Training pattern recognition of skin lesion morphology, configuration, and distribution.

Abstract

The ability to reliably recognize and classify a range of skin signs and symptoms remains a necessary skill across most clinical disciplines but one that is traditionally mastered via nonsystematic experience over long periods. We investigated whether online Perceptual and Adaptive Learning Modules (PALMs) could efficiently train preclerkship medical students to identify and discriminate primary skin lesion morphologies, configurations, and anatomic distributions. Medical students completed an online skin lesion morphology PALM voluntarily in year 1 and by requirement, along with configuration and anatomic distribution PALMs, in year 2. In controlled before-and-after studies, multiple-choice pretests and posttests using previously unused images, assessed PALM-induced learning. In prospective cohort studies, differences in year-2 performance between students who had and had not completed the morphology PALM in year 1 were also assessed. Multiple-choice tests, used to evaluate PALM effectiveness, demonstrated large (effect sizes of 1.1 [±0.1 SE] to 2.2 [±0.1 SE]) and statistically significant (P < .0001) improvements after PALM training, with learning retention when tested after 1 year. Results are from self-selected groups and a single class at 1 institution. PALMs are a useful tool for efficient development of the core clinical skills of pattern recognition and classification of skin lesion characteristics.