Christa Slaught1, Pamela Madu2, Aileen Y Chang3, Victoria L Williams4,5,6, Masego B Kebaetse7, Oathokwa Nkomazana8, Onkabetse Julia Molefe-Baikai9, Negussie A Bekele9, Bernard Omech10, Philip J Kellman11, Sally Krasne12, Carrie L Kovarik6. 1. 78843 Department of Dermatology, Oregon Health and Sciences University, Portland, OR, USA. 2. 12223 Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA. 3. 8785 Department of Dermatology, University of California San Francisco School of Medicine, CA, USA. 4. 14640 Botswana University of Pennsylvania Partnership, Gaborone, Botswana. 5. Merck & Co, Inc, North Wales, PA, USA. 6. 14640 Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, PA, USA. 7. 54547 Department of Medical Education, Faculty of Medicine, University of Botswana, Gaborone, Botswana. 8. 54547 Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana. 9. 54547 Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana. 10. 487455 Faculty of Health Sciences, Lira University, Uganda. 11. 8783 Department of Psychology, University of California, Los Angeles, CA, USA. 12. 12222 Department of Physiology, David Geffen School of Medicine, Los Angeles, CA, USA.
Abstract
BACKGROUND: Representative images of pathology in patients with skin of color are lacking in most medical education resources. This particularly affects training in dermatology, which relies heavily on the use of images to teach pattern recognition. The presentation of skin pathology can vary greatly among different skin tones, and this lack of representation of dark skin phototypes challenges providers' abilities to provide quality care to patients of color.In Botswana and other countries in sub-Saharan Africa, this challenge is further compounded by limited resources and access to dermatologists. There is a need for improved and accessible educational resources to train medical students and local medical providers in basic skin lesion description and diagnosis. OBJECTIVES: We examined whether online Perceptual and Adaptive Learning Modules (PALMs) composed of representative dark skin images could efficiently train University of Botswana medical students to more accurately describe and diagnose common skin conditions in their community. METHODS: Year 4 and 5 medical students voluntarily completed PALMs that teach skin morphology, configuration, and distribution terminology and diagnosis of the most common dermatologic conditions in their community. Pre-tests, post-tests and delayed-tests assessed knowledge acquisition and retention. RESULTS: PALMs training produced statistically significant (P < .0001) improvements in accuracy and fluency with large effect sizes (1.5, 3.7) and good retention after a 12.5-21-week median delay. Limitations were a self-selected group of students, a single institution, slow internet connections, and high drop-out rates. CONCLUSIONS: Overall, population-specific PALMs are a useful tool for efficient development of pattern recognition in skin disease description and diagnosis.
BACKGROUND: Representative images of pathology in patients with skin of color are lacking in most medical education resources. This particularly affects training in dermatology, which relies heavily on the use of images to teach pattern recognition. The presentation of skin pathology can vary greatly among different skin tones, and this lack of representation of dark skin phototypes challenges providers' abilities to provide quality care to patients of color.In Botswana and other countries in sub-Saharan Africa, this challenge is further compounded by limited resources and access to dermatologists. There is a need for improved and accessible educational resources to train medical students and local medical providers in basic skin lesion description and diagnosis. OBJECTIVES: We examined whether online Perceptual and Adaptive Learning Modules (PALMs) composed of representative dark skin images could efficiently train University of Botswana medical students to more accurately describe and diagnose common skin conditions in their community. METHODS: Year 4 and 5 medical students voluntarily completed PALMs that teach skin morphology, configuration, and distribution terminology and diagnosis of the most common dermatologic conditions in their community. Pre-tests, post-tests and delayed-tests assessed knowledge acquisition and retention. RESULTS: PALMs training produced statistically significant (P < .0001) improvements in accuracy and fluency with large effect sizes (1.5, 3.7) and good retention after a 12.5-21-week median delay. Limitations were a self-selected group of students, a single institution, slow internet connections, and high drop-out rates. CONCLUSIONS: Overall, population-specific PALMs are a useful tool for efficient development of pattern recognition in skin disease description and diagnosis.