PDF(Pubmed)
Abstract：
BACKGROUND: Skin cancers are the most common group of cancers diagnosed worldwide. Aging and sun exposure increase their risk. The decline in the number of dermatologists is pushing the issue of dermatological screening back onto family doctors. Dermoscopy is an easy-to-use tool that increases the sensitivity of melanoma diagnosis by 60% to 90%, but its use is limited due to lack of training. The characteristics of \"ideal\" dermoscopy training have yet to be established. We created a Moodle (Moodle HQ)-based e-learning course to train family medicine residents in dermoscopy.
OBJECTIVE: This study aimed to evaluate the evolution of dermoscopy knowledge among family doctors immediately and 1 and 3 months after e-learning training.
METHODS: We conducted a prospective interventional study between April and November 2020 to evaluate an educational program intended for family medicine residents at the University of Montpellier-Nîmes, France. They were asked to complete an e-learning course consisting of 2 modules, with an assessment quiz repeated at 1 (M1) and 3 months (M3). The course was based on a 2-step algorithm, a method of dermoscopic analysis of pigmented skin lesions that is internationally accepted. The objectives of modules 1 and 2 were to differentiate melanocytic lesions from nonmelanocytic lesions and to precisely identify skin lesions by looking for dermoscopic morphological criteria specific to each lesion. Each module consisted of 15 questions with immediate feedback after each question.
RESULTS: In total, 134 residents were included, and 66.4% (n=89) and 47% (n=63) of trainees fully participated in the evaluation of module 1 and module 2, respectively. This study showed a significant score improvement 3 months after the training course in 92.1% (n=82) of participants for module 1 and 87.3% (n=55) of participants for module 2 (P<.001). The majority of the participants expressed satisfaction (n=48, 90.6%) with the training course, and 96.3% (n=51) planned to use a dermatoscope in their future practice. Regarding final scores, the only variable that was statistically significant was the resident\'s initial scores (P=.003) for module 1. No measured variable was found to be associated with retention (midtraining or final evaluation) for module 2. Residents who had completed at least 1 dermatology rotation during medical school had significantly higher initial scores in module 1 at M0 (P=.03). Residents who reported having completed at least 1 dermatology rotation during their family medicine training had a statistically significant higher score at M1 for module 1 and M3 for module 2 (P=.01 and P=.001).
CONCLUSIONS: The integration of an e-learning training course in dermoscopy into the curriculum of FM residents results in a significant improvement in their diagnosis skills and meets their expectations. Developing a program combining an e-learning course and face-to-face training for residents is likely to result in more frequent and effective dermoscopy use by family doctors.
OBJECTIVE: This study aimed to evaluate the evolution of dermoscopy knowledge among family doctors immediately and 1 and 3 months after e-learning training.
METHODS: We conducted a prospective interventional study between April and November 2020 to evaluate an educational program intended for family medicine residents at the University of Montpellier-Nîmes, France. They were asked to complete an e-learning course consisting of 2 modules, with an assessment quiz repeated at 1 (M1) and 3 months (M3). The course was based on a 2-step algorithm, a method of dermoscopic analysis of pigmented skin lesions that is internationally accepted. The objectives of modules 1 and 2 were to differentiate melanocytic lesions from nonmelanocytic lesions and to precisely identify skin lesions by looking for dermoscopic morphological criteria specific to each lesion. Each module consisted of 15 questions with immediate feedback after each question.
RESULTS: In total, 134 residents were included, and 66.4% (n=89) and 47% (n=63) of trainees fully participated in the evaluation of module 1 and module 2, respectively. This study showed a significant score improvement 3 months after the training course in 92.1% (n=82) of participants for module 1 and 87.3% (n=55) of participants for module 2 (P<.001). The majority of the participants expressed satisfaction (n=48, 90.6%) with the training course, and 96.3% (n=51) planned to use a dermatoscope in their future practice. Regarding final scores, the only variable that was statistically significant was the resident\'s initial scores (P=.003) for module 1. No measured variable was found to be associated with retention (midtraining or final evaluation) for module 2. Residents who had completed at least 1 dermatology rotation during medical school had significantly higher initial scores in module 1 at M0 (P=.03). Residents who reported having completed at least 1 dermatology rotation during their family medicine training had a statistically significant higher score at M1 for module 1 and M3 for module 2 (P=.01 and P=.001).
CONCLUSIONS: The integration of an e-learning training course in dermoscopy into the curriculum of FM residents results in a significant improvement in their diagnosis skills and meets their expectations. Developing a program combining an e-learning course and face-to-face training for residents is likely to result in more frequent and effective dermoscopy use by family doctors.
摘要：
背景：皮肤癌是世界范围内诊断出的最常见的癌症。衰老和阳光照射会增加他们的风险。皮肤科医生数量的减少正在将皮肤科筛查的问题推回到家庭医生身上。皮肤镜检查是一种易于使用的工具，可将黑色素瘤诊断的敏感性提高60％至90％，但是由于缺乏培训，它的使用受到限制。“理想”皮肤镜检查训练的特点尚未确立。我们创建了基于Moodle（MoodleHQ）的电子学习课程，以培训家庭医学居民的皮肤镜检查。
目的：本研究旨在评估在线学习培训后立即以及1和3个月家庭医生的皮肤镜检查知识的演变。
方法：我们在2020年4月至11月之间进行了一项前瞻性干预研究，以评估蒙彼利埃尼姆大学针对家庭医学居民的教育计划。法国。他们被要求完成由两个模块组成的电子学习课程，在1个月（M1）和3个月（M3）重复评估测验。该课程基于两步算法，一种国际上接受的色素沉着皮肤病变的皮肤镜分析方法。模块1和模块2的目标是区分黑素细胞病变与非黑素细胞病变，并通过寻找特定于每个病变的皮肤镜形态学标准来精确识别皮肤病变。每个模块由15个问题组成，每个问题后都有即时反馈。
结果：总计，其中包括134名居民，66.4%(n=89)和47%(n=63)的受训者分别充分参与了模块1和模块2的评估。这项研究表明，培训课程后3个月，模块1的92.1％（n=82）的参与者和模块2的87.3％（n=55）的参与者得分显着提高（P<0.001）。大多数参与者对培训课程表示满意（n=48，90.6％），96.3%(n=51)计划在未来的实践中使用皮镜。关于最后的分数，唯一有统计学意义的变量是第1组居民的初始评分(P=.003).没有发现测量变量与模块2的保留(中期训练或最终评估)相关。在医学院期间完成至少1次皮肤科轮换的居民在M0时在模块1中的初始得分明显更高（P=0.03）。报告在家庭医学培训期间完成至少1次皮肤科轮换的居民在模块1的M1和模块2的M3时具有统计学上显着的较高得分（P=0.01和P=0.001）。
结论：将皮肤镜检查的电子学习培训课程整合到FM居民的课程中，可以显着提高他们的诊断技能并满足他们的期望。为居民开发一个结合电子学习课程和面对面培训的计划，可能会导致家庭医生更频繁和有效地使用皮肤镜检查。
目的：本研究旨在评估在线学习培训后立即以及1和3个月家庭医生的皮肤镜检查知识的演变。
方法：我们在2020年4月至11月之间进行了一项前瞻性干预研究，以评估蒙彼利埃尼姆大学针对家庭医学居民的教育计划。法国。他们被要求完成由两个模块组成的电子学习课程，在1个月（M1）和3个月（M3）重复评估测验。该课程基于两步算法，一种国际上接受的色素沉着皮肤病变的皮肤镜分析方法。模块1和模块2的目标是区分黑素细胞病变与非黑素细胞病变，并通过寻找特定于每个病变的皮肤镜形态学标准来精确识别皮肤病变。每个模块由15个问题组成，每个问题后都有即时反馈。
结果：总计，其中包括134名居民，66.4%(n=89)和47%(n=63)的受训者分别充分参与了模块1和模块2的评估。这项研究表明，培训课程后3个月，模块1的92.1％（n=82）的参与者和模块2的87.3％（n=55）的参与者得分显着提高（P<0.001）。大多数参与者对培训课程表示满意（n=48，90.6％），96.3%(n=51)计划在未来的实践中使用皮镜。关于最后的分数，唯一有统计学意义的变量是第1组居民的初始评分(P=.003).没有发现测量变量与模块2的保留(中期训练或最终评估)相关。在医学院期间完成至少1次皮肤科轮换的居民在M0时在模块1中的初始得分明显更高（P=0.03）。报告在家庭医学培训期间完成至少1次皮肤科轮换的居民在模块1的M1和模块2的M3时具有统计学上显着的较高得分（P=0.01和P=0.001）。
结论：将皮肤镜检查的电子学习培训课程整合到FM居民的课程中，可以显着提高他们的诊断技能并满足他们的期望。为居民开发一个结合电子学习课程和面对面培训的计划，可能会导致家庭医生更频繁和有效地使用皮肤镜检查。
