Dermatology medical student history taking via the telephone: a way to minimize disruption to medical education, particularly during a pandemic

ABSTRACT

With an ever-ageing population the socioeconomic burden of skin disease continues to grow. Undergraduate dermatology training is essential to counter this. With dermatology exposure in medical schools limited by the current global COVID- 19 pandemic, we demonstrate how we can minimize educational disruptions without compromising the holistic approach to dermatology teaching. At our medical school, fourth-year medical students undergo a 1-week clinical dermatology attachment before sitting their fourth-year summative, which includes a dermatology objective structured clinical examination (OSCE). In view of the reduced clinics as a result of the pandemic, we implemented a virtual history-taking project. Volunteer patients with common long-term skin conditions were selected in accordance with medical student curriculum and consented to participate from their own homes. Students were observed taking a focused, timed dermatology OSCE-style history using departmental mobile telephones in loudspeaker mode, to involve their peers. They were then asked to describe an image of the skin condition and to attempt a diagnosis and management plan. They received immediate feedback on their OSCE from both the patient and a dermatology trainee. The session was evaluated via a pre- and postsession student questionnaire using a Likert scale of confidence, as well as anonymous feedback for global qualitative assessment. Preliminary feedback from 35 pre- and postsession questionnaires demonstrated a marked improvement in students' self-reported confidence in taking dermatology histories. Prior to these sessions, no students strongly agreed and 40% agreed to feeling confident in taking a dermatology history. Postsession questionnaires revealed that 37% strongly agreed and 62% agreed to feeling confident with taking a dermatology history. Students reported the opportunity to take histories from real patients useful and 'phone calls worked surprisingly well'. This project allowed the educational process to continue amidst a pandemic. Students were able to appreciate the important aspects of a dermatology history and gained knowledge about therapeutics previously used in these patients, while having a safe, empathetic and sensitive interaction with patients with skin disease.