SAN FRANCISCO A national survey suggests it may be time for dermatopathology education to embrace computer-based learning.
The survey showed that although U.S. dermatology residency programs devote considerable time to teaching dermatopathologyan average of 570 hourscurricular content varies considerably, and some significant inequalities exist, Dr. Phillip T. Hsu reported at the annual meeting of the American Academy of Dermatology.
The survey, billed as one of the first attempts to paint a comprehensive picture of dermatopathology education in the United States, concluded that only 54% of programs employ journal review with faculty and only 38% include problem-based learning as part of their dermatopathology training curriculum, noted Dr. Hsu of the University of Wisconsin, Madison.
Particularly noteworthy was the finding that only one in five programs feature computer-based learning, said Dr. Hsu. "This may be an underutilized teaching modality with high potential."
Five programs did not have access to teaching slide sets for their residents. Six programs did not offer a dermatopathology rotation. Computer technology could readily be harnessed to address these disparities by providing access to virtual slide sets and virtual dermatopathology lectures, according to Dr. Hsu.
The survey of the Association of Professors of Dermatology membership elicited responses from 48% of the nation's 109 dermatology residency programs.
Among these programs, 53% have more than two faculty members teaching dermatopathology; 36% of the instructors are board certified in dermatology, while 23% are board certified in pathology; and 92% of programs use academic board-certified dermatopathologists in teaching residents.
Most programs spent an average of 6 hours monthly on dermatopathology training. But residency programs in the South spent an average of 13 hours monthly on dermatopathology.
Residents interpret their own slides in 73% of training programs, and in 68% of those programs, faculty are present during the interpretation.
Dermatopathology education lacks a dermatologist-oriented textbook that is comprehensive yet less detailed than what is now available, according to respondents. The most widely used primary textbooks nationally are "Lever's Histopathology of the Skin" (David E. Elder, M.D. Philadelphia: Lippincott Williams & Wilkins, 2004) and "Skin Pathology" (David Weedon, M.D. Edinburgh: Churchill Livingstone, 2002). "Practical Dermatopathology" (Ronald Rapini, M.D. Philadelphia: Mosby, 2005) was rated highly by its users. Respondents indicated they would like better guidance as to what aspects of dermatopathology residents need to know.
Most graduates who applied for a dermatopathology fellowship were able to match. Opportunities for dermatology residents to participate in dermatopathology rotations, either inside or outside the residency program and regardless of rotation duration, were identified as a critical factor in inspiring trainees to become dermatopathology fellows, Dr. Hsu said.