ABSTRACT
The COVID-19 pandemic diverted medical education within dermatology towards technology-enhanced learning (TEL) delivery. Concurrent societal movements also raised awareness of racial inequalities in health outcomes. This has been highlighted as a priority within dermatology research and education (Guckian J, Ingram J, Rajan N, Linos E. Dermatology is finally talking about race. Br J Dermatol 2021;185: 875-6). The British Association of Dermatology acknowledges that 'the education of undergraduate and postgraduates. . .needs to be updated to better include skin of colour' (https://www.bad. org.uk/healthcare-professionals/inclusivity-and-representation). Numerous distance courses in this domain have been piloted, but there is little published evidence regarding efficacy or sustainability. This study evaluated whether TEL methodologies can facilitate effective and sustainable ethnic dermatology education. The study explored the existing competence and confidence of a cohort of dermatology trainees towards managing dermatology conditions affecting skin of colour, specifically central centrifugal cicatricial alopecia (CCCA) and keloid scarring. The short- and long-term impact of TEL interventions upon trainees' confidence and competence of managing these conditions was investigated. A prospective cohort study was designed and included 14 dermatology registrars and regional fellows across Yorkshire. A Zoom teaching session was provided, covering keloid scarring and CCCA, supported by a 'flipped-classroom' approach via pre-reading materials. Survey methodology was used;three questionnaires were circulated: presession (survey 1), postsession (survey 2) and 6 weeks afterwards (survey 3). These featured multiple choice questions gathering data regarding participant knowledge and questioned confidence and competence. Multiple-choice questions were normed by 15 external trainees to ensure suitable difficulty. Presession, 64% participants felt that, on completion of specialty training, they would be competent in treating patients with ethnic skin. Ninety-three per cent believed that formal outcomes related to ethnic dermatology should be included in the curriculum. Postsession, 42% strongly agreed that the teaching course would change their practice. Fifty per cent felt that the teaching content was 'somewhat new'. Average knowledge scores demonstrated an initial rise then fall (survey 1: 5.67/10;survey 2: 7.83/10;survey 3: 6.36/10). Despite an innovative TEL education session, trainee knowledge did not significantly improve and improvement did not prove sustainable 6 weeks after teaching. Trainees were not confident in adopting newly acquired knowledge on skin of colour into their practice. Results show that the benefit of providing TEL education on ethnic dermatology may prove transient, and there is disparity in the perceived and actual benefit of ethnic dermatology education. Systemic solutions may be warranted, combining both education and human factors, including tackling systemic injustices and social inequalities.
ABSTRACT
Dermatology has long been recognized as under-represented in UK's undergraduate curricula. With a diagnostic and educational toolkit that is heavily centred around face-to-face clinical examination, dermatology education has been disproportionately affected by the COVID-19 pandemic. Innovative approaches to distance teaching and learning within dermatology are essential, but historically have been unidirectional with a lack of community and patient-centred resources readily available. Online channel-based messaging apps such as Slack offer an opportunity to engage students in remote, multimodal collaborative learning by reproducing a classroom environment in the virtual space, while simultaneously maintaining a strong focus on patient care. The aim of this study was to determine the feasibility, acceptability and proof of concept for an online Slack community as an undergraduate dermatology learning platform. Undergraduate medical students participated in an online classroom for 6 weeks with a structured teaching programme encompassing online casebased discussions, seminars and journal clubs. The platform was facilitated by junior doctors (n = 10) and featured patient educators (n = 6). Students, faculty and patient educators completed a postcourse evaluation. In addition, students completed a pre-and postintervention dermatology quiz to determine knowledge acquisition. Mixed-methods analyses were applied including quantitative analyses to explore data trends and qualitative phenomenographic analyses to assimilate key underlying themes. Students (n = 65) were enrolled to join the platform for a 6-week period. The evaluation was completed by students (n = 52) from UK universities (n = 27). The majority of students (n = 27) interacted with the platform as passive observers (<= 5 active interactions). A small group of 'super users' (n = 4) actively engaged with the platform over 100 times during the study period. Ninety-six per cent of participants and 100% of faculty agreed that the overall quality of the course was excellent. No statistically significant difference in the pre-and postcourse dermatology quiz scores was noted, possibly owing to suboptimal levels of active engagement with the platform from many users. Barriers to engagement cited by the students included high university workload and the lack of a timetable for live sessions. A community-based online classroom can act as an enjoyable, acceptable and collaborative means of supplementing traditional educational methodologies for teaching dermatology to undergraduate medical students. Its ease of use and supportive nature can facilitate patient involvement, as well as other innovative approaches to teaching and learning dermatology, such as interuniversity collaboration and gamification of learning. Such advances may provide vital safeguards against the reduction in face-to-face learning that has accompanied the pandemic.
ABSTRACT
BACKGROUND: Dermatology is under-represented in UK undergraduate curricula, and with a diagnostic and educational toolkit that is heavily centred on face-to-face (F2F) clinical examination, dermatology education has been disproportionately affected by the COVID-19 pandemic. Online channel-based messaging apps such as Slack offer an opportunity to engage students in remote, multimodal collaborative learning by reproducing a classroom environment in the virtual space. AIM: To determine the feasibility, acceptability and proof of concept for an online Slack community in undergraduate dermatology education. METHODS: Undergraduate medical students participated in an online classroom for a 6-week programme encompassing case-based discussions, seminars and journal clubs. The platform was facilitated by junior doctors (n = 10) and patient educators (n = 6). Students and faculty completed a post-course evaluation. Students additionally completed a pre- and post-intervention dermatology quiz. Mixed methods analyses included quantitative analyses to explore data trends and qualitative phenomenographic analyses to assimilate key underlying themes. RESULTS: Students (n = 65) were enrolled to join the platform. The evaluation was completed by students (n = 52) from UK universities (n = 27). The majority of students (n = 27) interacted with the platform as passive observers (≤ 5 active interactions with the channel), with a small group (n = 4) of 'super-users' (≥ 100 active interactions). The overall quality of the course was described as 'excellent' by 96% of participants and 100% of faculty. CONCLUSION: A community-based online classroom can act as an enjoyable, acceptable and collaborative means of delivering dermatology education to undergraduate medical students. Its ease of use and supportive nature may also facilitate patient involvement. Such advances may provide vital safeguards against the reduction in F2F learning that has accompanied the COVID-19 pandemic.