title: Melanoma simulation model: promoting opportunistic screening and patient counseling.
abstract: OBJECTIVE
  Lack of training hampers melanoma recognition by physicians.
  
  
  OBJECTIVE
  To evaluate a melanoma simulation model to teach visual assessment and counseling skills.
  
  
  METHODS
  Simulation model study in an academic research setting.
  
  
  METHODS
  A convenience sample of third-year medical students was randomly assigned to receive the intervention before or after a standardized patient.
  
  
  METHODS
  During the primary care clerkship, medical students participated in melanoma skills training using 2 simulation models replicating melanomas and abnormal or benign nevi. Scoring threshold rules for visual assessment and management of pigmented lesions and videos of patient counseling were provided.
  
  
  METHODS
  Identifying a melanoma moulage and counseling the standardized patient. Secondary measures were preintervention and 2-week postintervention knowledge, attitudes about and confidence in their ability to perform opportunistic surveillance and counseling, as well as identification on the model of clinically suspicious pigmented lesions, lesions needing a biopsy, and lesions to be monitored for change. RESULTS Among 74 students, confidence in their ability to perform opportunistic surveillance improved significantly after skills training (P < .05, χ2 test). Monitoring clinically suspicious lesions for change decreased from 16% (12 of 74) to 3% (2 of 74) and performing a biopsy increased from 80% (59 of 74) to 96% (71 of 74), monitoring benign lesions for change decreased from 43% (32 of 74) to 3% (2 of 74), and biopsying melanoma in situ increased from 10% (7 of 74) to 26% (20 of 74) (P < .05 for all, χ2 test). Detection of the melanoma moulage on the standardized patient occurred more often by trained students (P < .05, χ2 test).
  
  
  CONCLUSIONS
  A 1-hour melanoma simulation education and skills training experience improved performance of opportunistic surveillance, management, and patient counseling by third-year medical students.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT01191294.
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, 676NSt Clair St, Ste 1260, Chicago, IL 60611, USA.
authors.forename: Namita
authors.initials: N
authors.lastname: Jain
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Anderson
authors.forename: Pooja
authors.initials: P
authors.lastname: Patel
authors.forename: Hanz
authors.initials: H
authors.lastname: Blatt
authors.forename: Lauren
authors.initials: L
authors.lastname: Davis
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bierman
authors.forename: William
authors.initials: W
authors.lastname: McGaghie
authors.forename: James B
authors.initials: JB
authors.lastname: Brucker
authors.forename: Mary
authors.initials: M
authors.lastname: Martini
authors.forename: June K
authors.initials: JK
authors.lastname: Robinson
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods; D002982:Clinical Clerkship; D002983:Clinical Competence; D003162:Competency-Based Education / Q000379:methods*; D003376:Counseling / Q000379:methods; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D008954:Models, Biological; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013337:Students, Medical; D014743:Videotape Recording; D055815:Young Adult