MD, MEd Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA Department of Dermatology, Harvard Medical School, Boston Children’s Hospital, Boston, MA, USASearch for more papers by this authorSteven T. Chen MD, MPH, MS-HPEd, Steven T. Chen MD, MPH, MS-HPEd Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorJennifer T. Huang MD, Jennifer T. Huang MD Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Boston Children’s Hospital, Boston, MA, USASearch for more papers by this authorJean S. McGee MD, PhD, Jean S. McGee MD, PhD Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USASearch for more papers by this authorKristina J. Liu MD, MHS, Corresponding Author Kristina J. Liu MD, MHS [email protected] Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA Correspondence Kristina J. Liu, md, MHS Brigham Dermatology Associates 221 Longwood Avenue Boston MA 02115 USA E-mail: [email protected]Search for more papers by this author Lauren N. Ko MD, MEd, Lauren N. Ko MD, MEd Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA Department of Dermatology, Harvard Medical School, Boston Children’s Hospital, Boston, MA, USASearch for more papers by this authorSteven T. Chen MD, MPH, MS-HPEd, Steven T. Chen MD, MPH, MS-HPEd Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USASearch for more papers by this authorJennifer T. Huang MD, Jennifer T. Huang MD Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Boston Children’s Hospital, Boston, MA, USASearch for more papers by this authorJean S. McGee MD, PhD, Jean S. McGee MD, PhD Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USASearch for more papers by this authorKristina J. Liu MD, MHS, Corresponding Author Kristina J. Liu MD, MHS [email protected] Harvard Combined Dermatology Residency Program, Boston, MA, USA Department of Dermatology, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA Correspondence Kristina J. Liu, md, MHS Brigham Dermatology Associates 221 Longwood Avenue Boston MA 02115 USA E-mail: [email protected]Search for more papers by this author First published: 07 October 2020 https://doi.org/10.1111/ijd.15235Citations: 1 Conflict of interest: None. Funding source: None. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume59, Issue12December 2020Pages 1539-1540 This article also appears in:International Journal of Dermatology COVID-19 Papers RelatedInformation

Dermatology resident education for skin of color.

Department of Dermatology, University of Wisconsin Hospital and Clinics, Madison.

The heightened focus on wellness in dermatology residency education

Dermatology residents and dermatology faculty members experience stress in the workplace, placing them at risk for burnout. As a profession, dermatologists have one of the fastest growing rates of burnout clinical manifestations across all specialties. The Accreditation Council for Graduate Medical Education has revised its program requirements for residency programs to include greater emphasis on actions to promote wellness. Examples of actions to promote wellness that are used currently in dermatology and other residency and medical education settings are explored.

The corporatization of dermatopathology

The corporatization of dermatopathology has long preceded that of dermatology and has been driven by federal legislation and economic influences. Although the Clinical Laboratory Improvement Amendments and the Stark Law limited physician-owned laboratories, loopholes via the Safe Harbor Exemptions outlined in the Anti-Kickback Statute allowed corporate laboratories to flourish through relationships built by health information technology donations. The rise of corporatization has had widespread effects on the fields of dermatopathology and dermatology, resulting in reduced numbers of dermatology-trained dermatopathologists and decreased caseloads in academic institutions, potentially compromising dermatology residency education. Although there have been efforts to counteract these effects, more global changes will be required to alter the direction of this subspecialty.

A video-based, flipped classroom, simulation curriculum for dermatologic surgery: A prospective, multi-institution study

Medical education is evolving to emphasize trainee engagement. The impact of a flipped classroom curriculum and surgical simulation on dermatology resident education has not been evaluated. To assess the impact of video education and surgical simulation on dermatology resident procedural skills. We created a curriculum on foundational surgical skills for 31 first- and second-year dermatology residents at 3 institutions. The flipped classroom approach replaces traditional in-person lectures with at-home viewing of instructional videos. After this self-directed learning, trainees had 3 hands-on sessions using simulated skin models. The Objective Structured Assessment of Technical Skills (OSATS) instrument was used to assess residents performing a simulated elliptical excision with intermediate repair before and after the curriculum. Residents completed precurriculum and postcurriculum surveys evaluating operative confidence and perceived value of the curriculum. Residents' total OSATS score increased from a median of 27 (interquartile range, 22-38.5) before the curriculum to 46 (interquartile range, 39.5-51.5) after the curriculum (P<.001). Self-reported confidence in surgical performance significantly improved, and residents were highly satisfied. Limitations include the small sample size and potential influence from concurrent learning on surgical rotations. Video education and simulation are effective for improving dermatology residents' procedural skills. We hope to serve as a template for other institutions and nondermatology trainees hoping to improve procedural skills.

Teledermatology and teledermatopathology as educational tools for international dermatology: a virtual grand rounds pilot curriculum.

Teledermatology may improve dermatologic care access in underserved areas and expand the clinical experience of dermatologists-in-training. The potential for teledermatology to supplement global health curricula in dermatology residency education has not been explored. An international virtual grand rounds (VGR) curriculum was created based on teledermatology cases from Kabul, Afghanistan. The learning objectives included understanding the diagnosis and management of skin diseases in unfamiliar resource-limited settings and highlighting socioeconomic, cross-cultural, and ethical issues. A 17-item, Likert scale questionnaire was used to assess the effectiveness of the curriculum, including specific Accreditation Council for Graduate Medical Education (ACGME) competencies, as well as interest in global health and teledermatology. The survey was completed by 85 of 118 VGR attendees (72% response rate). Most respondents considered the curriculum valuable to their education (mean 4.5 on a 5-point Likert scale; standard deviation, 0.5), learned more about diagnosis and treatment of skin diseases in international settings (4.5; 0.6) and in the US (4.1; 0.8), and learned more about socioeconomic, cultural, and ethical issues in skin health (4.6; 0.5). The majority also reported being more interested in global dermatology (4.1; 0.8) and would recommend VGR to a colleague (4.5; 0.6). This pilot curriculum provided an innovative platform to enhance undergraduate and graduate medical education in international dermatology. International teledermatology education may be used to address multiple ACGME core competencies and increase resident awareness of sociocultural determinants of skin health.

Dermatology resident education in molecular diagnostics, genomics, and personalized medicine

Dermatology resident education in molecular diagnostics, genomics, and personalized medicine

Practice and Educational Gaps in Genodermatoses.

In the past 2 decades, there has been enormous progress in determining the molecular bases of genodermatoses. This progress has expanded the interface between dermatology and genetics. Integration of clinical and molecular data has simplified disease classification and highlighted relationships among conditions. However, the recent explosion in genetic knowledge has not yet been fully incorporated into clinical dermatology practice or dermatology resident education. This article highlights strategies to overcome barriers and correct practice and educational gaps, enhancing the ability of dermatologists to diagnose, counsel, evaluate, and treat patients and families affected by genodermatoses.

Nail Surgery Techniques: A Single Center Survey Study on the Effect of a Cadaveric Hand Practicum in Dermatology Resident Education.

Nail Surgery Techniques: A Single Center Survey Study on the Effect of a Cadaveric Hand Practicum in Dermatology Resident Education.

Deficiencies of phototherapy training in dermatology residency education

Deficiencies of phototherapy training in dermatology residency education

A survey of dermatology resident education in cosmetic procedures

The demands for cosmetic procedures are increasing. Dermatologists perform many of these procedures, therefore adequate education and training during residency is important. Surveys demonstrate dermatology residents desire more training even while faculty members believe this has already become a more prominent feature of resident education. We sought to assess the time and methods dedicated to education and training of cosmetic procedures in dermatology residency. A 26-question survey was developed and electronically distributed in May 2010 to dermatology program directors via the Association of Professors of Dermatology list-serve with their approval. Program directors were asked to forward the e-mail to their instructors of cosmetic/procedural dermatology, and chief residents. Responses were anonymous. A total of 86 responses were collected. In all, 67% (n = 54) of respondents had formal lectures focusing on cosmetic dermatology. Lecture topics reported by more than 50% of respondents included botulinum toxin injection, lasers, soft tissue augmentation, chemical peels, and sclerotherapy. Topics such as dermabrasion, liposuction, and scar revision were less commonly taught. The most commonly encountered and performed procedures were botulinum toxin injection and lasers (100%, n = 86); 98.8% (n = 85) encounter soft tissue augmentation and 95.4% (n = 82) encounter both chemical peels and sclerotherapy. Resident experience performing procedures as the first assistant or as the first surgeon varied widely. The limitations of this study are that the data were subjectively reported so results may differ from the true amount of time spent in any activity. The data may be biased by the population that responded as they may have strong opinions supporting or opposing training in cosmetic procedures. The data also may have been skewed by the small percentage of participants who were instructors of cosmetic dermatology (21%), chief residents (20%), and others respondents (8% total). The results demonstrate the variability of training in cosmetic procedures. The challenge for programs is to find the balance between insufficiency and overemphasis. The results of this study will hopefully assist programs in determining the quantity and methods of resident training in cosmetic procedures.

The perceived influence of cosmetic dermatology on dermatology resident education

To the Editor: Over the past decade, an increased focus on cosmetic products and procedures has increased the demand for cosmetic dermatology. Dermatology residents consistently report inadequate exposure to cosmetics.1Freeman S.R. Greene R.E. Kimball A.B. Freiman A. Barzilai D.A. Muller S. et al.US dermatology residents' satisfaction with training and mentoring: survey results from the 2005 and 2006 Las Vegas Dermatology Seminars.Arch Dermatol. 2008; 144: 896-900Crossref PubMed Scopus (36) Google Scholar, 2Freiman A. Barzilai D.A. Barankin B. Natsheh A. Shear N.H. National appraisal of dermatology residency training: a Canadian study.Arch Dermatol. 2005; 141: 1100-1104Crossref PubMed Scopus (49) Google Scholar, 3Reid D.C. Kimball A.B. Ehrlich A. Medical versus surgical dermatology: how much training do residents receive?.Dermatol Surg. 2006; 32: 597Crossref PubMed Scopus (7) Google Scholar It is unknown if residency programs have increased training in cosmetics and, if so, if this change has compromised interest or expertise in other areas of dermatology. To investigate this, we surveyed those responsible for resident education: dermatology residency program directors and department chairmen. In May 2008, an electronic survey was e-mailed to 171 dermatology residency program directors and chairmen who are members of the Association of Professors of Dermatology. Responses were anonymous. Seven Likert scale questions assessed the perceived influence of cosmetics on dermatology training. The Likert scale was scored from 1 (no) to 9 (definitely). Fifty-three members completed the survey (31% response rate). Eighty-five percent of respondents believed that cosmetics have become a more prominent part of resident training over the past decade (average Likert score, 8.1 out of 9). Fifty-three percent believed that this increase has resulted in decreased expertise and interest in medical dermatology (average, 5.6). Respondents felt that it was less important for residents to gain expertise in cosmetics than in other areas of dermatology (92-100% said it was “very important” to gain experience in medical dermatology, noncosmetic surgery, and dermatopathology during residency, compared with only 36% for cosmetics). Despite this perception, few respondents believed the Residency Review Committee or American Board of Dermatology should formally limit time spent learning cosmetics (average, 4.6), require case logs for medical dermatology (average, 3.3), or reserve cosmetics training for postresidency fellowships (average, 3.0). Notably, they felt, despite the increased prominence of cosmetics in resident training and the perceived inadequacy of cosmetics training by residents, that residents are not more motivated to gain expertise in cosmetics compared with other areas of dermatology (average, 7.2-8.0). Our results confirm previous data that program directors and chairmen believe that training in cosmetics is less important during residency than training in noncosmetic areas of dermatology.1Freeman S.R. Greene R.E. Kimball A.B. Freiman A. Barzilai D.A. Muller S. et al.US dermatology residents' satisfaction with training and mentoring: survey results from the 2005 and 2006 Las Vegas Dermatology Seminars.Arch Dermatol. 2008; 144: 896-900Crossref PubMed Scopus (36) Google Scholar, 2Freiman A. Barzilai D.A. Barankin B. Natsheh A. Shear N.H. National appraisal of dermatology residency training: a Canadian study.Arch Dermatol. 2005; 141: 1100-1104Crossref PubMed Scopus (49) Google Scholar, 4Reichel J.L. Peirson R.P. Berg D. Teaching and evaluation of surgical skills in dermatology: results of a survey.Arch Dermatol. 2004; 140: 1365-1369Crossref PubMed Scopus (41) Google Scholar, 5Todd M.M. Miller J.J. Ammirati C.T. Dermatologic surgery training in residency.Dermatol Surg. 2002; 28: 547-550Crossref PubMed Scopus (26) Google Scholar The important new findings in our survey are that 85% of respondents feel cosmetics has become more prominent in residency training, and 53% believe the increased emphasis on cosmetics has lessened residents' interest and expertise in medical dermatology. Limitations of this study are that it assessed a subpopulation of dermatologists who may be biased toward medical dermatology—yet these are the people charged with educating residents, so we believe their opinions are important. Second, the response rate of 31%, although well within the accepted range for survey studies of physicians, may have affected the data.6Asch D.A. Jedrziewski M.K. Christakis N.A. Response rates to mail surveys published in medical journals.J Clin Epidemiol. 1997; 50: 1129-1136Abstract Full Text PDF PubMed Scopus (1788) Google Scholar Lastly, responders may have stronger feelings about the role of cosmetic dermatology than nonresponders, introducing bias. Our study raises the concern that residents may have less interest and expertise in medical dermatology as a result of increased emphasis on cosmetics. As the field of dermatology expands, it is vitally important that residency programs consider how to offer comprehensive training in all areas of dermatology, including cosmetics, without compromising expertise in traditional aspects of dermatology such as medical dermatology. We are indebted to Dr Sarah O'Brien for her assistance in statistical analysis. Dr O'Brien is affiliated with the Center for Innovation in Pediatric Practice at Nationwide Children's Hospital, Columbus, OH.

Interesting cases from Tanzania: Why international rotations are an important part of dermatology resident education

Interesting cases from Tanzania: Why international rotations are an important part of dermatology resident education