• Elizabeth V Seiverling, Hadjh T Ahrns, Amrit Greene, Melissa Butt, Oriol Yélamos, Stephen W Dusza, and Ashfaq A Marghoob.
• From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM). vseiverling@gmail.com.
• J Am Board Fam Med. 2019 Jan 1; 32 (1): 96-102.

IntroductionDermoscopy aids family physicians (FPs) in skin cancer detection. The triage amalgamated dermoscopic algorithm (TADA) was created to simplify the dermoscopic evaluation of a skin growth. The purpose of this image-based study was to evaluate the effect of teaching the clinical and dermoscopic features of benign skin lesions on the diagnostic accuracy of skin cancer identification using TADA. We also sought to determine the best method to teach benign neoplasms.MethodsIn this cross-sectional study of an educational intervention, FPs participated in dermoscopy training. Participants were divided into 3 groups for teaching of common benign neoplasms (dermatofibroma, angioma, and seborrheic keratosis/lentigo): didactic + interactive, didactic + heuristic, and didactic. For each group, the benign teaching was followed by skin cancer identification training with TADA. All participants took a 30 image pre-test and 30 image post-test.ResultsFifty-nine participants completed the study. The mean preintervention score (out of 30 correct responses) was 17.9 (SD, 4.5) and increased to 23.5 (SD, 3.0) on the postintervention evaluation (P < .001). Sensitivity for skin cancer increased from 62.5% to 88.1% following the intervention. Postintervention specificity for skin cancer was 87.8%. Sensitivity and specificity increased following the intervention for all 3 types of benign neoplasms. Diagnostic accuracy was not impacted by the method of benign teaching.ConclusionShort dermoscopy training sessions with dedicated time for benign growths followed by TADA training for malignant growths are an effective means of teaching FPs dermoscopy and result in a high sensitivity and specificity for the identification of benign and malignant skin neoplasms.© Copyright 2019 by the American Board of Family Medicine.

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