Dermoscopy education to improve provider confidence in skin cancer identification
View/ Open
Abstract
Skin cancer is the most common form of cancer in the United States and is becoming more prevalent each year. Patients often consult their primary care provider (PCP) for initial evaluation of skin lesions, and PCPs typically use naked-eye examination (NEE) to evaluate the lesion. Using NEE alone can yield varying results of accuracy and differential diagnosis. PCPs can utilize a dermatoscope to aid their visual inspection of suspicious lesions.
Dermoscopy, a non-invasive technique for examining skin lesions, has been recognized as an invaluable tool in the early detection of skin cancer. While traditionally used by dermatologists, the need for early identification of skin cancer demands that PCPs utilize dermoscopy to improve patient outcomes. This practice improvement project aimed to increase PCPs accuracy in dermoscopic analysis while improving confidence in performing skin cancer screening and dermatoscope use.
The practice improvement project utilized a pre-training assessment and dermoscopy training that was presented in-person at a primary care clinic in the Midwest and was available online to providers unable to attend in-person. The training was created to equip providers with knowledge of dermoscopy principles, the PASS algorithm, and the ability to differentiate between benign and malignant lesions. Following the training, the clinic was provided with two dermatoscopes, as well as a binder containing PASS algorithm and training references. Providers then had three months to utilize dermoscopy in their clinical practice prior to taking the post-implementation assessment. Pre- and post-assessments were used to gauge the participants' knowledge and confidence levels throughout the project. Project results support literature findings, including actual and perceived improvement in knowledge and confidence of skin lesion identification and triaging.
Continued rise in skin cancer prevalence necessitates PCPs to become more proficient in secondary prevention strategies. The project concluded with the need to advocate for the integration of dermatoscope access and training aimed to equip PCPs with the necessary skills to effectively identify and prioritize skin lesions. By empowering PCPs with the skills to use dermatoscopes in combination with the PASS algorithm, communities can benefit from early detection of skin cancer, fewer unnecessary referrals, and better healthcare outcomes.