title: Recognition of melanoma: a dermatologic clinical competency in medical student education.
abstract: BACKGROUND
  Non-dermatologist physicians are well positioned for opportunistic melanoma detection; however, education in the skin cancer examination is limited during medical school and traditionally lecture-based. Simulating melanoma cases provides a means to demonstrate whether proficiency in knowledge and recognition of melanoma images translates into improved clinical skill.
  
  
  OBJECTIVE
  To evaluate medical student recognition and appropriate response to a prosthetic melanoma placed on a standardized patient (SP) during a simulated clinical encounter.
  
  
  METHODS
  In this pilot study, prosthetic mimics of melanoma were placed on the backs of SPs unbeknownst to a convenience sample of 59 second-year medical students. The study took place during clinical skills practice sessions with SPs conducted from February to April 2010 at Mount Sinai School of Medicine (New York, NY). SPs presented with non-dermatologic chief complaints typical for an acute office visit. All students had the opportunity to attend a lecture on the clinical signs of melanoma 2 to 4 months earlier, for which pre-test and post-test data were collected.
  
  
  RESULTS
  Recognition and evaluation of a prosthetic melanoma as determined by querying the SPs and reviewing the students' examination notes. During the SP encounter, 37 students (63%) asked about the melanoma moulage; of those, 25 (68%) made recommendations for further evaluation. The moulage was documented in 17 examination notes (43%). Thirty-three students (56%) asked about the skin on review of systems, although this did not predict moulage detection.
  
  
  CONCLUSIONS
  Prosthetic mimics of melanoma are useful tools for assessing skin cancer awareness and detection skills among medical students.
authors.affiliation: Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10022, USA.
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Goulart
authors.forename: Stephen
authors.initials: S
authors.lastname: Dusza
authors.forename: Amanda
authors.initials: A
authors.lastname: Pillsbury
authors.forename: Rainier P
authors.initials: RP
authors.lastname: Soriano
authors.forename: Allan C
authors.initials: AC
authors.lastname: Halpern
authors.forename: Ashfaq A
authors.initials: AA
authors.lastname: Marghoob
mesh_terms: D002983:Clinical Competence; D003162:Competency-Based Education / Q000379:methods*; D003880:Dermatology / Q000193:education*; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D008545:Melanoma / Q000175:diagnosis*; D008953:Models, Anatomic; D016544:Patient Simulation; D010865:Pilot Projects; D012878:Skin Neoplasms / Q000175:diagnosis*