Analyzing diversity, equity, and inclusion content on dermatology fellowship program websites.

Diversity, Equity, and Inclusion (DEI) initiatives have garnered increasing attention within medical education as there have been increased efforts to diversify the physician workforce among medical students, residents, fellows, and attendings. One way in which programs can improve their DEI initiatives and attract a more diverse pool of applicants is through DEI content on their graduate medical education websites. Prior studies characterizing the content and prevalence of DEI material on residency webpages have shown that dermatology residencies have relatively low levels of DEI content on their websites in which almost ¾ of all programs having no DEI content. Little is known, however, if similar findings are to be expected for the three main dermatology subspecialty fellowship program webpages: Dermatopathology, Pediatric Dermatology, and Micrographic Surgery and Dermatology Oncology. Fellowship programs were identified using the Accreditation Council for Graduate Medical Education's online database of fellowship programs. Programs were evaluated on a standardized scoring system for five equally weighted criteria: fellowship-specific DEI webpage, DEI commitment statement, DEI initiatives (summer research opportunities for under-represented minorities, DEI council, etc.), link to the institution's DEI homepage, and information about bias training. The mean score among all programs was 12.5. Pediatric dermatology ranked the highest among all specialties, while Mohs ranked the lowest. A link to the institution's DEI homepage was the most prevalent factor accounting for 42.1% of all programs collected, whereas information about bias training and fellowship-associated DEI webpage were the least prevalent. The results of this study reveal an overall lack of DEI content across all dermatology subspecialties' webpages and represent an actionable area of improvement for fellowship directors to increase their DEI efforts to attract a diverse pool of applicants to their program.

Beyond graduation: a survey study exploring drivers of alumni contributions to dermatology residencies.

Philanthropic donations are an increasingly important funding source for academic medical centers. Minimal published data is available about factors that influence alumni donations to residency programs. We performed a cross-sectional analysis of a single-site dermatology and combined internal medicine-dermatology residency programs to assess factors impacting alumni donations. Donors tended to have graduated less recently (only 20% graduating after 2010) and practice in the same region of their alma mater (50%). Respondents preferred funds be allocated to resident needs over needs of medical students. Strategically engaging senior alumni and offering fund allocation opportunities could increase philanthropy, with alumni perceptions of the residency program warranting further investigation for their impact on donation decisions.

Assessing the Application of Large Language Models in Generating Dermatologic Patient Education Materials According to Reading Level: Qualitative Study.

BACKGROUND: Dermatologic patient education materials (PEMs) are often written above the national average seventh- to eighth-grade reading level. ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT are large language models (LLMs) that are responsive to user prompts. Our project assesses their use in generating dermatologic PEMs at specified reading levels. OBJECTIVE: This study aims to assess the ability of select LLMs to generate PEMs for common and rare dermatologic conditions at unspecified and specified reading levels. Further, the study aims to assess the preservation of meaning across such LLM-generated PEMs, as assessed by dermatology resident trainees. METHODS: The Flesch-Kincaid reading level (FKRL) of current American Academy of Dermatology PEMs was evaluated for 4 common (atopic dermatitis, acne vulgaris, psoriasis, and herpes zoster) and 4 rare (epidermolysis bullosa, bullous pemphigoid, lamellar ichthyosis, and lichen planus) dermatologic conditions. We prompted ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT to "Create a patient education handout about [condition] at a [FKRL]" to iteratively generate 10 PEMs per condition at unspecified fifth- and seventh-grade FKRLs, evaluated with Microsoft Word readability statistics. The preservation of meaning across LLMs was assessed by 2 dermatology resident trainees. RESULTS: The current American Academy of Dermatology PEMs had an average (SD) FKRL of 9.35 (1.26) and 9.50 (2.3) for common and rare diseases, respectively. For common diseases, the FKRLs of LLM-produced PEMs ranged between 9.8 and 11.21 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). For rare diseases, the FKRLs of LLM-produced PEMs ranged between 9.85 and 11.45 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). At the fifth-grade reading level, GPT-4 was better at producing PEMs for both common and rare conditions than ChatGPT-3.5 (P=.001 and P=.01, respectively), DermGPT (P<.001 and P=.03, respectively), and DocsGPT (P<.001 and P=.02, respectively). At the seventh-grade reading level, no significant difference was found between ChatGPT-3.5, GPT-4, DocsGPT, or DermGPT in producing PEMs for common conditions (all P>.05); however, for rare conditions, ChatGPT-3.5 and DocsGPT outperformed GPT-4 (P=.003 and P<.001, respectively). The preservation of meaning analysis revealed that for common conditions, DermGPT ranked the highest for overall ease of reading, patient understandability, and accuracy (14.75/15, 98%); for rare conditions, handouts generated by GPT-4 ranked the highest (14.5/15, 97%). CONCLUSIONS: GPT-4 appeared to outperform ChatGPT-3.5, DocsGPT, and DermGPT at the fifth-grade FKRL for both common and rare conditions, although both ChatGPT-3.5 and DocsGPT performed better than GPT-4 at the seventh-grade FKRL for rare conditions. LLM-produced PEMs may reliably meet seventh-grade FKRLs for select common and rare dermatologic conditions and are easy to read, understandable for patients, and mostly accurate. LLMs may play a role in enhancing health literacy and disseminating accessible, understandable PEMs in dermatology.

Beyond the surface: unveiling gaps in medical education through eyes of diverse learners.

Inadequate education regarding disease manifestations in diverse skin colors hinders diagnosis and exacerbates health disparities. All levels of medical trainees report low confidence in accurately identifying disease in skin of color (SOC). To help further elucidate these concerns, our research aims to assess medical student confidence in recognizing cutaneous diseases in SOC and their viewpoints regarding SOC education within their institution. An eight-question, open-ended survey was provided to medical students before and after a SOC presentation. The survey assessed participants' confidence in their diagnostic ability and perspectives on educational material. Among the 70 attendees, 58 (82.8%) and 64 (91.4%) completed the pre- and post-seminar surveys, respectively. There was a significant discrepancy in confidence levels when assessing cutaneous manifestations of internal pathology in light (Monk Skin Colors 1-5) versus dark (Monk Skin Colors 6-10) skin (p < 0.009). Notably, 78.7% (37/47) perceived the institutional learning materials as insufficient for SOC. Post-seminar reflections indicated that 87.2% (40/46) of students lacked confidence in diagnosing SOC, with 78.7% (32/46) citing inadequate curriculum coverage as the cause. An additional 8.5% (6/46) identified the predominance of white-centric medical descriptions as a hindrance. Students collectively called for improved educational approaches, including better visual representation of diseases in darker skin. Medical education must continue to strive for increased SOC representation to train competent physicians in treating a diverse patient population and reduce disparities in SOC patients.

Family planning influences and perceptions among dermatology residents from ACGME-accredited training programs: a survey-based study.

As an increasing number of women pursue careers in dermatology, the structure and culture of training must reflect the evolving needs of dermatology residents. To examine perceived barriers to and perceptions of family planning amongst dermatology residents capable of becoming pregnant, evidence-based principles were employed to develop a 40-question survey for dermatology residents in ACGME-accredited training programs. A pilot study was conducted with the Harvard Combined Dermatology Residency Training Program residents before full-scale national electronic survey distribution from April to June 2023. Information was collected regarding factors influencing attitudes towards becoming pregnant during residency, as well as information regarding residency program family leave, fertility preservation, and lactation policies. Ultimately, 95 dermatology residents capable of becoming pregnant completed the survey. The majority (77.9%) of respondents reported intentionally delaying having children because of their careers, and 73.7% believed there is a negative stigma attached to being pregnant or having children during dermatology residency. Of respondents who had not yet attempted to become pregnant, 75.3% were concerned about the possibility of future infertility. Of the 60% of respondents considering fertility preservation options, 84.6% noted concerns about these procedures being cost-prohibitive on a resident salary. Only 2% of respondents reported that cryopreservation was fully covered through their residency benefits, while 20% reported partial coverage. Reported program parental leave policies varied considerably with 54.9%, 25.4%, 1.4%, and 18.3% of residents reporting 4-6 weeks, 7-8 weeks, 9-10 weeks, and 11 + weeks of available leave, respectively. Notably, 53.5% of respondents reported that vacation or sick days must be used for parental leave. Respondents reported lactation policies and on-site childcare at 49.5% and 8.4% of residency programs, respectively. The trends noted in the survey responses signal concerning aspects of family planning and fertility for dermatology residents capable of becoming pregnant. Residency family planning policies, benefits, and resources should evolve and homogenize across programs to fully support trainees.

How to Navigate Challenging Patient Encounters in Dermatology Residency.

Dermatology residents experience a variety of challenging clinical encounters in their work. There are multiple factors that can contribute to the clinical situation to make it challenging-not only for the resident but also for the patient. Thankfully, there are several strategies published in the medical literature that may be utilized to mediate conflict resolution and de-escalate tension in the dermatology clinic.

Patient Learning Pathway: Identifying Patient Competencies in Teledermatology for Effective Management of Dermatological Conditions.

BACKGROUND: Dermatology consultations in Québec, Canada, face accessibility challenges, with most dermatologists concentrated in urban areas. Teledermatology, offering remote diagnosis and treatment, holds promise in overcoming these limitations. However, concerns regarding patient-doctor relationships and logistical issues exist. OBJECTIVES: This article aims to introduce a dermatology patient learning pathway (PLP) developed by the Centre of Excellence on Partnership with Patients and the Public (CEPPP), focusing on knowledge, abilities, and skills mobilized by patients and their loved ones at key moments of the life course with an illness, as well as emerging educational needs. METHODS: The PLP development was co-developed with dermatology patient and caregiver partners, stakeholders, and the CEPPP team. The process encompassed stakeholder engagement, exploration, recruitment of patient and caregiver partners, co-development of the PLP draft, and validation through consensus building. RESULTS: The PLP methodology led to the creation of 44 learning objectives, comprising a total of 107 subobjectives. These objectives were organized into 8 phases of the patient life course with a dermatological condition: (1) prevention and predisposition; (2) discovery, self-examination, or observation of a change; (3) first consultation; (4) wandering; (5) consultation with a dermatologist; (6) diagnosis; (7) treatments; and (8) living with it. CONCLUSIONS: The dermatology PLP serves as a resource outlining patient competency across different stages of managing a dermatological condition throughout their life course. In the context of teledermatology, the PLP might facilitate patient and caregiver engagement by helping select appropriate information and tools to support active participation in care.

Sensitive Skin: A Survey of Dermatology Resident Physicians' Perspectives and Educational Exposures.

Sensitive skin (SS) is a common patient complaint presenting to the dermatology office, but there exists a lack of consensus on defining criteria and evidence-based management approaches. Furthermore, incorporation of SS training into the dermatology residency curriculum is unknown, and therefore the authors herein sought to determine dermatology resident physicians' exposure to education about SS, perspectives on SS, and management approaches. Ninety-nine percent of residents believe that SS should be included in some capacity in their dermatology residency training. However, less than half of responding residents received education specifically about SS during their training and less than one-fourth of residents reported feeling very knowledgeable about SS diagnosis, clinical evaluation, or management. Residents who had received specific education about SS were significantly more likely to self-describe as "very knowledgeable" about all queried topics. Residents reported challenges with all aspects of SS patient care, and cited heterogenous approaches to SS patients. These data highlight a gap in residency education, as indicated by limited consensus over diagnostic and management approaches to SS.J Drugs Dermatol. 2024;23(2):85-89.   doi:10.36849/JDD.7830.