Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

  • Jacqueline M. Goulart
  • Elizabeth A. Quigley
  • Stephen Dusza
  • Sarah T. Jewell
  • Gwen Alexander
  • Maryam M. Asgari
  • Melody J. Eide
  • Suzanne W. Fletcher
  • Alan C. Geller
  • Ashfaq A. Marghoob
  • Martin A. Weinstock
  • Allan C. Halpern
  • INFORMED (INternet curriculum FOR Melanoma Early Detection) Group
Reviews

DOI: 10.1007/s11606-011-1692-y

Cite this article as:
Goulart, J.M., Quigley, E.A., Dusza, S. et al. J GEN INTERN MED (2011) 26: 1027. doi:10.1007/s11606-011-1692-y

ABSTRACT

BACKGROUND

Early detection of melanoma may provide an opportunity to positively impact melanoma mortality. Numerous skin cancer educational interventions have been developed for primary care physicians (PCPs) to improve diagnostic accuracy. Standardized training is also a prerequisite for formal testing of melanoma screening in the primary care setting.

OBJECTIVE

We conducted a systematic review to determine the extent of evaluated interventions designed to educate PCPs about skin cancer, including melanoma.

DESIGN

Relevant studies in the English language were identified through systemic searches performed in MEDLINE, EMBASE, BIOSIS, and Cochrane through December 2010. Supplementary information was obtained from corresponding authors of the included studies when necessary.

APPROACH

Studies eligible for inclusion formally evaluated skin cancer education interventions and were designed primarily for PCPs. Excluded studies lacked a specified training intervention, used decision-making software, focused solely on risk factor identification, or did not directly educate or assess participants. Twenty studies met the selection criteria. Data were extracted according to intervention content and delivery format, and study outcomes.

KEY RESULTS

All interventions included instructions about skin cancer diagnosis, but otherwise varied in content. Curricula utilized six distinct educational techniques, usually incorporating more than one. Intervention duration varied from 12 min to over 6 h. Eight of the 20 studies were randomized trials. Most studies (18/20, 90%) found a significant improvement in at least one of the following five outcome categories: knowledge, competence, confidence, diagnostic performance, or systems outcomes. Competence was most commonly measured; no study evaluated all categories. Variability in study design, interventions, and outcome measures prevented correlation of outcomes with intervention characteristics.

CONCLUSIONS

Despite the development of many isolated educational interventions, few have been tested rigorously or evaluated under sufficient standardized conditions to allow for quantitative comparison. Improved and rigorously tested skin cancer educational interventions for PCPs with outcome measures focusing on changes in performance are needed.

KEY WORDS

primary care medical education melanoma skin cancer 

Supplementary material

11606_2011_1692_MOESM1_ESM.docx (15 kb)
ESM 1(DOC 15 kb)

Copyright information

© Society of General Internal Medicine 2011

Authors and Affiliations

  • Jacqueline M. Goulart
    • 1
  • Elizabeth A. Quigley
    • 1
    • 11
  • Stephen Dusza
    • 1
  • Sarah T. Jewell
    • 2
  • Gwen Alexander
    • 3
  • Maryam M. Asgari
    • 4
  • Melody J. Eide
    • 3
    • 5
  • Suzanne W. Fletcher
    • 6
  • Alan C. Geller
    • 7
  • Ashfaq A. Marghoob
    • 1
  • Martin A. Weinstock
    • 8
    • 9
    • 10
  • Allan C. Halpern
    • 1
  • INFORMED (INternet curriculum FOR Melanoma Early Detection) Group
  1. 1.Dermatology ServiceMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Medical LibraryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  3. 3.Department of Biostatistics and Research EpidemiologyHenry Ford HospitalDetroitUSA
  4. 4.Division of ResearchKaiser Permanente Northern CaliforniaOaklandUSA
  5. 5.Department of DermatologyHenry Ford HospitalDetroitUSA
  6. 6.Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care InstituteBostonUSA
  7. 7.Division of Public Health PracticeHarvard School of Public HealthBostonUSA
  8. 8.Dermatoepidemiology UnitVeterans Affairs Medical CenterProvidenceUSA
  9. 9.Department of DermatologyRhode Island HospitalProvidenceUSA
  10. 10.Departments of Dermatology and Community HealthBrown UniversityProvidenceUSA
  11. 11.Dermatology ServiceMemorial Sloan-Kettering Cancer CenterBasking RidgeUSA

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