Skin Cancer Examination Teaching in US Medical Education | Cancer Screening, Prevention, Control | JAMA Dermatology | JAMA Network
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1.
American Cancer Society, Cancer facts & figures 2003. Available at:http://www.cancer.org/downloads/STT/CAFF2003PWSecured.pdfAccessed March 20, 2005
2.
Ries  LAGedEisner  MPedKosary  CLed  et al.  SEER Cancer Statistics Review, 1975-2001.  Bethesda, Md National Cancer InstituteAvailable at:http://www.seer.cancer.gov/csr/1975_2001Accessed March 20, 2005
3.
Karakousis  CPEmrich  LJRao  U Tumor thickness and prognosis in clinical stage I malignant melanoma.  Cancer 1989;641432- 1436PubMedGoogle ScholarCrossref
4.
Freedberg  KAGeller  ACMiller  DRLew  RAKoh  HK Screening for malignant melanoma: a cost-effectiveness analysis.  J Am Acad Dermatol 1999;41738- 745PubMedGoogle ScholarCrossref
5.
Helfand  MMahon  SMEden  KBFrame  PSOrleans  CT Screening for skin cancer.  Am J Prev Med 2001;20 ((suppl)) 47- 58PubMedGoogle ScholarCrossref
6.
Goldsmith  LAKoh  HKBewerse  BA  et al.  Full proceedings from the National Conference to Develop a National Skin Cancer Agenda: American Academy of Dermatology and Centers for Disease Control and Prevention, Washington, D.C., April 8-10, 1995.  J Am Acad Dermatol 1996;35748- 756PubMedGoogle ScholarCrossref
7.
Oliveria  SAChristos  PJMarghoob  AAHalpern  AC Skin cancer screening and prevention in the primary care setting: National Ambulatory Medical Care Survey 1997.  J Gen Intern Med 2001;16297- 301PubMedGoogle ScholarCrossref
8.
Feldman  SRFleischer  AB Skin examinations and skin cancer prevention counseling by US physicians: a long way to go.  J Am Acad Dermatol 2000;43234- 237PubMedGoogle ScholarCrossref
9.
Feldman  SRWilliford  PMFleischer  AB  Jr Lower utilization of dermatologists in managed care: despite growth in managed care, visits to dermatologists did not decrease: an analysis of National Ambulatory Medical Care Survey data, 1990-1992.  J Invest Dermatol 1996;107860- 864PubMedGoogle ScholarCrossref
10.
Geller  ACVenna  SProut  M  et al.  Should the skin cancer examination be taught in medical school?  Arch Dermatol 2002;1381201- 1203PubMedGoogle ScholarCrossref
11.
Robinson  JKMcGaghie  WC Skin cancer detection in a clinical practice examination with standardized patients.  J Am Acad Dermatol 1996;34709- 711PubMedGoogle ScholarCrossref
12.
Gerbert  BBronstone  AWolff  M  et al.  Improving primary care residents' proficiency in the diagnosis of skin cancer.  J Gen Intern Med 1998;1391- 97PubMedGoogle ScholarCrossref
13.
Mikkilineni  RWeinstock  MAGoldstein  MGDube  CERossi  JS Impact of the basic skin cancer triage curriculum on provider's skin cancer control practices.  J Gen Intern Med 2001;16302- 307PubMedGoogle ScholarCrossref
14.
Gerbert  BMaurer  TBerger  T  et al.  Primary care physicians as gatekeepers in managed care: primary care physicians' and dermatologists' skills at secondary prevention of skin cancer.  Arch Dermatol 1996;1321030- 1038PubMedGoogle ScholarCrossref
15.
Wolfson  P Teaching prevention in surgery: is it an oxymoron?  Acad Med 2000;75 ((suppl)) S77- S84PubMedGoogle ScholarCrossref
16.
Association of American Medical Colleges, 2003 Medical School Graduation Questionnaire, all schools report. Available at:http://www.aamc.org/data/gq/allschoolsreports/2003.pdfAccessed March 20, 2005
17.
Knable  AHood  AFPearson  TG Undergraduate medical education in dermatology: report from the AAD Interdisciplinary Education Committee, Subcommittee on Undergraduate Medical Education.  J Am Acad Dermatol 1997;36467- 470PubMedGoogle ScholarCrossref
Study
April 2006

Skin Cancer Examination Teaching in US Medical Education

Author Affiliations

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.

Arch Dermatol. 2006;142(4):439-444. doi:10.1001/archderm.142.4.439
Abstract

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.

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