Web-Based Course Improved Physician Skin Cancer Skills

The completion of a short web-based course improved the ability of primary care physicians to diagnose and manage benign and malignant skin cancer, according to the results of a study published in the Journal of the American Board of Family Medicine.

“We want to reduce skin cancer morbidity and mortality, and primary care is the frontline for early cancer detection; however, there are increasing demands on primary care providers’ time and talent,” said Melody Eide, MD, a dermatologist at Henry Ford Hospital, Detroit. “Recognizing these demands, web-based courses may be particularly efficient for continuing education.”

The INFORMED study (Internet Curriculum for Melanoma Early Detection) used a voluntary before-and-after evaluation of a 1- to 2-hour web-based course. The researchers recruited 54 primary care physicians from nine practices in June 2011. The participants’ ability to diagnose and manage skin cancer was evaluated prior to the course, immediately after the course, and again at 6 months.

The web-based course covered the three most common skin cancers-basal cell carcinoma, squamous cell carcinoma, and melanoma, and featured 450 clinical images of lesions. The participants chose from two web options-traditional textbook format and case-based format. The case-based format featured nine case studies with interactive self-assessment tests and immediate feedback.

“Our study was conducted in a “real world” environment,” Eide said. “Practicing primary care physicians took this short course after busy clinic days, and examination of their actual practice patterns showed they improved their skin cancer diagnostic and management skills for at least 6 months.”

Only 15% of the participants reported having had any skin cancer education since beginning their practice. After completing the education, participants improved their score for diagnosing and managing all skin cancer lesions from 36.1% on the pretest to 46.7% on the immediate post-test. In addition, scores for diagnosing benign lesions also increased from 32.1% to 46.3%.

As a result of the education, patient referrals for suspicious lesions or new visits to a dermatology specialist declined. At the 6-month evaluation, the participants had still retained their improved skill level.

“We hope our open access web-based program will be practical for use by many primary care physicians and ultimately result in earlier diagnosis and management of skin cancer,” Eide said.