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• W2111440601 abstract "To the Editor: The Accreditation Council for Graduate Medical Education commonly cites internal medicine (IM) residency programs for the lack of dermatology training, threatening accreditation and possible closure.1Accreditation Council for Graduate Medical Education Web site. Available at: http://www.acgme.org/acWebsite/RRC_140/140_Cit.asp. Accessed December 1, 2004.Google Scholar In addition, non-dermatologists have had an expanding role in treating dermatologic conditions, despite having received insufficient dermatology training.2McCarthy G.M. Lamb G.C. Russell T.J. Young M.J. Primary care based dermatology practice: internists need more training.J Gen Intern Med. 1991; 6: 52-56Crossref PubMed Scopus (51) Google Scholar, 3Pariser R.J. Pariser D.M. Primary care physicians' errors in handling cutaneous disorders: a prospective survey.J Am Acad Dermatol. 1987; 17: 239-245Abstract Full Text PDF PubMed Scopus (73) Google Scholar, 4Ramsay D.L. Weary P. Primary care in dermatology: whose role should it be?.J Am Acad Dermatol. 1996; 35: 1005-1008Abstract Full Text PDF PubMed Scopus (43) Google Scholar, 5Feldman S.R. Fleischer A.B. McConnell R.C. Most common dermatologic problems identified by internists, 1990-1994.Arch Intern Med. 1998; 158: 726-730Crossref PubMed Scopus (76) Google Scholar, 6Kirsner R.S. Federman D.G. Lack of correlation between internists' ability in dermatology and their patterns of treating patients with skin disease.Arch Dermatol. 1996; 132: 1043-1046Crossref PubMed Google Scholar While dermatologists have long been recognized as an integral part of primary care education, a geographically mal-distributed workforce and reports of current and projected dermatologist shortages contribute to a lack of dermatology education for primary care physicians.5Feldman S.R. Fleischer A.B. McConnell R.C. Most common dermatologic problems identified by internists, 1990-1994.Arch Intern Med. 1998; 158: 726-730Crossref PubMed Scopus (76) Google Scholar, 7Resneck J. Kimball A.B. The dermatology workforce shortage.J Am Acad Dermatol. 2004; 50: 50-54Abstract Full Text Full Text PDF PubMed Scopus (117) Google Scholar Therefore, we cannot rely solely on dermatologist recruitment and traditional means of education for training.Saint Michael's Medical Center is a 357-bed teaching hospital in Newark, NJ that serves predominantly minority and impoverished patients. The hospital has not been able to recruit a dermatologist, limiting their ability to provide basic dermatology care and to adequately train physicians in dermatology. To address this lack of access, we designed a 12-month educational curriculum in July 2002 to provide dermatology education via interactive videoconferencing from dermatology residents at Harvard Medical School Department of Dermatology in Boston, MA to internal medicine residents at Saint Michael's Medical Center. The curriculum was a combination of problem-based learning and didactic lectures designed for IM residents.We successfully executed 12 lectures and 10 case presentations. We also evaluated knowledge improvement of the IM residents using a 25-question standardized examination derived from Medical Knowledge Self-Assessment Program (MKSAP), made available by the American College of Physicians. Thirty-eight IM residents completed the pre-educational assessment (average score of 30%), and nineteen residents completed the same examination post-program (average score of 38%). Among the 17 residents who completed both examinations, average scores improved from 29% to 39% (an increase of 2.3 points; P = .0056). IM residents also completed an interim evaluation of the program at both 6 months and 12 months. Overall satisfaction with the dermatology education via interactive videoconferencing was high at 6 months. They rated overall satisfaction with the program at 3.4 on a 4.0 scale; 4.0 is considered “excellent” and 3.0 is considered “good.” They rated technical aspect the lowest at 3.3. A high percentage (≥87%) of residents rated all aspects of the program either excellent or good (Fig 1). At 12 months, overall satisfaction was 2.9 on a 4.0 scale. Residents rated the technical aspect the lowest of all categories at 2.6. We believe this reduction was a result of increasing technical difficulties from outdated equipment. Figure 2 shows the attitudes and perceptions of the program by the IM residents. When asked if they agreed with the statement: “The lectures improved my ability to provide effective patient care,” 87% of residents either agreed or strongly agreed. When the statement referred to the case presentations, the percentage increased to 92%. Similar to other studies, confidence in diagnosis and treatment of dermatologic conditions was low.6Kirsner R.S. Federman D.G. Lack of correlation between internists' ability in dermatology and their patterns of treating patients with skin disease.Arch Dermatol. 1996; 132: 1043-1046Crossref PubMed Google ScholarFig 2Resident attitudes and perceptions about teledermatology.View Large Image Figure ViewerDownload (PPT)Our results suggest that videoconferencing is a feasible and satisfactory tool to deliver dermatology education to IM residents from dermatology residents. Tele-education could play an important adjunctive role in meeting the need for dermatology education. Further research is needed to determine its overall effectiveness on resident education and future practices. We believe this model can be extrapolated to other medical disciplines, as well as for the education of additional medical staff and personnel in underserved regions. To the Editor: The Accreditation Council for Graduate Medical Education commonly cites internal medicine (IM) residency programs for the lack of dermatology training, threatening accreditation and possible closure.1Accreditation Council for Graduate Medical Education Web site. Available at: http://www.acgme.org/acWebsite/RRC_140/140_Cit.asp. Accessed December 1, 2004.Google Scholar In addition, non-dermatologists have had an expanding role in treating dermatologic conditions, despite having received insufficient dermatology training.2McCarthy G.M. Lamb G.C. Russell T.J. Young M.J. Primary care based dermatology practice: internists need more training.J Gen Intern Med. 1991; 6: 52-56Crossref PubMed Scopus (51) Google Scholar, 3Pariser R.J. Pariser D.M. Primary care physicians' errors in handling cutaneous disorders: a prospective survey.J Am Acad Dermatol. 1987; 17: 239-245Abstract Full Text PDF PubMed Scopus (73) Google Scholar, 4Ramsay D.L. Weary P. Primary care in dermatology: whose role should it be?.J Am Acad Dermatol. 1996; 35: 1005-1008Abstract Full Text PDF PubMed Scopus (43) Google Scholar, 5Feldman S.R. Fleischer A.B. McConnell R.C. Most common dermatologic problems identified by internists, 1990-1994.Arch Intern Med. 1998; 158: 726-730Crossref PubMed Scopus (76) Google Scholar, 6Kirsner R.S. Federman D.G. Lack of correlation between internists' ability in dermatology and their patterns of treating patients with skin disease.Arch Dermatol. 1996; 132: 1043-1046Crossref PubMed Google Scholar While dermatologists have long been recognized as an integral part of primary care education, a geographically mal-distributed workforce and reports of current and projected dermatologist shortages contribute to a lack of dermatology education for primary care physicians.5Feldman S.R. Fleischer A.B. McConnell R.C. Most common dermatologic problems identified by internists, 1990-1994.Arch Intern Med. 1998; 158: 726-730Crossref PubMed Scopus (76) Google Scholar, 7Resneck J. Kimball A.B. The dermatology workforce shortage.J Am Acad Dermatol. 2004; 50: 50-54Abstract Full Text Full Text PDF PubMed Scopus (117) Google Scholar Therefore, we cannot rely solely on dermatologist recruitment and traditional means of education for training. Saint Michael's Medical Center is a 357-bed teaching hospital in Newark, NJ that serves predominantly minority and impoverished patients. The hospital has not been able to recruit a dermatologist, limiting their ability to provide basic dermatology care and to adequately train physicians in dermatology. To address this lack of access, we designed a 12-month educational curriculum in July 2002 to provide dermatology education via interactive videoconferencing from dermatology residents at Harvard Medical School Department of Dermatology in Boston, MA to internal medicine residents at Saint Michael's Medical Center. The curriculum was a combination of problem-based learning and didactic lectures designed for IM residents. We successfully executed 12 lectures and 10 case presentations. We also evaluated knowledge improvement of the IM residents using a 25-question standardized examination derived from Medical Knowledge Self-Assessment Program (MKSAP), made available by the American College of Physicians. Thirty-eight IM residents completed the pre-educational assessment (average score of 30%), and nineteen residents completed the same examination post-program (average score of 38%). Among the 17 residents who completed both examinations, average scores improved from 29% to 39% (an increase of 2.3 points; P = .0056). IM residents also completed an interim evaluation of the program at both 6 months and 12 months. Overall satisfaction with the dermatology education via interactive videoconferencing was high at 6 months. They rated overall satisfaction with the program at 3.4 on a 4.0 scale; 4.0 is considered “excellent” and 3.0 is considered “good.” They rated technical aspect the lowest at 3.3. A high percentage (≥87%) of residents rated all aspects of the program either excellent or good (Fig 1). At 12 months, overall satisfaction was 2.9 on a 4.0 scale. Residents rated the technical aspect the lowest of all categories at 2.6. We believe this reduction was a result of increasing technical difficulties from outdated equipment. Figure 2 shows the attitudes and perceptions of the program by the IM residents. When asked if they agreed with the statement: “The lectures improved my ability to provide effective patient care,” 87% of residents either agreed or strongly agreed. When the statement referred to the case presentations, the percentage increased to 92%. Similar to other studies, confidence in diagnosis and treatment of dermatologic conditions was low.6Kirsner R.S. Federman D.G. Lack of correlation between internists' ability in dermatology and their patterns of treating patients with skin disease.Arch Dermatol. 1996; 132: 1043-1046Crossref PubMed Google Scholar Our results suggest that videoconferencing is a feasible and satisfactory tool to deliver dermatology education to IM residents from dermatology residents. Tele-education could play an important adjunctive role in meeting the need for dermatology education. Further research is needed to determine its overall effectiveness on resident education and future practices. We believe this model can be extrapolated to other medical disciplines, as well as for the education of additional medical staff and personnel in underserved regions." @default.
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• W2111440601 title "Teledermatology education for internal medicine residents" @default.
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