Evaluation Of Diagnostic Skills Of Interns Electively Rotating At The Dermatology Department Of King Fahad Hospital Of The University In Alkhobar, Saudi Arabia

摘要

Background: The dermatology elective enables interns during their internship to acquire useful diagnostic skills in dermatology. The aim of this study is to evaluate the efficacy of a 4-week dermatology elective in promoting diagnostic skills of interns.Methods: During the year 2004, kodachrome slide-based multiple-choice questions were administered to 20 interns at the beginning (pre-test) and completion (post-test) of their elective period.Results: The mean scores of correct answers for the pre- and post-test were 75.85% and 82.50%, respectively.Conclusions: The 4-week dermatology elective rotation significantly improved the diagnostic skills of the interns. Introduction Recent studies have shown that errors committed by general practitioners (GP) tend to occur most often in the realm of the diagnosis of skin lesions 1,2 which indicate that it is important to explore whether or not the current amount and type of dermatologic training prepares future GPs for management of skin disorders. King Fahad Hospital of the University is a high volume, clinically varied, academic and tertiary referral hospital. On the average, 60–80 patients are seen at the dermatology clinic each day. Interns are encouraged to see selected patients on their own, to write complete notes on the charts of patients that they evaluate and to formulate their thought processes relative to diagnosis. After that those patients are discussed with the consultant in the clinic. Besides, there are at least two didactic sessions per week. All interns spent 5 full days per week in the 4-week rotation. The aim of this study is to evaluate the efficacy of the 4-week dermatology elective during internship period in promoting diagnostic skills in new medical graduates, and to explore their ability to identify common dermatologic diagnoses. Material and Methods A total of 20 interns rotating as elective at the dermatology department of King Fahad Hospital of the University in alkhobar during the year 2004 were included in this study. A 20-item multiple choice questions pre-test was given to each candidate on the first day of joining the dermatology department as a rotating intern. The study period took one year as the number of the intern rotating at a time ranged between 1-3 interns. The test consisted of high-quality kodachrome slides of common dermatologic disorders. Subjects were not given the answers after completion of the pre-test. On the last day of the elective, a multiple choice question post-test consisting of slides identical to those presented at the pre-test was administered. Statistical analysis of the test results was conducted using SPSS version 10. Singlet-tests were used to determine whether the differences between pre-tests and post-tests results were significant ( P < 0.001). Results The results of the pre-tests and post-tests for students who took the dermatology elective are given in Table 1. Twenty students completed both pre-tests and post-tests. The mean scores were 75.85% and 82.50% (standard deviation, SD 13.77 and 13.33) respectively. Single t -tests revealed that the difference in scores between the pre-tests and post-tests was highly significant ( P < 0.001). The performance of the 20 students who took the elective was also analyzed with regard to their ability to recognize specific diagnoses. Table 2 shows the scores by diagnosis at the pre-tests and post-tests. The ability of the interns to recognize the correct diagnosis at the pre-test varied considerably depending on the disorder; however, the diagnostic accuracy improved at the post-test for most diagnoses.