title: The Skin Cancer Objective Structured Clinical Examination (SCOSCE): A multi-institutional collaboration to develop and validate a clinical skills assessment for melanoma.
abstract: BACKGROUND
  Assessing medical students on core skills related to melanoma detection is challenging in the absence of a well-developed instrument.
  
  
  OBJECTIVE
  We sought to develop an objective structured clinical examination for the detection and evaluation of melanoma among medical students.
  
  
  METHODS
  This was a prospective cohort analysis of student and objective rater agreement on performance of clinical skills and assessment of differences in performance across 3 schools.
  
  
  RESULTS
  Kappa coefficients indicated excellent agreement for 3 of 5 core skills including commenting on the presence of the moulage (k = 0.87, 95% confidence interval 0.77-0.96), obtaining a history for the moulage (k = 0.84, 95% confidence interval 0.74-0.94), and making a clinical impression (k = 0.80, 95% confidence interval 0.68-0.92). There were no differences in performance across schools with respect to 3 of 5 core skills: commenting on the presence of the moulage (P = .15), initiating a history (P = .53), and managing the suspicious lesion (P value range .07-.17). Overall, 54.2% and 44.7% of students commented on the presence of the moulage and achieved maximum performance of core skills, respectively, with no difference in performance across schools.
  
  
  CONCLUSIONS
  Limitations include overall sample size of students and schools.
  
  
  CONCLUSIONS
  The Skin Cancer Objective Structured Clinical Examination represents a potentially important instrument to measure students' performance on the optimal step-by-step evaluation of a melanoma.
authors.affiliation: Department of Dermatology, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Electronic address: amgarg@nshs.edu.
authors.forename: Amit
authors.initials: A
authors.lastname: Garg
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Katie
authors.initials: K
authors.lastname: Biello
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Joyce W
authors.initials: JW
authors.lastname: Hoot
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Shalini B
authors.initials: SB
authors.lastname: Reddy
authors.affiliation: Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Wilson
authors.affiliation: Department of Family Medicine, Brown Alpert Medical School, Providence, Rhode Island.
authors.forename: Paul
authors.initials: P
authors.lastname: George
authors.affiliation: Department of Dermatology, Brown Alpert Medical School, Providence, Rhode Island.
authors.forename: Leslie
authors.initials: L
authors.lastname: Robinson-Bostom
authors.affiliation: Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Leah
authors.initials: L
authors.lastname: Belazarian
authors.affiliation: Division of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Erik
authors.initials: E
authors.lastname: Domingues
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Powers
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Reza
authors.initials: R
authors.lastname: Jacob
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Michael
authors.initials: M
authors.lastname: Powers
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Justin
authors.initials: J
authors.lastname: Besen
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Geller
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D002983:Clinical Competence; D015331:Cohort Studies; D003479:Curriculum; D003880:Dermatology / Q000193:education*; D046169:Dermoscopy / Q000379:methods; D004504:Education, Medical, Undergraduate / Q000379:methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D010808:Physical Examination / Q000379:methods*; D011446:Prospective Studies; D012577:Schools, Medical; D012878:Skin Neoplasms / Q000175:diagnosis*; D013337:Students, Medical / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
keywords: Objective Structured Clinical Examination; cancer; curriculum; dermatology; education; examination; medical; skin; student; undergraduate