International Journal of Healthcare Simulation

Introduction:

Junior doctors and undergraduate medical students often describe feeling unconfident describing skin lesions [1]. This is likely multifactorial, as a result of varying clinical exposure, tutor experience and length of clinical placement. Traditional learning formats such as lectures and tutorials are modalities that are commonly used in undergraduate dermatology teaching. Dermatology is heavily reliant on clinical examination findings; the question arises of whether this speciality can be taught via a lecture-based approach. Skin manifestations of pathologies are regularly encountered by physicians, with 25% of GP consultations assessing skin lesions [2]. Therefore, adequate dermatology training at an undergraduate level is paramount.

Methods:

We created a simulated dermatology clinic, with the help of third year students who volunteered as role-players. We created common dermatological lesions with the use of modern moulage on students of varying skin textures and colour. Third year students were briefed on the conditions. Fourth year students had the opportunity to take a focussed dermatology history, examine the lesion and formulate a management plan.

Results:

Before the session, we assessed the third- and fourth-year students’ exposure and confidence to dermatology, with 100% students rating as ‘minimal’. Pre- teaching 60% of fourth year students felt they would be able to identify common skin conditions ‘with assistance’. This improved to 70% of students feeling ‘very confident’ to identify common skin conditions post facilitated near-peer teaching. 100% third year students felt more confident in transitioning into fourth year, in which dermatology is part of their curricula.

Discussion:

The diverse simulated clinic format allows the students to clinically examine the lesions. The use of near-peer teaching with senior students imparting dermatological knowledge to junior students has been proposed3. However, to date and to our knowledge there has not been a study on proposing facilitated near-peer simulation with junior medical students in an upward mentoring approach. This teaching method enables third year medical students to gain an early exposure to dermatology, build confidence and reinforces continuous learning which is at the core of medicine. Above all, this format challenges the notion of hierarchical teaching. Use of facilitated upward mentoring benefits both junior and senior medical students.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

References

1. Chiang YZ, Tan KT, Chiang YN, Burge SM, Griffiths CE, Verbov JL. Evaluation of educational methods in dermatology and confidence levels: a national survey of UK medical students. International Journal of Dermatology. 2011;50(2):198–202.

2. Schofield JK, Fleming D, Grindlay D, Williams H. Skin conditions are the commonest new reason people present to general practitioners in England and Wales. British Journal of Dermatology. 2011;165(5):1044–1050.

3. Elamin S, Boohan M. Non-traditional teaching methods in undergraduate dermatology training: a scoping review. MedEdPublish. 2021;10:165.