ABSTRACT
It is well recognized that dermatology education across the UK is variable, sparse and oftentimes entirely absent from undergraduate medical curricula. However, annually 24% of the population in England and Wales present to general practitioners with a dermatological complaint. This quality-improvement project (QIP) aimed to improve medical students' understanding of common dermatological presentations as defined by one university's curriculum. Teaching sessions were conducted with penultimate and final-year medical students on their clinical placements. A questionnaire was used to establish student confidence levels at baseline, and following each session relating to various learning outcomes. Session 1 covered describing lesions with interactive cases, while session 2 included Objective Structured Clinical Examination (OSCE)-style scenarios for mock examination. Quantitative data were analysed using Microsoft Excel and qualitative data analysed using framework theory. A total of 67 datasets were analysed for key curriculum aspects as per university dermatological curriculum. Mean quantitative self-reported confidence levels preteaching (mean across all domains 6.04), post-cycle 1 (mean 7.62) and postcycle 2 (mean 8.01). A statistically significant improvement was identified in confidence for the domains 'confident describing cutaneous signs' (P = 0.026;Mann-Whitney U-test), 'management of chronic dermatological conditions' (P = 0.028), 'management of acute severe dermatological conditions' (P = 0.003), 'management of common benign, premalignant and malignant skin conditions' (P = 0.014), 'management of immunobullous skin conditions' (P = 0.004) from baseline to cycle 1, and 'dermatological history taking skills' (P = 0.232), 'examining skin' (P = 0.008) and 'dermatological prescribing' (P = 0.004) from baseline to after cycle 2. Thematic analysis of open-question feedback revealed that students found this teaching session useful, particularly with the examination-style of the sessions. Key areas to improve on included inclusion of ethnic skin types in the teaching. The statistically significant increase in student confidence levels suggests that the teaching programme was successful, thus our QIP outcomes were achieved. Furthermore, one can assume running similar programmes across other medical schools would be beneficial, particularly as dermatology education is underrepresented and variable across medical schools' curricula. Use of visual aids and a problem-centred approach is an effective tool that can be easily integrated into dermatology teaching. We aim to pursue further work to complete additional sessions, particularly focusing on the inclusion of ethnic skin types, which was identified as a key improvement point from students and reflects existing literature. Given the restrictions imposed by the COVID-19 pandemic, e-learning is vastly developing and we could also consider, in a repeat cycle, the use of video technology to help provide educational equality.