Assessment in undergraduate dermatology

Dermatology teaching for undergraduate medical students in clinical routine - a structured four-week curriculum

BACKGROUND

Dermatology teaching is fundamental for the promotion of young colleagues in our specialty. However, traditional teaching methods are being scrutinized by students of the 'Generation Y and Z', which can pose new challenges for teaching institutions. We therefore aimed to assess the motivational impact and reception of a newly created four-week curriculum containing modernized teaching methods integrated into clinical routine.

METHODS

In this single-center study, 67 medical students completed this curriculum composed of weekly learning objectives including knowledge of morphological terms, 10 common dermatoses, communication and presentation skills. The participants provided information on their level of interest in dermatology each week as well as positive and negative aspects of the curriculum.

RESULTS

During the curriculum a significant median increase in interest in dermatology was reported with no differences between the genders. Low initial interest could be improved, high initial interest maintained. Participants with an interest in scientific work (20.9%) were more motivated during the curriculum. The variety, quality of teaching and structure were the main aspects rated positively. Suggestions for improvement included the need for more teaching by senior doctors, transfer of responsibility, and a working environment updated to the latest technology standards.

CONCLUSION

The presented curriculum was well received by the participants and allowed to better define learning preferences of new generations which can be helpful to modernize traditional teaching methods. Interest in scientific work could be a factor to identify students with a particularly strong interest in dermatology.

Dermatology undergraduate skin cancer training: a disconnect between recommendations, clinical exposure and competence

BACKGROUND

Skin cancers are the most common malignancies in Caucasian populations. Non-specialists are responsible for the initial assessment of skin lesions and are required to act as the gatekeepers to dermatological cancer services in many healthcare systems. The majority of such physicians receive very limited formal undergraduate or postgraduate dermatology training. The British Association of Dermatologists (BAD) has produced guidelines that list the lesions that students should be able to diagnose on graduation and the majority of UK medical schools' operate curricula in keeping with these. There is, however, virtually no evidence as to whether these competencies are being achieved. We set out to determine students' competence at skin lesion diagnosis and to quantify their clinical exposure to examples of such lesions during their dermatology attachment.

METHODS

Three linked studies were undertaken. In the first, students' competence was tested by randomized slideshows of images containing the 16 lesions recommended in the UK guidelines. Students' accuracy was tested at the beginning (Day 1) and end (Day 10) of their clinical placement, with a random sample of students retested 12 months later. Secondly, students' exposure to these lesions was recorded during their attachments. Finally a survey of the additional dermatological resources used by the students was undertaken.

RESULTS

Study 1: Students' diagnostic accuracy increased from 11% on Day 1 to 33% on Day 10 (effect size +2.72). After 12 months half of this effect had disappeared and the students accuracy had dropped to 24%. Study 2: Students' exposure to the recommended lesions was poor with 82% not even witnessing a single example of each of the 3 major skin cancers. Despite these measurements, only a minority of students reported that they were not confident at diagnosing skin tumours. Study 3: The majority of students use additional resources to supplement their learning.

CONCLUSIONS

In the light of what we know about learning in dermatology, our data would suggest, that the current (traditional) undergraduate attachment is inadequate to meet the UK recommendations for graduate competence. As well as critically examining the basis for these recommendations, we need more empirical data on student performance and exposure, in order to improve teaching and learning.

Self-learning digital modules in dermatology: a pilot study

BACKGROUND

Dermatological diseases are one of the most common problems in outpatient departments. Dermatology teaching unfortunately is facing two major issues: (i) a shortage of trained faculty and (ii) inadequate teaching time. Various methods utilizing modern information technology have been studied to overcome these problems.

OBJECTIVES

We attempted to evaluate the use of a digital self-learning module in the teaching of dermatology.

METHODS

We created digital modules of dermatology topics, which included power-point presentations, instructive videos demonstrating signs in dermatological examination, interactive quizzes and images. The module was pilot tested on 48 third semester students, each posted for 2 weeks in dermatology. Evaluation was performed using a 5-point Likert scale questionnaire for the students. Actual knowledge acquisition was evaluated using a post-test with two components: section A comprising questions from the sections covered by the digital module and a section B comprising questions from topics taught only in the conventional method.

RESULTS

The questionnaire analysis revealed that a majority of the students were comfortable using the module and felt that it encouraged them towards further in-depth self-learning on the concerned topics. The results from the post-test were compared between the test and control sections, using the Student's t-test, which gave a P-value of 0.084 (5% significance level) suggesting that the difference was not significant. Conclusion To conclude, we would like to suggest that the use of a 'play area' like concept coupled with an interactive information technology-based self-learning module might improve dermatology teaching.

Updates from the British Association of Dermatologists 84th annual meeting, 6-9 July 2004, Belfast, U.K

Herein is a synopsis of the main research and clinical findings presented at the British Association of Dermatologists meeting held during 6-9 July 2004, in Belfast, U.K. The conference highlighted the progress that has been made in understanding the increasing biological, epidemiological and therapeutic advances that have been made recently in the field of dermatology. The authors highlight the more important advances or summaries, but this is not meant as a substitute for reading the conference proceedings and related references quoted in this article.