Recognition of melanoma: A dermatologic clinical competency in medical student education Journal Article


Authors: Goulart, J. M.; Dusza, S.; Pillsbury, A.; Soriano, R. P.; Halpern, A. C.; Marghoob, A. A.
Article Title: Recognition of melanoma: A dermatologic clinical competency in medical student education
Abstract: Background: Non-dermatologist physicians are well positioned for opportunistic melanoma detection; however, education in the skin cancer examination is limited during medical school and traditionally lecture-based. Simulating melanoma cases provides a means to demonstrate whether proficiency in knowledge and recognition of melanoma images translates into improved clinical skill. Objective: To evaluate medical student recognition and appropriate response to a prosthetic melanoma placed on a standardized patient (SP) during a simulated clinical encounter. Methods: In this pilot study, prosthetic mimics of melanoma were placed on the backs of SPs unbeknownst to a convenience sample of 59 second-year medical students. The study took place during clinical skills practice sessions with SPs conducted from February to April 2010 at Mount Sinai School of Medicine (New York, NY). SPs presented with non-dermatologic chief complaints typical for an acute office visit. All students had the opportunity to attend a lecture on the clinical signs of melanoma 2 to 4 months earlier, for which pre-test and post-test data were collected. Results: Recognition and evaluation of a prosthetic melanoma as determined by querying the SPs and reviewing the students' examination notes. During the SP encounter, 37 students (63%) asked about the melanoma moulage; of those, 25 (68%) made recommendations for further evaluation. The moulage was documented in 17 examination notes (43%). Thirty-three students (56%) asked about the skin on review of systems, although this did not predict moulage detection. Conclusions: Prosthetic mimics of melanoma are useful tools for assessing skin cancer awareness and detection skills among medical students.
Keywords: cancer patient; cancer diagnosis; melanoma; skin neoplasms; diagnosis, differential; teaching; information processing; medical education; curriculum; clinical competence; pilot projects; early diagnosis; skin examination; clinical evaluation; models, anatomic; prosthesis; dermatology; skill; competency-based education; medical student; knowledge; medical school; patient simulation; sp; standardized patient; education, medical, undergraduate
Journal Title: Journal of the American Academy of Dermatology
Volume: 67
Issue: 4
ISSN: 0190-9622
Publisher: Mosby Elsevier  
Date Published: 2012-10-01
Start Page: 606
End Page: 611
Language: English
DOI: 10.1016/j.jaad.2011.12.007
PROVIDER: scopus
PUBMED: 22281164
DOI/URL:
Notes: --- - "Export Date: 1 October 2012" - "CODEN: JAADD" - "Source: Scopus"
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MSK Authors
  1. Allan C Halpern
    396 Halpern
  2. Stephen Dusza
    288 Dusza
  3. Ashfaq A Marghoob
    534 Marghoob