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Melanoma simulation helped students improve performance

Medical students raised their confidence to perform opportunistic surveillance, as well as manage and counsel patients, after a 1-hour melanoma simulation education and skills training experience, according to recent study results.

Researchers studied a sample of 74 third-year medical students who were randomly assigned to receive intervention before or after a standardized patient (SP). The SP wore an adhesive melanoma moulage (0.7 mm in diameter) applied to the neck near the carotid artery. Students also completed a questionnaire on melanoma risks.

Two simulation models replicating melanomas and abnormal or benign nevi were used for skills training. A presentation, practice with the simulation model and group discussion were included in the first 1-hour educational intervention. At the 2-week follow-up, students assessed the second simulation model, with a student from each four-person group presenting findings and recommending appropriate patient counseling.

Identifying a melanoma moulage and counseling an SP were main outcome measures. Pre-intervention and 2-week postintervention knowledge, attitudes about and confidence in the ability to perform opportunistic surveillance and counseling, as well as identification on the model of clinically suspicious pigmented lesions, lesions needing biopsy, and lesions to be monitored for change were secondary measures.

After skills training, students’ confidence in their abilities to perform surveillance improved significantly (P<.05, chi-square test). There was a decrease in monitoring clinically suspicious lesions for change (16% to 3%), and an increase in decisions to perform biopsies (80% to 96%). There was a significant reduction in monitoring benign lesions for change (43% to 3%), and an increase in biopsying melanoma in situ (10% to 26%; P<.05 for all, chi-square test). Trained students detected the melanoma moulage on the SP more often (P<.05, chi-square test).

“The self-efficacy of the medical students improved after formal instruction with skills training using a simulation model of melanoma combined with threshold rules and videos demonstrating patient counseling,” the researchers wrote.

Disclosure: Researcher June K. Robinson, MD, editor of JAMA Dermatology, was not involved in the editorial evaluation or editorial decision to accept this work for publication.