The Skin Cancer Objective Structured Clinical Examination (SCOSCE): A multi-institutional collaboration to develop and validate a clinical skills assessment for melanoma

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• 作者：Amit Garg ; MD^a ; ^{amgarg@nshs.edu" class="auth_mail" title="E-mail the corresponding author} ; Katie Biello ; MPH ; PhD^b ; Joyce W. Hoot ; MD^d ; Shalini B. Reddy ; MD^d ; Lindsay Wilson ; MD^e ; Paul George ; MD ; MHPE^f ; Leslie Robinson-Bostom ; MD^g ; Leah Belazarian ; MD^h ; Erik Domingues ; MD^h ; Jennifer Powers ; MD^d ; Reza Jacob ; MD^d ; Michael Powers ; BA^d ; Justin Besen ; MD^d ; Alan C. Geller ; RN ; MPH^c ; Submitted on behalf of the Integrated Skin Exam Consortium
• 关键词：cancer ; curriculum ; dermatology ; education ; examination ; medical ; Objective Structured Clinical Examination ; skin ; student ; undergraduate
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：73
• 期：6
• 页码：959-965
• 全文大小：288 K

文摘

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.

Limitations

Limitations include overall sample size of students and schools.

Conclusion

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.