The diagnosis of skin disease is not something that changes radically year to year. In fact, for hundreds of years physicians have been assessing the skin to diagnose and treat skin diseases and to “view” internal diseases. The latest edition of this review provides several updates that enhance our approach to the diagnosis of skin disease with active links to updated digital references and atlases. These will be valuable to students, residents, and physicians interested in improving their dermatologic diagnostic skills. A new algorithm highlights our suggested approach to cutaneous diagnoses. It is our hope that readers will begin to “think like dermatologists” as they digest the contents of this review.
Key words: Macule, papule, vesicle, bulla, plaque, excoriation, scale, ulceration, diagnosis, errors
This review contains 13 figures, 5 tables, 17 references, and 7 additional readings.
Objective The American Institute of Ultrasound in Medicine has described what constitutes a detailed fetal anatomic examination but what comprises an appropriate physician training program has not been described. The purpose of this paper is to describe a highly-structured program developed by our center to train maternal-fetal medicine fellows in a systematic approach to fetal diagnostic imaging.
Study Design We describe this approach in three phases. Phase I: Development of Skills as a Perinatal Sonographer, Phase II: Mentored Evolution to a Perinatal Sonologist and Phase III: Supervised Independent Practice as Consultant-in-training.
Results This curriculum was implemented in 2006. Of the eight maternal-fetal medicine fellows who completed this program, 100% were capable of following this curriculum and 100% felt comfortable performing and interpreting detailed sonograms including sonograms with significant and uncommon anomalies. Qualitative feedback was also positive. Finally, this structured approach resulted in an increase in the average total number of sonograms interpreted.
Conclusion Our curriculum, by following the explicit guidelines and expectations set out by the American Institute of Ultrasound in Medicine and the American Board of Obstetrics and Gynecology for practicing maternal-fetal medicine fellowship graduates, provides an opportunity to explore national standardization for this component of training.
Objective: To compared pattern recognition abilities of final-year medical students and dermatology residents to distinguish and classify superficial fungal infections and resembling lesions.Methods: The study was conducted at the Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand, in 2019. The participants had to make diagnosis from 78 images including typical and atypical lesions within 50 second. No history or any description was given. The answer sheets were reviewed.Results: Medical students (n = 18) and dermatology residents (n = 19) showed no significant differences in the means of overall accuracy scores. Residents demonstrated a statistically higher mean score than the medical students in diagnoses of anthropophilic infection with mostly presented with typical lesion. However, there were no significant differences in the mean scores for their diagnoses of zoophilic dermatophytosis as atypical lesions and other skin lesions.Conclusion: Pattern recognition was helpful for the diagnosis of cutaneous dermatophytosis, especially in cases of typical lesions. Nonetheless, pattern recognition alone is insufficient for the diagnosis of atypical dermatophytosis lesions: analytical diagnostic skills should also be enhanced to an increase in the accuracies of atypical-lesion diagnoses.
A reflective practitioner is an active individual who explores the possibilities of solving problems in practice and who is characterised by being reflectively open to reexamining their own opinion. The authors of this paper start from the premise that the process of education, however consistent and well-founded it may be, is exposed to constant inspection and improvement. The aim of this research is to identify the teachers' skills needed for conducting action researches. This goal is accomplished by examining the possibility of connecting action researches with teachers' reflective practice. The methods used are the descriptive method, scaling technique and the Likert-type scale (AIRP). This scale examines the teachers' skills for conducting action researches and is based on five factors extracted by the factor analysis: diagnostic skills, attitudes towards action researches, data collecting skills, practical skills and skills needed for conducting action researches. This study involved 305 respondents from the territory of the Republic of Serbia. The obtained results show statistically significant differences between the teachers with long teaching experience and those with a few years of teaching experience, p<0.05. This research represents an attempt to change the current practice at the micro level with the purpose of initiating qualitative changes and improving teaching practice by means of action researches. Therefore, it will be possible to induce changes at the meso and macro level of the system of education.
In Reply.—
The analysis of our data by Mayes and Perrin is certainly appreciated. First, in answer to their inquiry about diagnosis, Schwartz diagnosed the otitis media in each case, using both pneumatic otoscopy and tympanometry. Though Schwartz' accuracy in diagnosis could be questioned, we feel that his diagnostic skills are at least as good as those of any other investigator who has reported on the management of otitis media.
Second, as for the problem of changing denominators, we are grateful to Mayes and Perrin for pointing out the confusion between the table and the text.
The utility of digital pathology in improving the diagnostic skills of pathology trainees in commonly encountered pigmented cutaneous lesions during the COVID-19 pandemic: A single academic institution experience