Melanoma Simulation Model: Promoting Opportunistic Screening and Patient Counseling Journal Article


Authors: Jain, N.; Anderson, M. J.; Patel, P; Blatt, H.; Davis, L.; Bierman, J.; McGaghie, W.; Brucker, J. B.; Martini, M.; Robinson, J. K.
Article Title: Melanoma Simulation Model: Promoting Opportunistic Screening and Patient Counseling
Abstract: IMPORTANCE Lack of training hampers melanoma recognition by physicians. OBJECTIVE To evaluate a melanoma simulation model to teach visual assessment and counseling skills. DESIGN AND SETTING Simulation model study in an academic research setting. PARTICIPANTS A convenience sample of third-year medical students was randomly assigned to receive the intervention before or after a standardized patient. INTERVENTION During the primary care clerkship, medical students participated in melanoma skills training using 2 simulation models replicating melanomas and abnormal or benign nevi. Scoring threshold rules for visual assessment and management of pigmented lesions and videos of patient counseling were provided. MAIN OUTCOME MEASURES Identifying a melanoma moulage and counseling the standardized patient. Secondary measures were preintervention and 2-week postintervention knowledge, attitudes about and confidence in their ability to perform opportunistic surveillance and counseling, as well as identification on the model of clinically suspicious pigmented lesions, lesions needing a biopsy, and lesions to be monitored for change. RESULTS Among 74 students, confidence in their ability to perform opportunistic surveillance improved significantly after skills training (P .05, chi2 test). Monitoring clinically suspicious lesions for change decreased from 16% (12 of 74) to 3% (2 of 74) and performing a biopsy increased from 80% (59 of 74) to 96% (71 of 74), monitoring benign lesions for change decreased from 43% (32 of 74) to 3% (2 of 74), and biopsying melanoma in situ increased from 10% (7 of 74) to 26% (20 of 74) (P .05 for all, chi2 test). Detection of the melanoma moulage on the standardized patient occurred more often by trained students (P .05, chi2 test). CONCLUSION AND RELEVANCE A 1-hour melanoma simulation education and skills training experience improved performance of opportunistic surveillance, management, and patient counseling by third-year medical students. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01191294.
Journal Title: JAMA dermatology (Chicago, Ill.)
ISSN: 2168-6084
Publisher: Unknown  
Date Published: 2013
Start Page: 1
End Page: 7
Language: ENG
DOI/URL:
Notes: ID: 12704; JID: 101589530; aheadofprint; SO: JAMA Dermatol. 2013 Mar 20:1-7. doi: 10.1001/jamadermatol.2013.2882.