Effects on skills and practice from a web-based skin cancer course for primary care providers

Background: melanoma incidence and mortality is a growing concern. better recognition and management of skin cancer by primary care providers (pcps) could help,but studies suggest they would benefit from additional education. effective educational programs are needed. methods: we developed and conducted a voluntary before-and-after evaluation of a 1-to 2-hour interactive,web-based course in skin cancer detection for practicing,board-certified pcps (http://www.skinsight.com/info/for-professionals/dermatology-education- resources). voluntary participants' ability to diagnose and manage skin cancer was assessed using pretests,immediate tests,and 6-month posttests. the effect on actual practice patterns was assessed using participants' patient panels: referrals or visits to dermatology and skin biopsies during the 6 months after the course were compared with those during the same period before the course. results: the mean age of the 54 participants was 50.5 years (standard deviation,11.1); 54% were women and 52% were asian. the mean score for appropriate diagnosis and management increased from 36.1% to 46.7% (odds ratio,1.6; 95% confidence interval,1.4-1.9),with greatest improvement in benign lesions,from 32.1% to 46.3% (odds ratio,1.9; 95% confidence interval,1.6-2.4). dermatology referrals for suspicious lesions or new visits by participants' patients decreased at both sites after the course (from 630 to 607 and from 726 to 266,respectively). conclusions: this course improved skills in practicing pcps. improvement was greatest in the diagnosis and appropriate management of benign lesions and dermatology utilization decreased.