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Skin Cancer Examination Teaching in US Medical Education
Megan M. Moore, MD;
Alan C. Geller, MPH, RN;
Zi Zhang, MB, MPH;
Benjamin B. Hayes, MD, PhD;
Kendra Bergstrom, MD;
Julia E. Graves, MD;
Andrea Kim, MD;
Juan-Carlos Martinez, MD;
Ladan Shahabi, MD;
Donald R. Miller, ScD;
Barbara A. Gilchrest, MD
Arch Dermatol. 2006;142:439-444.
Objective To determine physician preparation for performing the skin cancer examination (SCE).
Design We evaluated medical students' observation, training, and practice of the SCE; hours spent in a dermatology clinic; and self-reported skill level for the SCE by a self-administered survey.
Participants Graduating students at 7 US medical schools during the 2002-2003 academic year.
Main Outcome Measures Percentages of students reporting SCE skill observation, training, and practice.
Results Of 934 students, 659 (70.6%) completed surveys. Twenty-three percent of students had never observed an SCE, 26.7% had never been trained to perform an SCE, and 43.4% had never examined a patient for skin cancer. Only 28.2% rated themselves as somewhat or very skilled in the SCE. This rate dropped to 19.7% among 553 students who had not completed a dermatology elective. Compared with students without training, students who had been trained at least once in the SCE were 7 times more likely to rate themselves as being somewhat or very skilled in the SCE. Sixty-nine percent of students agreed that insufficient emphasis in their medical training was placed on learning about the SCE.
Conclusions This survey documents the need for more consistent training of medical students in SCE. Even brief curricular additions would augment students' perceived skill levels and improve practice patterns and competencies of future physicians. More frequent and improved SCEs might result in earlier detection of melanoma and nonmelanoma skin cancers by nondermatologists, with significant public health benefits.
Author Affiliations: Harvard Medical School (Dr Moore), Department of Dermatology, Boston University School of Medicine (Mr Geller and Drs Hayes, Miller, and Gilchrest), Cancer Prevention and Control Center and Departments of Epidemiology and Biostatistics, Boston University School of Public Health (Mr Geller), and Massachusetts Department of Public Health (Dr Zhang), Boston; Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York (Dr Moore); Stanford University School of Medicine, Stanford, Calif (Dr Bergstrom); Virginia Commonwealth University School of Medicine, Richmond (Dr Graves); The University of Texas Southwestern Medical School, Dallas (Dr Kim); Mayo Medical School, Rochester, Minn (Dr Martinez); and University of Michigan Medical School, Ann Arbor (Dr Shahabi). Drs Moore and Bergstrom are now with the Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York; Dr Hayes is now with the Division of Dermatology, Vanderbilt University School of Medicine, Nashville, Tenn; Dr Graves is now with the Division of Dermatology, Washington University School of Medicine, St Louis, Mo; Dr Kim is now with the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas; Dr Martinez is now with the Division of Dermatology, Duke University Medical Center, Durham, NC; Dr Shahabi is now with the Department of Dermatology, University of Michigan Medical School, Ann Arbor.
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