Amit Garg1, Katie Biello2, Joyce W Hoot3, Shalini B Reddy3, Lindsay Wilson4, Paul George5, Leslie Robinson-Bostom6, Leah Belazarian7, Erik Domingues7, Jennifer Powers3, Reza Jacob3, Michael Powers3, Justin Besen3, Alan C Geller8. 1. Department of Dermatology, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Electronic address: amgarg@nshs.edu. 2. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. 3. Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts. 4. Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah. 5. Department of Family Medicine, Brown Alpert Medical School, Providence, Rhode Island. 6. Department of Dermatology, Brown Alpert Medical School, Providence, Rhode Island. 7. Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts. 8. Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts.
Abstract
BACKGROUND: Assessing medical students on core skills related to melanoma detection is challenging in the absence of a well-developed instrument. OBJECTIVE: We sought to develop an objective structured clinical examination for the detection and evaluation of melanoma among medical students. METHODS: This was a prospective cohort analysis of student and objective rater agreement on performance of clinical skills and assessment of differences in performance across 3 schools. RESULTS: Kappa coefficients indicated excellent agreement for 3 of 5 core skills including commenting on the presence of the moulage (k = 0.87, 95% confidence interval 0.77-0.96), obtaining a history for the moulage (k = 0.84, 95% confidence interval 0.74-0.94), and making a clinical impression (k = 0.80, 95% confidence interval 0.68-0.92). There were no differences in performance across schools with respect to 3 of 5 core skills: commenting on the presence of the moulage (P = .15), initiating a history (P = .53), and managing the suspicious lesion (P value range .07-.17). Overall, 54.2% and 44.7% of students commented on the presence of the moulage and achieved maximum performance of core skills, respectively, with no difference in performance across schools. LIMITATIONS: Limitations include overall sample size of students and schools. CONCLUSION: The Skin Cancer Objective Structured Clinical Examination represents a potentially important instrument to measure students' performance on the optimal step-by-step evaluation of a melanoma.
BACKGROUND: Assessing medical students on core skills related to melanoma detection is challenging in the absence of a well-developed instrument. OBJECTIVE: We sought to develop an objective structured clinical examination for the detection and evaluation of melanoma among medical students. METHODS: This was a prospective cohort analysis of student and objective rater agreement on performance of clinical skills and assessment of differences in performance across 3 schools. RESULTS: Kappa coefficients indicated excellent agreement for 3 of 5 core skills including commenting on the presence of the moulage (k = 0.87, 95% confidence interval 0.77-0.96), obtaining a history for the moulage (k = 0.84, 95% confidence interval 0.74-0.94), and making a clinical impression (k = 0.80, 95% confidence interval 0.68-0.92). There were no differences in performance across schools with respect to 3 of 5 core skills: commenting on the presence of the moulage (P = .15), initiating a history (P = .53), and managing the suspicious lesion (P value range .07-.17). Overall, 54.2% and 44.7% of students commented on the presence of the moulage and achieved maximum performance of core skills, respectively, with no difference in performance across schools. LIMITATIONS: Limitations include overall sample size of students and schools. CONCLUSION: The Skin Cancer Objective Structured Clinical Examination represents a potentially important instrument to measure students' performance on the optimal step-by-step evaluation of a melanoma.
Authors: Daniel Bauer; Andrea C Lörwald; Sandra Wüst; Helmut Beltraminelli; Miria Germano; Adrian Michel; Kai P Schnabel Journal: BMC Med Educ Date: 2021-06-21 Impact factor: 2.463