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Curricular factors associated with medical students' practice of the skin cancer examination: an educational enhancement initiative by the integrated skin exam consortium
Journal article   Open access   Peer reviewed

Curricular factors associated with medical students' practice of the skin cancer examination: an educational enhancement initiative by the integrated skin exam consortium

Amit Garg, Joyce Wang, Shalini B Reddy, Jennifer Powers, Reza Jacob, Michael Powers, Katie Biello, Rachael Cayce, Stephanie Savory, Leah Belazarian, …
JAMA dermatology (Chicago, Ill.), Vol.150(8), pp.850-855
08/2014
DOI: 10.1001/jamadermatol.2013.8723
PMID: 24898482
url
https://doi.org/10.1001/jamadermatol.2013.8723View
Published (Version of record) Open Access

Abstract

As medical school curricula become progressively integrated, a need exists to optimize education related to the skin cancer examination (SCE) for melanoma, a relevant competency gap that influences secondary prevention efforts. To identify curricular factors associated with medical students' confidence, intent, and performance regarding the SCE. Survey-based cross-sectional study from the Integrated Skin Exam Consortium at accredited US medical schools among a volunteer sample of second-year students representing 8 geographically varied public and private institutions. Students were administered a questionnaire to assess characteristics, curricular exposures, and educational and practical experiences related to skin cancer, as well as knowledge of melanoma risk and a detection method. Primary outcomes were confidence in performing the SCE, intent to perform an integrated skin examination, and actual performance of the SCE. Physical diagnosis session and clinical encounter were most predictive of confidence in performance of the SCE (odds ratios [ORs], 15.35 and 11.48, respectively). Other curricular factors associated with confidence included instruction time of at least 60 minutes on skin cancer (OR, 6.35), lecture on the SCE (OR, 7.54), knowledge of melanoma risk (OR, 3.71), and at least 1 opportunity to observe the SCE (OR, 2.70). Physical diagnosis session and at least 4 opportunities to observe the SCE were most predictive of intent to perform an integrated skin examination (ORs, 4.84 and 4.72, respectively). Other curricular factors associated with intent included knowledge of melanoma risk (OR, 1.83), clinical encounter (OR, 2.39), and at least 1 opportunity to observe the SCE (OR, 1.95). Clinical encounter, physical diagnosis session, and at least 1 opportunity to observe the SCE were most predictive of performance of the SCE (ORs, 21.67, 15.48, and 9.92, respectively). Other curricular factors associated with performance included instruction time of at least 60 minutes on skin cancer (OR, 2.42) and lecture on the SCE (OR, 5.04). To augment the practice of the SCE among medical students, course directors may design an integrated curriculum that includes at least 60 minutes of instruction related to melanoma and the SCE, a description of the integrated skin examination as part of the physical diagnosis course, and education on high-risk demographic groups and anatomic sites specific to men and women and on the ABCDEs of melanoma, and at least 1 opportunity to observe the SCE.
United States Melanoma - diagnosis Self Efficacy Cross-Sectional Studies Students, Medical - psychology Humans Male Health Knowledge, Attitudes, Practice Dermatology - education Time Factors Skin Neoplasms - diagnosis Physical Examination Female Intention Schools, Medical Task Performance and Analysis

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