title: A multifaceted intervention: no increase in general practitioners' competence to diagnose skin cancer (minSKIN) - randomized controlled trial.
abstract: BACKGROUND
  General practitioners (GPs) play crucial roles in early detection of skin cancer. A pilot-study found a positive short-term effect of a 1-day dermatologic education programme on GPs' diagnostic competence.
  
  
  OBJECTIVE
  To determine effects of a multifaceted intervention, including technical equipment and continuing feedback by a dermatologist, on GPs' diagnostic skills regarding skin cancer.
  
  
  METHODS
  Randomized controlled trial with 78 GPs of the Canton of Zurich, Switzerland.
  
  
  METHODS
  GPs in intervention group received a 1-day training, a Lumio (magnifying glass with polarized light, 3Gen), a Nikon digital camera and - during 1 year - feedback on skin lesion pictures sent to the dermatologist. GPs in control group only received the 1-day training.
  
  
  METHODS
  
  
  
  METHODS
  structured assessment of GP's diagnostic skills in correctly diagnosing images of skin lesions regarding skin cancer. At baseline prior to intervention (T0), after the full-day training course in both groups (T1), and after 1 year of continuing feedback (T2) to the intervention group.
  
  
  METHODS
  Non-parametric unpaired (Wilcoxon-Mann-Whitney) tests were used to compare numbers of correctly classified skin lesions between both groups at T2 and for the change between T1 and T2.
  
  
  RESULTS
  At T0, both groups classified a median of 23 skin lesions of the 36 images correctly. This value rose to 28 for both groups at T1 and fell to 24 for both groups at T2. No difference between control and intervention group at T2. Furthermore, we compared differences in the sum scores per GP between T1 and T2 for each group. Also in this comparison, no difference between control and intervention group was found.
  
  
  CONCLUSIONS
  No long-term effect of the multifaceted intervention was found on the competence to diagnose skin cancer by GPs. The positive short-term effect of the 1-day dermatologic education programme did not persist over 12 months.
authors.affiliation: Institute of Primary Care, University Hospital and University of Zurich, Zurich, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Badertscher
authors.affiliation: Institute of Primary Care, University Hospital and University of Zurich, Zurich, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Tandjung
authors.affiliation: Institute of Primary Care, University Hospital and University of Zurich, Zurich, Switzerland.
authors.forename: O
authors.initials: O
authors.lastname: Senn
authors.affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, University Hospital Zurich, Zurich, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Kofmehl
authors.affiliation: Horten Centre for Patient Oriented Research and Knowledge Transfer, University Hospital Zurich, Zurich, Switzerland.
authors.forename: U
authors.initials: U
authors.lastname: Held
authors.affiliation: Institute of Primary Care, University Hospital and University of Zurich, Zurich, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Rosemann
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: G F L
authors.initials: GF
authors.lastname: Hofbauer
authors.affiliation: Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Wensing
authors.affiliation: Institute of Primary Care, University Hospital and University of Zurich, Zurich, Switzerland.
authors.forename: P O
authors.initials: PO
authors.lastname: Rossi
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: R P
authors.initials: RP
authors.lastname: Braun
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003880:Dermatology; D005260:Female; D058006:General Practice / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis*