title: Effects on skills and practice from a web-based skin cancer course for primary care providers.
abstract: BACKGROUND
  Melanoma incidence and mortality is a growing concern. Better recognition and management of skin cancer by primary care providers (PCPs) could help, but studies suggest they would benefit from additional education. Effective educational programs are needed.
  
  
  METHODS
  We developed and conducted a voluntary before-and-after evaluation of a 1- to 2-hour interactive, web-based course in skin cancer detection for practicing, board-certified PCPs (http://www.skinsight.com/info/for_professionals/dermatology-education-resources). Voluntary participants' ability to diagnose and manage skin cancer was assessed using pretests, immediate tests, and 6-month posttests. The effect on actual practice patterns was assessed using participants' patient panels: referrals or visits to dermatology and skin biopsies during the 6 months after the course were compared with those during the same period before the course.
  
  
  RESULTS
  The mean age of the 54 participants was 50.5 years (standard deviation, 11.1); 54% were women and 52% were Asian. The mean score for appropriate diagnosis and management increased from 36.1% to 46.7% (odds ratio, 1.6; 95% confidence interval, 1.4-1.9), with greatest improvement in benign lesions, from 32.1% to 46.3% (odds ratio, 1.9; 95% confidence interval, 1.6-2.4). Dermatology referrals for suspicious lesions or new visits by participants' patients decreased at both sites after the course (from 630 to 607 and from 726 to 266, respectively).
  
  
  CONCLUSIONS
  This course improved skills in practicing PCPs. Improvement was greatest in the diagnosis and appropriate management of benign lesions and dermatology utilization decreased.
authors.affiliation: the Department of Dermatology and the Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI; the Division of Research, Kaiser Permanente Northern California, Oakland, CA; the Department of Population Medicine, Harvard Medical School, Boston, MA; the Harvard Pilgrim Health Care Institute, Boston, MA; the Division of Public Health Practice, Harvard School of Public Health, Boston, MA; Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY; the Dermatoepidemiology Unit, Veterans Affairs Medical Center, Providence, RI; the Department of Dermatology, Rhode Island Hospital, Providence, RI; and the Departments of Dermatology and Community Health, Brown University, Providence, RI.
authors.forename: Melody J
authors.initials: MJ
authors.lastname: Eide
authors.forename: Maryam M
authors.initials: MM
authors.lastname: Asgari
authors.forename: Suzanne W
authors.initials: SW
authors.lastname: Fletcher
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
authors.forename: Allan C
authors.initials: AC
authors.lastname: Halpern
authors.forename: Waqas R
authors.initials: WR
authors.lastname: Shaikh
authors.forename: Lingling
authors.initials: L
authors.lastname: Li
authors.forename: Gwen L
authors.initials: GL
authors.lastname: Alexander
authors.forename: Andrea
authors.initials: A
authors.lastname: Altschuler
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Dusza
authors.forename: Ashfaq A
authors.initials: AA
authors.lastname: Marghoob
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Quigley
authors.forename: Martin A
authors.initials: MA
authors.lastname: Weinstock
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002983:Clinical Competence; D003880:Dermatology / Q000193:education*; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000193:education*; D010818:Practice Patterns, Physicians'; D012878:Skin Neoplasms / Q000175:diagnosis*; D014481:United States
keywords: Educational Research; Medical Education; Prevention; Primary Health Care; Screening; Skin Cancer