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

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 Th...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2015-12, Vol.73 (6), p.959-965
Main Authors: Garg, Amit, MD, Biello, Katie, MPH, PhD, Hoot, Joyce W., MD, Reddy, Shalini B., MD, Wilson, Lindsay, MD, George, Paul, MD, MHPE, Robinson-Bostom, Leslie, MD, Belazarian, Leah, MD, Domingues, Erik, MD, Powers, Jennifer, MD, Jacob, Reza, MD, Powers, Michael, BA, Besen, Justin, MD, Geller, Alan C., RN, MPH
Format: Article
Language:English
Subjects:
Adult
Biopsy, Needle
cancer
Clinical Competence
Cohort Studies
Curriculum
Dermatology
Dermatology - education
Dermoscopy - methods
education
Education, Medical, Undergraduate - methods
examination
Female
Humans
Immunohistochemistry
Male
medical
Melanoma - diagnosis
Objective Structured Clinical Examination
Physical Examination - methods
Prospective Studies
Schools, Medical
skin
Skin Neoplasms - diagnosis
student
Students, Medical - statistics & numerical data
undergraduate
United States
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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. 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.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2015.08.014