Instructional Strategies to Enhance Dermoscopic Image Interpretation Education: A Review of the Literature

Instructional Strategies to Enhance Dermoscopic Image Interpretation Education: A Review of the Literature

Authors

  • Tiffaney Tran a:1:{s:5:"en_US";s:25:"MD Anderson Cancer Center";}
  • Niels K. Ternov Department of Plastic Surgery, Herlev Hospital, Herlev, Denmark
  • Jochen Weber Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
  • Catarina Barata Institute for Systems and Robotics; Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
  • Elizabeth G. Berry Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
  • Hung Q. Doan Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
  • Ashfaq A. Marghoob Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
  • Elizabeth V. Seiverling Division of Dermatology, Maine Medical Center, Portland, ME, USA; Department of Dermatology, Tufts University School of Medicine, Boston, MA,USA
  • Shelly Sinclair Department of Biology, Davidson College, Davidson, NC, USA
  • Jennifer A. Stein The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
  • Elizabeth R. Stoos Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
  • Martin G. Tolsgaard Copenhagen Academy for Medical Education and Simulation; Copenhagen University Hospital Rigshospitalet
  • Maya Wolfensperger Department of Dermatology, University Hospital of Zürich, University of Zürich, Zürich, Switzerland
  • Ralph P. Braun Department of Dermatology, University Hospital of Zürich, University of Zürich, Zürich, Switzerland
  • Kelly C. Nelson Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Keywords:

dermoscopy education, image interpretation education, instructional strategies, educational methods, gamification

Abstract

Introduction: In image interpretation education, many educators have shifted away from traditional methods that involve passive instruction and fragmented learning to interactive ones that promote active engagement and integrated knowledge. By training pattern recognition skills in an effective manner, these interactive approaches provide a promising direction for dermoscopy education.

Objectives: A narrative review of the literature was performed to probe emerging directions in medical image interpretation education that may support dermoscopy education. This article represents the second of a two-part review series.

Methods: To promote innovation in dermoscopy education, the International Skin Imaging Collaboration (ISIC) assembled an Education Working Group that comprises international dermoscopy experts and educational scientists. Based on a preliminary literature review and their experiences as educators, the group developed and refined a list of innovative approaches through multiple rounds of discussion and feedback. For each approach, literature searches were performed for relevant articles.

Results: Through a consensus-based approach, the group identified a number of theory-based approaches, as discussed in the first part of this series. The group also acknowledged the role of motivation, metacognition, and early failures in optimizing the learning process. Other promising teaching tools included gamification, social media, and perceptual and adaptive learning modules (PALMs).

Conclusions: Over the years, many dermoscopy educators may have intuitively adopted these instructional strategies in response to learner feedback, personal observations, and changes in the learning environment. For dermoscopy training, PALMs may be especially valuable in that they provide immediate feedback and adapt the training schedule to the individual’s performance.

Author Biographies

Niels K. Ternov, Department of Plastic Surgery, Herlev Hospital, Herlev, Denmark

Department of Plastic Surgery

Jochen Weber, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Dermatology Service

Elizabeth G. Berry, Department of Dermatology, Oregon Health & Science University, Portland, OR, USA

Department of Dermatology

Hung Q. Doan, Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Department of Dermatology

Ashfaq A. Marghoob, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Dermatology Service

Elizabeth V. Seiverling, Division of Dermatology, Maine Medical Center, Portland, ME, USA; Department of Dermatology, Tufts University School of Medicine, Boston, MA,USA

Division of Dermatology

Shelly Sinclair, Department of Biology, Davidson College, Davidson, NC, USA

Department of Biology

Jennifer A. Stein, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA

The Ronald O. Perelman Department of Dermatology

Elizabeth R. Stoos, Department of Dermatology, Oregon Health & Science University, Portland, OR, USA

Department of Dermatology

Martin G. Tolsgaard, Copenhagen Academy for Medical Education and Simulation; Copenhagen University Hospital Rigshospitalet

Department of Obstetrics

Maya Wolfensperger, Department of Dermatology, University Hospital of Zürich, University of Zürich, Zürich, Switzerland

Department of Dermatology

Ralph P. Braun, Department of Dermatology, University Hospital of Zürich, University of Zürich, Zürich, Switzerland

Department of Dermatology

Kelly C. Nelson, Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Department of Dermatology

References

Liason Committee on Medical Education (LCME). Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the MD Degree. 2017:40. Mar. https://medicine.vtc.vt.edu/content/dam/medicine_vtc_vt_edu/about/accreditation/2018-19_Functions-and-Structure.pdf

Sadofsky M, Knollmann-Ritschel B, Conran RM, Prystowsky MB. National standards in pathology education: developing competencies for integrated medical school curricula. Arch Pathol Lab Med. Mar 2014;138(3):328-332. doi:10.5858/arpa.2013-0404-RA

Lubarsky S, Dory V, Audétat MC, Custers E, Charlin B. Using script theory to cultivate illness script formation and clinical reasoning in health professions education. Can Med Educ J. 2015;6(2):e61-70.

Linaker KL. Pedagogical approaches to diagnostic imaging education: a narrative review of the literature. J Chiropr Humanit. 2015;22(1):9-16. doi:10.1016/j.echu.2015.09.005

Murdoch Eaton D, Cottrell D. Structured teaching methods enhance skill acquisition but not problem-solving abilities: an evaluation of the 'silent run through'. Med Educ. Jan 1999;33(1):19-23. doi:10.1046/j.1365-2923.1999.00265.x

Erinjeri JP, Bhalla S. Redefining radiology education for first-year medical students: shifting from a passive to an active case-based approach. Acad Radiol. Jun 2006;13(6):789-796. doi:10.1016/j.acra.2006.02.041

Morrison G, Goldfarb S, Lanken PN. Team training of medical students in the 21st century: would Flexner approve? Acad Med. Feb 2010;85(2):254-9. doi:10.1097/ACM.0b013e3181c8845e

Tran T, Ternov NK, Weber J, et al. Theory-based approaches to support dermoscopic image interpretation education: a review of the literature [manuscript submitted for publication]. 2021;

Cook DA, Artino AR, Jr. Motivation to learn: an overview of contemporary theories. Med Educ. 2016;50(10):997-1014. doi:10.1111/medu.13074

Malone TW, Lepper MR. Making Learning Fun: A Taxonomy of Intrinsic Motivations for Learning. vol 3. Aptitude, Learning, and Instruction: Conative and Affective Process Analyses. Lawrence Erlbaum Associates; 1987.

Sailer M, Hense JU, Mayr SK, Mandl H. How gamification motivates: an experimental study of the effects of specific game design elements on psychological need satisfaction. Comput Hum Behav. 2017/04/01 2017;69:371-380. doi:doi.org/10.1016/j.chb.2016.12.033

Nebel S, Schneider S, Schledjewski J, Rey GD. Goal-setting in educational video games. Simul Gaming. 2017;48(1):98–130. doi:10.1177/1046878116680869

Schumacher C, Ifenthaler D. The importance of students’ motivational dispositions for designing learning analytics. J Comput High Educ. 2018/12/01 2018;30(3):599-619. doi:10.1007/s12528-018-9188-y

YouDermoscopy. Home. Metter Congressi SRL Tutti. Accessed October 12, 2021, https://www.youdermoscopytraining.org/

Kittler H. About DermaChallenge and Dermonaut. Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Medical University of Vienna. Updated 2021. Accessed October 12, 2021, https://dermonaut.meduniwien.ac.at/dermachallenge/about

DiagnosUs. About DiagnosUs. Centaur Labs. Accessed October 12, 2021, https://www.diagnosus.com/about

Liu Y. Social media tools as a learning resource. J Educ Tech Dev Exch. 2010;3(1):101-114. doi:10.18785/jetde.0301.08

Wang T, Wang F, Shi L. The use of microblog-based case studies in a pharmacotherapy introduction class in China. BMC Med Educ. Sep 8 2013;13:120. doi:10.1186/1472-6920-13-120

Flynn L, Jalali A, Moreau KA. Learning theory and its application to the use of social media in medical education. Postgraduate Medical Journal. 2015;91(1080):556. doi:10.1136/postgradmedj-2015-133358

Collective Minds. Collective Minds Radiology. Accessed November 10, 2021, https://www.cmrad.com/

Bledsoe S, Harmeyer D, Wu F. Utilizing Twitter and #hashtags toward enhancing student learning in an online course environment. In: Khrosrow-Pour M, Clarke S, Jennes ME, Anttiroiko A-V, eds. Student Engagement and Participation: Concepts, Methodologies, Tools, and Applications. IGI Global; 2017:1217-1226:chap 60.

International Dermoscopy Society (IDS). Category Archive: Best Forum Cases. International Dermoscopy Society. Accessed October 12,2021, https://dermoscopy-ids.org/category/best-forum-cases/

International Dermoscopy Society (IDS). International Dermoscopy Society. Facebook. Accessed October 12, 2021, https://www.facebook.com/Dermoscopy

Bedin G, De Marque C. Dermoscopy - Skin Cancer. In: @dermoscopy_, editor.: Instagram; 2021.

Latif MZ, Hussain I, Saeed R, Qureshi MA, Maqsood U. Use of smart phones and social media in medical education: trends, advantages, challenges and barriers. Acta Inform Med. 2019;27(2):133-138. doi:10.5455/aim.2019.27.133-138

Kellman PJ, Krasne S. Accelerating expertise: perceptual and adaptive learning technology in medical learning. Med Teach. 2018/08/03 2018;40(8):797-802. doi:10.1080/0142159X.2018.1484897

Kellman PJ. Perceptual learning. In: Pashler H, Gallistel R, eds. Stevens' Handbook of Experimental Psychology: Learning, Motivation, and Emotion. 3 ed. John Wiley & Sons Inc; 2002:259-299:chap 7.

Mettler E, Kellman PJ. Adaptive response-time-based category sequencing in perceptual learning. Vis Res. 2014/06/01/ 2014;99:111-123. doi:10.1016/j.visres.2013.12.009

Mettler E, Massey C, Kellman P. Improving adaptive learning technology through the use of response times. Proc Annu Conf Cogn Sci Soc. 2011;33:6.

Romito BT, Krasne S, Kellman PJ, Dhillon A. The impact of a perceptual and adaptive learning module on transoesophageal echocardiography interpretation by anaesthesiology residents. Br J Anaesth. Oct 2016;117(4):477-481. doi:10.1093/bja/aew295

Krasne S, Stevens CD, Kellman PJ, Niemann JT. Mastering electrocardiogram interpretation skills through a perceptual and adaptive learning module. Academic Emergency Medicine Education and Training. 2020;5(2):e10454. doi:10.1002/aet2.10454

Rimoin L, Altieri L, Craft N, Krasne S, Kellman PJ. Training pattern recognition of skin lesion morphology, configuration, and distribution. J Am Acad Dermatol. 2015;72(3):489-495. doi:10.1016/j.jaad.2014.11.016

Chen W, HolcDorf D, McCusker MW, Gaillard F, Howe PDL. Perceptual training to improve hip fracture identification in conventional radiographs. PLoS One. 2017;12(12):e0189192. doi:10.1371/journal.pone.0189192

Flavell JH. Stage-related properties of cognitive development. Cogn Psychol. 1971/10/01/ 1971;2(4):421-453. doi:10.1016/0010-0285(71)90025-9

Hong WH, Vadivelu J, Daniel EGS, Sim JH. Thinking about thinking: changes in first-year medical students’ metacognition and its relation to performance. Med Educ Online. 2015/01/01 2015;20(1):27561. doi:10.3402/meo.v20.27561

Gonullu I, Artar M. Metacognition in medical education. Letter to the Editor. Educ Health. May 1, 2014 2014;27(2):225-226. doi:10.4103/1357-6283.143784

Schraw G, Dennison RS. Assessing metacognitive awareness. Contemp Educ Psychol. 1994;19(4):460-475. doi:10.1006/ceps.1994.1033

Edelbring S. Measuring strategies for learning regulation in medical education: scale reliability and dimensionality in a Swedish sample. BMC Med Educ. 2012;12:76. doi:10.1186/1472-6920-12-76

Turan S, Demirel O, Sayek I. Metacognitive awareness and self-regulated learning skills of medical students in different medical curricula. Med Teach. Oct 2009;31(10):e477-83. doi:10.3109/01421590903193521

Myers SJ, Rhodes MG, Hausman HE. Judgments of learning (JOLs) selectively improve memory depending on the type of test. Mem Cogn. Jul 2020;48(5):745-758. doi:10.3758/s13421-020-01025-5

Witherby AE, Tauber SK. The influence of judgments of learning on long-term learning and short-term performance. J Appl Res Mem Cogn. 2017;6(4):496-503. doi:10.1016/j.jarmac.2017.08.004

Dunlap JC. Changes in students' use of lifelong learning skills during a problem-based learning project. Perform Improv Q. 2005/03/01 2005;18(1):5-33. doi:10.1111/j.1937-8327.2005.tb00324.x

Kapur M. Learning from productive failure. Learning: Research and Practice. 2015/01/02 2015;1(1):51-65. doi:10.1080/23735082.2015.1002195

Henriksen D, Mishra P, Creely E, Henderson M. The role of creative risk taking and productive failure in education and technology futures. TechTrends. 2021;65:602-605. doi:10.1007/s11528-021-00622-8

Schwartz DL, Martin T. Inventing to prepare for future learning: the hidden efficiency of encouraging original student production in statistics instruction. Cogn Instr. 2010;22(2):129-184. doi:10.1207/s1532690xci2202_1

Kahneman D, Knetsch JL, Thaler RH. Anomalies: the endowment effect, loss aversion, and status quo bias. J Econ Perspect. 1991;5(1):193-206. doi:10.1257/jep.5.1.193

Roediger HL, Karpicke JD. Test-enhanced learning: taking memory tests improves long-term retention. Psychol Sci. 2006/03/01 2006;17(3):249-255. doi:10.1111/j.1467-9280.2006.01693.x

Greving S, Richter T. Examining the testing effect in university teaching: retrievability and question format matter. Front Psychol. 2018;9:2412. doi:10.3389/fpsyg.2018.02412

Steenhof N, Woods NN, Mylopoulos M. Exploring why we learn from productive failure: Insights from the cognitive and learning sciences. Adv Health Sci Educ Theory Pract. Dec 2020;25(5):1099-1106. doi:10.1007/s10459-020-10013-y

Dyre L, Tabor A, Ringsted C, Tolsgaard MG. Imperfect practice makes perfect: error management training improves transfer of learning. Med Educ. Feb 2017;51(2):196-206. doi:10.1111/medu.13208

Downloads

Published

2022-10-31

Issue

Section

Review

How to Cite

1.
Tran T, Ternov NK, Weber J, et al. Instructional Strategies to Enhance Dermoscopic Image Interpretation Education: A Review of the Literature. Dermatol Pract Concept. 2022;12(4):e2022189. doi:10.5826/dpc.1204a189

Share