title: Training pattern recognition of skin lesion morphology, configuration, and distribution.
abstract: BACKGROUND
  The ability to reliably recognize and classify a range of skin signs and symptoms remains a necessary skill across most clinical disciplines but one that is traditionally mastered via nonsystematic experience over long periods.
  
  
  OBJECTIVE
  We investigated whether online Perceptual and Adaptive Learning Modules (PALMs) could efficiently train preclerkship medical students to identify and discriminate primary skin lesion morphologies, configurations, and anatomic distributions.
  
  
  METHODS
  Medical students completed an online skin lesion morphology PALM voluntarily in year 1 and by requirement, along with configuration and anatomic distribution PALMs, in year 2. In controlled before-and-after studies, multiple-choice pretests and posttests using previously unused images, assessed PALM-induced learning. In prospective cohort studies, differences in year-2 performance between students who had and had not completed the morphology PALM in year 1 were also assessed.
  
  
  RESULTS
  Multiple-choice tests, used to evaluate PALM effectiveness, demonstrated large (effect sizes of 1.1 [±0.1 SE] to 2.2 [±0.1 SE]) and statistically significant (P < .0001) improvements after PALM training, with learning retention when tested after 1 year.
  
  
  CONCLUSIONS
  Results are from self-selected groups and a single class at 1 institution.
  
  
  CONCLUSIONS
  PALMs are a useful tool for efficient development of the core clinical skills of pattern recognition and classification of skin lesion characteristics.
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Rimoin
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles, California.
authors.forename: Lisa
authors.initials: L
authors.lastname: Altieri
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; Olive View-UCLA Medical Center, Sylmar, California; Science 37, Inc, Los Angeles, California; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California.
authors.forename: Noah
authors.initials: N
authors.lastname: Craft
authors.affiliation: Department of Physiology, David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: skrasne@mednet.ucla.edu.
authors.forename: Sally
authors.initials: S
authors.lastname: Krasne
authors.affiliation: Department of Psychology, University of California, Los Angeles, California; Insight Learning Technology Inc, Santa Monica.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Kellman
mesh_terms: D002983:Clinical Competence; D003880:Dermatology / Q000193:education*; D004501:Education, Medical / Q000379:methods; D006801:Humans; D007588:Job Satisfaction; D012871:Skin Diseases / Q000473:pathology*
keywords: adaptive learning; dermatology; diagnosis; experiential learning; lesion configuration; lesion distribution; lesion morphology; pattern recognition; perceptual learning; skin lesions