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Skin of color education in dermatology residency programs: Does residency training reflect the changing demographics of the United States?
P1804
P1806
Impact of a cybertutor in dermatology teaching Mariana Soirefmann, MD, Federal University of Rio Grande do Sul, Porto Alegre, Santa Cecilia, Brazil; Chao Wen, MD, PhD, University of Sao Paulo, Sao Paulo, Cerqueira Cesar, Brazil; Cristiane Comparin, MD, Federal University of Rio Grande do Sul, Porto Alegre, Bom Fim, Brazil; Tania Cestari, MD, PhD, Federal University of Rio Grande do Sul, Porto Alegre, Santa Cecı´lia, Brazil
Skin of color education in dermatology residency programs: Does residency training reflect the changing demographics of the United States? Rajiv I. Nijhawan, MD, University of Miami Miller School of Medicine, Miami, FL, United States; Heather Woolery-Lloyd, MD, University of Miami Miller School of Medicine, Miami Beach, FL, United States; Sharon E. Jacob, MD, University of CA, San Diego, San Diego, CA, United States
Background: Telemedicine and its branch, teledermatology, is the use of telecommunication technologies to bridge distance and support health care delivery and education. The current model of undergraduate medical education is under debate because knowledge retention and student interest seems to be decreasing. We have proposed this study in order to develop and evaluate a computer-aided learning program, using a multimedia presentation about infestations in dermatology as a model, aiming to provide a more attractive and updated learning tool. Objective: To evaluate the impact of an interactive Web site or multimedia program, the Cybertutor, for undergraduate teaching in dermatology. Methods: A total of 50 medical students from the fifth and sixth semesters of the Federal University of Rio Grande do Sul (UFRGS) were randomized into two groups: group 1 was submitted to a multimedia program of a specific dermatologic subject (infestations), and group 2 attended a standard lecture on the same subject at the same time. At the end, the level of knowledge acquisition for the two groups was evaluated by a multiple choice test containing 15 questions. Group 1 students also answered a questionnaire about their subjective feelings on computer based teaching; their opinion about a digital lecture format as an adequate replacement for live lectures was also assessed. Results: The average of correct answers were 11.16 (SD ¼ 1.625) in group 1 and 11.96 (SD ¼ 1.645) in group 2. There were no statistically significant difference between the two groups (P ¼.09). More than 80% of the students who attended the Cybertutor group manifested interest in participating on similar activities in the future. However, 20 of 25 students using the multimedia program believed that it did not entirely replace the instructor and the interaction with a mentor was considered relevant.
Background: It is projected that by the year 2050, close to 50% of the United States population will be comprised of people with skin of color.
Conclusions: According to this study, multimedia programs can be used for undergraduate education in dermatology as a complementary educational tool. Moreover, the direct contact with an instructor is still considered to be important, and should be concomitantly offered to students.
Objective: To assess if the future dermatologists will be prepared to treat patients with skin of color. Methods: An e-mail with a link to a brief 9-question survey was sent to all 109 program directors and chief residents. Results: Forty-one (37.6%) program directors and 63 (50.0%) chief residents completed the online survey. More than 14% (14.3%; P \.001) of chief residents and 14.6% (P \.001) of program directors recognized an expert at their institutions who conducted a skin of color clinic. More than one quarter (25.4%; P \.001) of chief residents and 19.5% (P \.001) of program directors reported having lectures on skin of color from an acknowledged expert. Almost one-third (30.2%; P\.001) of chief residents and 12.2% (P \ .001) of program directors reported a specific rotation in which residents gained specific experience in treating patients with skin of color (52.4%; P ¼.70) of chief residents and 65.9% (P \.02) of program directors reported to have either lectures or didactic sessions focusing on diseases in skin of color incorporated into their curriculums. More than 80% (84.1%; P \.001) of chief residents and 90.2% (P \ .001) of program directors reported having training programs in which residents gained experience treating patients with central centrifugal cicatricial alopecia. All (100%; P \ .001) of both chief residents and program directors reported having training programs in which residents gained experience treating patients with keloids and melasma. Conclusion: The results indicate a need for increased exposure, educational sessions, and overall training in diseases pertaining to skin of color in US dermatology residencies. Commercial support: None identified.
Commercial support: None identified.
P1807 A cost-effective proficiency- and knowledge-based shave biopsy workshop for health care provider trainees Brenda Chrastil-LaTowsky, University of Texas MD Anderson Cancer Center, Houston, TX, United States; Rungsima Wanitphakdeedecha, MD, Siriraj Hospital, Bangkok, Bangkoknoi, Thailand; T. Minsue Chen, MD, University of Texas MD Anderson Cancer Center, Houston, TX, United States; Tri H. Nguyen, MD, University of Texas MD Anderson Cancer Center, Houston, TX, United States
P1805 The changing attitudes and behaviors of sun protection Jessica Taff, PhD, New Age Skin Research Foundation, Fresh Meadows, NY, United States; James Briley, MD, New Age Skin Research Foundation, Fresh Meadows, NY, United States; Joshua Fox, MD, New Age Skin Research Foundation, Fresh Meadows, NY, United States; New Age Skin Research Group, New Age Skin Research Foundation, Fresh Meadows, NY, United States; Rao Saladi, MD, New Age Skin Research Foundation, Fresh Meadows, NY, United States Background: In recent years, studies of attitudes and behaviors of sun protection have concentrated largely on Australian populations. To our knowledge, these changing attitudes and behaviors have been minimally assessed in the United States. Objective: In this study, we assessed the knowledge of proper sunscreen use and other sun protectionerelated behaviors and attitudes. Methods: A survey of 24 questions assessed the variables of age, sex, race, education, and skin type. The attitudes, knowledge, and behaviors of tanning and sunscreen use, etc, were also evaluated. The study was conducted at four categorical locations; public beach(es), public area(s) such as malls and parks, dermatology office(s), and college campus(es) in the Tristate area (New York, New Jersey, or Connecticut). Results: Two thousand two hundred fifty-two respondents were collected: 34.6% from public beaches, 33.3% from public malls, 24.6% from college campuses, and 7.5% from dermatology offices. At these settings, 42.13% of the beach goers used sunscreen daily or almost everyday, 31.33 % used sunscreen occasionally, and 25.63% never used sunscreen. Among these, 15.5% reported going to the tanning salon. More than 30 % (30.30%) of the public area goers used sunscreen daily or almost everyday, 32.90% used sunscreen occasionally, and 36.80% never used sunscreen. Among these, 10.05% reported going to the tanning salon. The college campus results indicated 38.9% sunscreen use daily or almost everyday, 21.63% occasional sunscreen use, and 38.23% never using sunscreen. Among these, 15.6% reported going to the tanning salon. Of those questioned in the dermatology offices, 56.90% indicated sunscreen use daily or almost everyday, 23.00% reported sunscreen use occasionally, and 20.00 % never used sunscreen. Among these, 10.40% reported going to the tanning salon.
Background: The shave biopsy is a commonly performed skin biopsy procedure. Trainees (medical students and nondermatology residents) on a general dermatology rotation at our institution are provided with a training workshop for indications and technique for the shave biopsy procedure. Subsequently, trainees are allowed to perform shave biopsies during the rotation. Objectives: To validate a cost-effective shave biopsy training model to teach health care provider trainees: (1) indications and (2) technique. Methods: Sixty-one second-year medical students were surveyed on their previous exposure and experience with shave biopsies and evaluated on knowledge of indications. After demonstrating their technique, each trainee was graded by two independent investigators using a 5-point scale on: whether the lesional skin biopsy had a smooth edge, if biopsied specimen was accurate (at the ink), and if technique used was safe. Afterwards, a 10-minute PowerPoint presentation reviewed key principles (indications, technique, and safety). Participants were then given a series of tasks to practice and refine their skills (various depths, size, and shapes) accompanied with real-time feedback. Trainees again were evaluated using the same criteria and grading scale as before. Postintervention surveys were completed to assess trainee confidence to perform a shave biopsy and satisfaction with the workshop. Results: Only one trainee reported receiving formal training on the shave biopsy technique and had performed a shave biopsy before the workshop. The average confidence the students reported before teaching workshop was 2.75 on a 5-point scale (1 ¼ strongly disagree to confidence, 5¼ strongly agree to confidence) before instruction and 4.85 after instruction. More than half of participants (n ¼ 34) demonstrated unsafe technique. The average score for a smooth edge and accuracy before instruction was 1.17 and 2.66, respectively (1 ¼ 0-20% of circumference, 2 ¼ 21-40%, 3 ¼ 41-60%, 4 ¼ 61-80%, and 5 ¼ 81-100%). After the intervention, participants demonstrated knowledge of shave biopsy indications, technique (smooth edge and accuracy average score, respectively: 4.87 and 4.82), safe instrument handling (n ¼ 61), and confidence (4.85 on 5-point scale) to perform a shave biopsy. All participants reported this training model to be helpful. Comments were all positive and included ‘‘this was the best hour of medical school thus far.’’
Conclusions: While many individuals are educated about the dangers of sun damage and skin cancer and the importance of sunscreen use, understanding of proper use and reinforcement of positive sunscreen behaviors remains insufficient and additional efforts to educate are needed.
Conclusions: Although a relatively straightforward procedure, health care providers rarely receive formal training on the indications and technique of the shave biopsy. A formal training module such as the one we describe is an effective way to provide training, increase safety and confidence as well as educate trainees on the indications of a shave biopsy.
Commercial support: None identified.
Commercial support: None identified.
MARCH 2009
J AM ACAD DERMATOL
AB91
P1806
Impact of a cybertutor in dermatology teaching Mariana Soirefmann, MD, Federal University of Rio Grande do Sul, Porto Alegre, Santa Cecilia, Brazil; Chao Wen, MD, PhD, University of Sao Paulo, Sao Paulo, Cerqueira Cesar, Brazil; Cristiane Comparin, MD, Federal University of Rio Grande do Sul, Porto Alegre, Bom Fim, Brazil; Tania Cestari, MD, PhD, Federal University of Rio Grande do Sul, Porto Alegre, Santa Cecı´lia, Brazil
Skin of color education in dermatology residency programs: Does residency training reflect the changing demographics of the United States? Rajiv I. Nijhawan, MD, University of Miami Miller School of Medicine, Miami, FL, United States; Heather Woolery-Lloyd, MD, University of Miami Miller School of Medicine, Miami Beach, FL, United States; Sharon E. Jacob, MD, University of CA, San Diego, San Diego, CA, United States
Background: Telemedicine and its branch, teledermatology, is the use of telecommunication technologies to bridge distance and support health care delivery and education. The current model of undergraduate medical education is under debate because knowledge retention and student interest seems to be decreasing. We have proposed this study in order to develop and evaluate a computer-aided learning program, using a multimedia presentation about infestations in dermatology as a model, aiming to provide a more attractive and updated learning tool. Objective: To evaluate the impact of an interactive Web site or multimedia program, the Cybertutor, for undergraduate teaching in dermatology. Methods: A total of 50 medical students from the fifth and sixth semesters of the Federal University of Rio Grande do Sul (UFRGS) were randomized into two groups: group 1 was submitted to a multimedia program of a specific dermatologic subject (infestations), and group 2 attended a standard lecture on the same subject at the same time. At the end, the level of knowledge acquisition for the two groups was evaluated by a multiple choice test containing 15 questions. Group 1 students also answered a questionnaire about their subjective feelings on computer based teaching; their opinion about a digital lecture format as an adequate replacement for live lectures was also assessed. Results: The average of correct answers were 11.16 (SD ¼ 1.625) in group 1 and 11.96 (SD ¼ 1.645) in group 2. There were no statistically significant difference between the two groups (P ¼.09). More than 80% of the students who attended the Cybertutor group manifested interest in participating on similar activities in the future. However, 20 of 25 students using the multimedia program believed that it did not entirely replace the instructor and the interaction with a mentor was considered relevant.
Background: It is projected that by the year 2050, close to 50% of the United States population will be comprised of people with skin of color.
Conclusions: According to this study, multimedia programs can be used for undergraduate education in dermatology as a complementary educational tool. Moreover, the direct contact with an instructor is still considered to be important, and should be concomitantly offered to students.
Objective: To assess if the future dermatologists will be prepared to treat patients with skin of color. Methods: An e-mail with a link to a brief 9-question survey was sent to all 109 program directors and chief residents. Results: Forty-one (37.6%) program directors and 63 (50.0%) chief residents completed the online survey. More than 14% (14.3%; P \.001) of chief residents and 14.6% (P \.001) of program directors recognized an expert at their institutions who conducted a skin of color clinic. More than one quarter (25.4%; P \.001) of chief residents and 19.5% (P \.001) of program directors reported having lectures on skin of color from an acknowledged expert. Almost one-third (30.2%; P\.001) of chief residents and 12.2% (P \ .001) of program directors reported a specific rotation in which residents gained specific experience in treating patients with skin of color (52.4%; P ¼.70) of chief residents and 65.9% (P \.02) of program directors reported to have either lectures or didactic sessions focusing on diseases in skin of color incorporated into their curriculums. More than 80% (84.1%; P \.001) of chief residents and 90.2% (P \ .001) of program directors reported having training programs in which residents gained experience treating patients with central centrifugal cicatricial alopecia. All (100%; P \ .001) of both chief residents and program directors reported having training programs in which residents gained experience treating patients with keloids and melasma. Conclusion: The results indicate a need for increased exposure, educational sessions, and overall training in diseases pertaining to skin of color in US dermatology residencies. Commercial support: None identified.
Commercial support: None identified.
P1807 A cost-effective proficiency- and knowledge-based shave biopsy workshop for health care provider trainees Brenda Chrastil-LaTowsky, University of Texas MD Anderson Cancer Center, Houston, TX, United States; Rungsima Wanitphakdeedecha, MD, Siriraj Hospital, Bangkok, Bangkoknoi, Thailand; T. Minsue Chen, MD, University of Texas MD Anderson Cancer Center, Houston, TX, United States; Tri H. Nguyen, MD, University of Texas MD Anderson Cancer Center, Houston, TX, United States
P1805 The changing attitudes and behaviors of sun protection Jessica Taff, PhD, New Age Skin Research Foundation, Fresh Meadows, NY, United States; James Briley, MD, New Age Skin Research Foundation, Fresh Meadows, NY, United States; Joshua Fox, MD, New Age Skin Research Foundation, Fresh Meadows, NY, United States; New Age Skin Research Group, New Age Skin Research Foundation, Fresh Meadows, NY, United States; Rao Saladi, MD, New Age Skin Research Foundation, Fresh Meadows, NY, United States Background: In recent years, studies of attitudes and behaviors of sun protection have concentrated largely on Australian populations. To our knowledge, these changing attitudes and behaviors have been minimally assessed in the United States. Objective: In this study, we assessed the knowledge of proper sunscreen use and other sun protectionerelated behaviors and attitudes. Methods: A survey of 24 questions assessed the variables of age, sex, race, education, and skin type. The attitudes, knowledge, and behaviors of tanning and sunscreen use, etc, were also evaluated. The study was conducted at four categorical locations; public beach(es), public area(s) such as malls and parks, dermatology office(s), and college campus(es) in the Tristate area (New York, New Jersey, or Connecticut). Results: Two thousand two hundred fifty-two respondents were collected: 34.6% from public beaches, 33.3% from public malls, 24.6% from college campuses, and 7.5% from dermatology offices. At these settings, 42.13% of the beach goers used sunscreen daily or almost everyday, 31.33 % used sunscreen occasionally, and 25.63% never used sunscreen. Among these, 15.5% reported going to the tanning salon. More than 30 % (30.30%) of the public area goers used sunscreen daily or almost everyday, 32.90% used sunscreen occasionally, and 36.80% never used sunscreen. Among these, 10.05% reported going to the tanning salon. The college campus results indicated 38.9% sunscreen use daily or almost everyday, 21.63% occasional sunscreen use, and 38.23% never using sunscreen. Among these, 15.6% reported going to the tanning salon. Of those questioned in the dermatology offices, 56.90% indicated sunscreen use daily or almost everyday, 23.00% reported sunscreen use occasionally, and 20.00 % never used sunscreen. Among these, 10.40% reported going to the tanning salon.
Background: The shave biopsy is a commonly performed skin biopsy procedure. Trainees (medical students and nondermatology residents) on a general dermatology rotation at our institution are provided with a training workshop for indications and technique for the shave biopsy procedure. Subsequently, trainees are allowed to perform shave biopsies during the rotation. Objectives: To validate a cost-effective shave biopsy training model to teach health care provider trainees: (1) indications and (2) technique. Methods: Sixty-one second-year medical students were surveyed on their previous exposure and experience with shave biopsies and evaluated on knowledge of indications. After demonstrating their technique, each trainee was graded by two independent investigators using a 5-point scale on: whether the lesional skin biopsy had a smooth edge, if biopsied specimen was accurate (at the ink), and if technique used was safe. Afterwards, a 10-minute PowerPoint presentation reviewed key principles (indications, technique, and safety). Participants were then given a series of tasks to practice and refine their skills (various depths, size, and shapes) accompanied with real-time feedback. Trainees again were evaluated using the same criteria and grading scale as before. Postintervention surveys were completed to assess trainee confidence to perform a shave biopsy and satisfaction with the workshop. Results: Only one trainee reported receiving formal training on the shave biopsy technique and had performed a shave biopsy before the workshop. The average confidence the students reported before teaching workshop was 2.75 on a 5-point scale (1 ¼ strongly disagree to confidence, 5¼ strongly agree to confidence) before instruction and 4.85 after instruction. More than half of participants (n ¼ 34) demonstrated unsafe technique. The average score for a smooth edge and accuracy before instruction was 1.17 and 2.66, respectively (1 ¼ 0-20% of circumference, 2 ¼ 21-40%, 3 ¼ 41-60%, 4 ¼ 61-80%, and 5 ¼ 81-100%). After the intervention, participants demonstrated knowledge of shave biopsy indications, technique (smooth edge and accuracy average score, respectively: 4.87 and 4.82), safe instrument handling (n ¼ 61), and confidence (4.85 on 5-point scale) to perform a shave biopsy. All participants reported this training model to be helpful. Comments were all positive and included ‘‘this was the best hour of medical school thus far.’’
Conclusions: While many individuals are educated about the dangers of sun damage and skin cancer and the importance of sunscreen use, understanding of proper use and reinforcement of positive sunscreen behaviors remains insufficient and additional efforts to educate are needed.
Conclusions: Although a relatively straightforward procedure, health care providers rarely receive formal training on the indications and technique of the shave biopsy. A formal training module such as the one we describe is an effective way to provide training, increase safety and confidence as well as educate trainees on the indications of a shave biopsy.
Commercial support: None identified.
Commercial support: None identified.
MARCH 2009
J AM ACAD DERMATOL
AB91