Using the Internet to teach melanoma management guidelines to primary care physicians

The aim of this study was to determine whether a brief Internet-based education programme could improve physicians' abilities to manage pigmented skin lesions. A pre-test-post-test assessment was used of subjects' knowledge of skin cancer, confidence in their management abilities and actual ability to recommend appropriate treatment for 20 hypothetical patients with pigmented skin lesions. The setting was the general medicine service of an academic medical centre. Seventeen volunteer medical students, house officers and faculty members took part in the study. Following the pre-test, subjects completed a 1-hour computer-based educational programme, distributed via the Internet, presenting a guideline for recognizing and managing potentially malignant pigmented skin lesions. The guideline was based on the ABCD rule and the Glasgow seven-point checklist. The educational programme had a positive effect on the subjects' overall skin cancer knowledge and had significantly positive effects on their confidence and ability to apply the management guideline. Based on the guideline criteria, the subjects made the correct management decision on the clinical scenarios 63.2% of the time before the programme and 74.1% of the time after the programme (P = 0.002). We were able to teach melanoma management guidelines to physicians and medical students using a brief, interactive computer programme distributed via the Internet. Such an approach is more cost-effective than classroom teaching and could be used to improve the clinical skills of practising physicians to recognize and manage early melanomas. This approach to distributed learning could also be used to teach other clinical guidelines to physicians.