Early Melanoma Detection in Primary Care: Clinical Recognition of Melanoma is Not Enough, One Must Also Learn the Basics

Harkemanne, Evelyne; Goublomme, Noémie; Sawadogo, Kiswendsida; Tromme, Isabelle

doi:10.1007/s13187-020-01897-w

Cited by 7 publications

(8 citation statements)

References 22 publications

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“…Of the 63 manuscripts selected for inclusion, 13 (21%) were randomized controlled trials (RCTs) that randomly allocated participants to an intervention or control group [ 22 , 25 , 27 , 29 , 33 , 43 , 48 , 50 , 57 , 64 – 66 , 73 ]. Thirty-seven (59%) were diagnostic accuracy (DA) studies that evaluated changes in diagnostic accuracy following nonrandomized educational or community interventions [ 11 , 15 – 21 , 23 , 24 , 26 , 28 , 31 , 32 , 34 – 36 , 38 , 39 , 41 , 42 , 45 – 47 , 49 , 51 , 54 , 55 , 59 – 61 , 67 , 69 – 72 , 74 , 75 ]. Most DA studies (73%) were prospective cross-sectional studies that evaluated educational outcomes immediately or soon after the intervention, often in comparison to a baseline measure [ 11 , 19 , 21 , 23 , 24 , 26 , 28 , 32 , 34 – 36 , 39 , 41 , 42 , 45 , 46 , 49 , 51 , 54 , 55 , 60 , 61 , 67 , …”

Section: Findings/resultsmentioning

confidence: 99%

“…Thirty-seven (59%) were diagnostic accuracy (DA) studies that evaluated changes in diagnostic accuracy following nonrandomized educational or community interventions [ 11 , 15 – 21 , 23 , 24 , 26 , 28 , 31 , 32 , 34 – 36 , 38 , 39 , 41 , 42 , 45 – 47 , 49 , 51 , 54 , 55 , 59 – 61 , 67 , 69 – 72 , 74 , 75 ]. Most DA studies (73%) were prospective cross-sectional studies that evaluated educational outcomes immediately or soon after the intervention, often in comparison to a baseline measure [ 11 , 19 , 21 , 23 , 24 , 26 , 28 , 32 , 34 – 36 , 39 , 41 , 42 , 45 , 46 , 49 , 51 , 54 , 55 , 60 , 61 , 67 , 69 – 71 , 74 ]. In contrast, a subset of DA studies followed cohorts over time, typically greater than 6 months.…”

Section: Findings/resultsmentioning

confidence: 99%

“…Of these interventions, all taught the clinical appearance of melanoma, while the inclusion of keratinocytic carcinomas (i.e., basal cell carcinoma, squamous cell carcinoma) was variable. Only a third of programs (33%) included skin cancer epidemiology [ 19 – 22 , 26 , 27 , 32 , 33 , 39 , 41 – 43 , 46 , 51 , 52 , 54 , 55 , 57 , 61 , 63 , 75 ]. Counseling on sun safety and skin self-examinations was fairly uncommon (21%), and most interventions that included behavioral counseling for skin cancer prevention did not specify whether primary and/or secondary prevention topics were discussed [ 20 – 22 , 26 , 41 – 43 , 51 , 55 , 59 , 61 , 63 ].…”

Section: Findings/resultsmentioning

confidence: 99%

“…One third of programs (33%) included dermoscopy [ 23 – 25 , 29 – 31 , 34 , 40 , 57 , 59 , 60 , 62 , 65 , 66 , 69 – 71 ]. Of all the programs, 17% and 21% taught clinical algorithms [ 11 , 20 – 22 , 29 , 34 , 48 , 54 , 55 , 63 , 75 ] and dermoscopic algorithms [ 23 – 25 , 29 , 30 , 34 , 40 , 57 , 65 , 67 , 69 , 71 ], respectively, to support diagnostic accuracy.…”

Section: Findings/resultsmentioning

confidence: 99%

“…Each study was also assessed for delivery methods and outcomes, as defined in Table 1 . Over half of the included programs (52%) delivered their content via live/synchronous methods [ 20 , 21 , 23 , 26 , 29 , 31 – 33 , 35 – 38 , 41 , 42 , 42 – 44 , 44 – 46 , 52 , 54 , 57 – 61 , 63 , 67 – 71 , 73 , 74 ]. In contrast, less than a third (30%) of the included programs adopted web-based delivery methods [ 11 , 12 , 15 , 18 , 19 , 22 , 30 , 47 , 50 , 51 , 53 , 55 , 56 , 59 , 65 , 68 , 70 ].…”

Section: Findings/resultsmentioning

confidence: 99%

See 4 more Smart Citations

Educational Interventions to Support Primary Care Provider Performance of Diagnostic Skin Cancer Examinations: A Systematic Literature Review

et al. 2022

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To our knowledge, there is no available standardized educational curriculum designed to promote the incorporation of skin cancer examinations and procedures into general practice. To explore the contemporary training landscape, we conducted a systematic review of educational interventions designed to support skin cancer diagnostic examinations by primary care providers (PCPs). Our review uniquely encompasses all PCPs, including practicing physicians, residents, and advanced practice practitioners (APPs). The objective of this study is to review and synthesize worldwide data on educational interventions addressing PCP performance of skin cancer diagnostic examinations. A systematic review was performed in MEDLINE , Cochrane , EMBASE, and Scopus for English language articles worldwide published from 2000 onwards. Articles were screened for eligibility, and possibly overlapping datasets were resolved. Data extracted included curriculum content, delivery format, and educational outcomes. This review followed the PRISMA guidelines. A total of 63 studies were selected for data inclusion with one addressing training for resident physicians, 4 for APPs, and the remainder for practicing physicians. Educational interventions included in this review reflect the pre-SARS-CoV-2 pandemic educational environment: half provided live/synchronous instruction of about 5-h duration on average, and a quarter featured interactive components. Less than a quarter of interventions included practice change as a specific reported outcome. Without sustainable practice change, the anticipated long-term benefits of early cancer detection in patients remain limited. Previous and existing educational interventions designed to support skin cancer detection by PCPs demonstrate heterogeneous curriculum content, delivery methods, and educational outcomes. An ideal intervention would teach consensus-derived clinical competencies, provide meaningful learner feedback, and measure outcomes, such as knowledge/competency, confidence/attitudes, and practice change, using validated instruments. Supplementary Information The online version contains supplementary material available at 10.1007/s13187-021-02118-8.

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Section: Findings/resultsmentioning

confidence: 99%

Section: Findings/resultsmentioning

confidence: 99%

Section: Findings/resultsmentioning

confidence: 99%

Section: Findings/resultsmentioning

confidence: 99%

Section: Findings/resultsmentioning

confidence: 99%

See 3 more Smart Citations

Educational Interventions to Support Primary Care Provider Performance of Diagnostic Skin Cancer Examinations: A Systematic Literature Review

et al. 2022

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Skin Cancer Education Interventions for Primary Care Providers: A Scoping Review

et al. 2022

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Primary care physicians (PCPs) are often the first line of defense against skin cancers. Despite this, many PCPs do not receive a comprehensive training in skin conditions. Educational interventions aimed at skin cancer screening instruction for PCPs offer an opportunity to detect skin cancer at earlier stages and subsequent improved morbidity and mortality. A scoping review was conducted to collect data about previously reported skin cancer screening interventions for PCPs. A structured literature search found 51 studies describing 37 unique educational interventions. Curriculum elements utilized by the interventions were divided into categories that would facilitate comparison including curriculum components, delivery format, delivery timing, and outcome measures. The interventions varied widely in design, including literature-based interventions, live teaching sessions, and online courses with durations ranging from 5 min to 24 months. While several interventions demonstrated improvements in skin cancer knowledge and competency by written exams, only a few revealed positive clinical practice changes by biopsy review or referral analysis. Examining successful interventions could aid in developing a skin cancer detection curriculum for PCPs that can produce positive clinical practice and population-based changes in the management of skin cancer.

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Short- and Long-Term Evaluation of General Practitioners’ Competences After a Training in Melanoma Diagnosis: Refresher Training Sessions May Be Needed

et al. 2021

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General practitioners (GPs) are first-line clinicians in melanoma diagnosis. It is, therefore, important to ensure that they maintain their melanoma diagnostic accuracy over time. The objective of this study was to assess the short- and long-term competences of GPs after a training session in naked-eye melanoma diagnosis. An interventional prospective study was conducted whereby, over a 6-month period, GPs attended a 1-h melanoma diagnostic training session. To assess their acquired competences, GPs were asked to fill in a questionnaire on basic melanoma knowledge and to evaluate 10 clinical images of pigmented skin lesions prior to training, immediately after and 1 year later. In total, 89 GPs completed the questionnaire prior and immediately after training. As expected, the number of GPs who appropriately managed 50% of the melanoma cases increased after training ( P < 0.001). One year after training, only 27 (30%) of the 89 GPs completed the questionnaire. This number of participants was too low to obtain significant figures but the GPs’ mean overall score of appropriately managed clinical cases was much lower than in the immediate post-test. In conclusion, although this short training improved the GPs’ diagnostic accuracy and management of melanoma in the short-term, participating GPs do not seem to have maintained these competences in the long-term. Further studies are needed to assess whether refresher training sessions are able to sustain acquired diagnostic and management skills. Supplementary Information The online version contains supplementary material available at 10.1007/s13187-021-02063-6.

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Early Melanoma Detection in Primary Care: Clinical Recognition of Melanoma is Not Enough, One Must Also Learn the Basics

Cited by 7 publications

References 22 publications

Educational Interventions to Support Primary Care Provider Performance of Diagnostic Skin Cancer Examinations: A Systematic Literature Review

Educational Interventions to Support Primary Care Provider Performance of Diagnostic Skin Cancer Examinations: A Systematic Literature Review

Skin Cancer Education Interventions for Primary Care Providers: A Scoping Review

Short- and Long-Term Evaluation of General Practitioners’ Competences After a Training in Melanoma Diagnosis: Refresher Training Sessions May Be Needed

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