1
|
Yeung H, Sargen MR, Luk KM, Berry EG, Gurnee EA, Heuring E, McMichael J, Chen SC, Stoff BK. Teledermatology and teledermatopathology as educational tools for international dermatology: a virtual grand rounds pilot curriculum. Int J Dermatol 2018; 57:1358-1362. [PMID: 29693243 DOI: 10.1111/ijd.14014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/10/2018] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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). CONCLUSION 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.
Collapse
Affiliation(s)
- Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Michael R Sargen
- Departments of Dermatology and Pathology, Stanford University, Stanford, CA, USA
| | - Kevin M Luk
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Elizabeth G Berry
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Emily A Gurnee
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Erin Heuring
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Josette McMichael
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA
| | - Suephy C Chen
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.,Division of Dermatology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Benjamin K Stoff
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.,Division of Dermatology, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA.,Emory Center for Ethics, Emory University, Atlanta, GA, USA
| |
Collapse
|
2
|
Bruce AF, Mallow JA, Theeke LA. The use of teledermoscopy in the accurate identification of cancerous skin lesions in the adult population: A systematic review. J Telemed Telecare 2017; 24:75-83. [PMID: 28056600 DOI: 10.1177/1357633x16686770] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background The use of teledermoscopy in the diagnostic management of pre-cancerous and cancerous skin lesions involves digital dermoscopic images transmitted over telecommunication networks via email or web applications. Teledermoscopy may improve the accuracy in clinical diagnoses of melanoma skin cancer if integrated into electronic medical records and made available to rural communities, potentially leading to decreased morbidity and mortality. Objective and method The purpose of this paper is to present a systematic review of evidence on the use of teledermoscopy to improve the accuracy of skin lesion identification in adult populations. The PRISMA method guided the development of this systematic review. A total of seven scholarly databases were searched for articles published between the years of 2000 and 2015. All studies were critically appraised using the Rosswurm and Larrabee critique worksheet, placed in a matrix for comparison evaluating internal and external validity and inspected for homogeneity of findings. Results Sixteen articles met inclusion criteria for this review. A majority of the studies were cross-sectional and non-experimental. Ten of the 16 focused on interobserver concordance and diagnostic agreement between teledermoscopy and another comparator. Instrumentation in conducting the studies showed inconsistency with reported results. Discussion Higher level evidence is needed to support clinical application of teledermoscopy for accuracy of diagnostic measurement in the treatment of pre-cancerous and cancerous skin lesions in adults. Future research is needed to develop a standardized, reliable and valid measurement tool for implementation in clinical practice.
Collapse
Affiliation(s)
- Amy F Bruce
- 1 Department of Nursing, West Virginia University Institute of Technology, Montgomery, WV, USA
| | - Jennifer A Mallow
- 2 Department of Adult Health, West Virginia University School of Nursing, Morgantown, WV, USA
| | - Laurie A Theeke
- 2 Department of Adult Health, West Virginia University School of Nursing, Morgantown, WV, USA
| |
Collapse
|
3
|
Deldar K, Bahaadinbeigy K, Tara SM. Teleconsultation and Clinical Decision Making: a Systematic Review. Acta Inform Med 2016; 24:286-292. [PMID: 27708494 PMCID: PMC5037984 DOI: 10.5455/aim.2016.24.286-292] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 04/15/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The goal of teleconsultation is to omit geographical and functional distance between two or more geographically separated health care providers. The purpose of present study is to review and analyze physician-physician teleconsultations. METHOD The PubMed electronic database was searched. The primary search was done on January 2015 and was updated on December 2015. A fetch and tag plan was designed by the researchers using an online Zotero library. RESULTS 174 full-text articles of 1702 records met inclusion criteria. Teleconsultation for pediatric patients accounts for 14.36 percent of accepted articles. Surgery and general medicine were the most prevalent medical fields in the adults and pediatrics, respectively. Most teleconsultations were inland experiences (no=135), and the USA, Italy and Australia were the three top countries in this group. Non-specialists health care providers/centers were the dominant group who requested teleconsultation (no=130). Real time, store and forward, and hybrid technologies were used in 50, 31, and 16.7 percent of articles, respectively. The teleconsultation were reported to result in change in treatment plan, referral or evacuation rate, change in diagnosis, educational effects, and rapid decision making. Use of structured or semi-structured template had been noticed only in a very few articles. CONCLUSION The present study focused on the recent ten years of published articles on physician-physician teleconsultations. Our findings showed that although there are positive impacts of teleconsultation as improving patient management, still have gaps that need to be repaired.
Collapse
Affiliation(s)
- Kolsoum Deldar
- Student Research Committee, Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Seyed Mahmood Tara
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| |
Collapse
|
4
|
Cohen JM, Tan JK, Chen ST, Burgin S. Perspectives on dermatology grand rounds: a survey of United States residency program directors. Int J Dermatol 2015; 55:e310-1. [DOI: 10.1111/ijd.13093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 04/20/2015] [Accepted: 05/07/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jennifer K. Tan
- Harvard Medical School; Boston MA USA
- Department of Dermatology; Brigham and Women's Hospital; Boston MA USA
| | - Steven T. Chen
- Harvard Medical School; Boston MA USA
- Harvard Combined Dermatology Residency Program; Boston MA USA
| | - Susan Burgin
- Harvard Medical School; Boston MA USA
- Department of Dermatology; Beth Israel Deaconess Medical Center; Boston MA USA
| |
Collapse
|
5
|
Lee P, Chen CF, Wan HT, Jian WS, Hsu MH, Syed-Abdul S, Huang CW, Huang YC, Lin YT, Chen TJ, Wu YH, Li YC. iSlide: a 'big picture' interactive teledermatopathology e-learning system. Br J Dermatol 2014; 172:692-9. [PMID: 25040884 DOI: 10.1111/bjd.13274] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dermatopathology training is often limited by facilities and a dearth of specialists. Advancements in information and communication technologies have made possible the adoption of innovative learning techniques, especially in places where specialists are lacking. OBJECTIVES To implement and evaluate the performance of the iSlide system, which is an interactive dermatopathology training platform (http://scope.tmu.edu.tw/islide2/). METHODS Fifty-two cases representing a variety of dermatopathology conditions and complications were used to set up the iSlide system, and virtual slides of these cases were produced. Medical students from the Dermatology Department of Taipei Medical University were taught to use the system. Performance of the system was evaluated and validated using questionnaires, the first comprising 20 questions and the second a shorter, six-question telephone-based survey on 15 of the 96 interns. Twenty cases prepared by the iSlide system were also presented at an international dermatopathology conference and evaluated by conference participants. RESULTS Ninety-six students and 72 experts participated in the study. Ninety-two per cent of the students and 98% of the experts found the iSlide system to be a useful tool for learning dermatopathology. Of these, 82% of the students and 63% of the experts felt that iSlide was easy to use. CONCLUSIONS iSlide is useful for dermatopathology. As only 82% of the student evaluators and 63% of the expert evaluators found the system easy to use, further work has to be done to improve the iSlide interface to make the system more user friendly.
Collapse
Affiliation(s)
- P Lee
- Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan; College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Osman OT, Mufaddel A, Almugaddam F, Augusterfer EF. The psychiatric aspects of skin disorders. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.11.10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
7
|
Quoi de neuf en dermatologie clinique ? Ann Dermatol Venereol 2010; 137 Suppl 4:S125-36. [DOI: 10.1016/s0151-9638(10)70039-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|