DT01: Technology-enhanced learning interventions on skin-of-colour dermatology for dermatology trainees and fellows: are they effective or sustainable?

Orals

Shivani Puri,¹ Jonathan Guckian² and Noha Elshimy³

¹Leeds University, Leeds, UK; ²Leeds Teaching Hospitals Trust, Leeds, UK; and ³Walsall Healthcare NHS Trust, Walsall, UK

The COVID-19 pandemic diverted medical education within dermatology towards technology-enhanced learning (TEL) delivery. Concurrent societal movements also raised awareness of racial inequalities in health outcomes. This has been highlighted as a priority within dermatology research and education (Guckian J, Ingram J, Rajan N, Linos E. Dermatology is finally talking about race. Br J Dermatol 2021; 185: 875–6). The British Association of Dermatology acknowledges that ‘the education of undergraduate and postgraduates…needs to be updated to better include skin of colour’ (https://www.bad.org.uk/healthcare-professionals/inclusivity-and-representation). Numerous distance courses in this domain have been piloted, but there is little published evidence regarding efficacy or sustainability. This study evaluated whether TEL methodologies can facilitate effective and sustainable ethnic dermatology education. The study explored the existing competence and confidence of a cohort of dermatology trainees towards managing dermatology conditions affecting skin of colour, specifically central centrifugal cicatricial alopecia (CCCA) and keloid scarring. The short- and long-term impact of TEL interventions upon trainees’ confidence and competence of managing these conditions was investigated. A prospective cohort study was designed and included 14 dermatology registrars and regional fellows across Yorkshire. A Zoom teaching session was provided, covering keloid scarring and CCCA, supported by a ‘flipped-classroom’ approach via pre-reading materials. Survey methodology was used; three questionnaires were circulated: presession (survey 1), postsession (survey 2) and 6 weeks afterwards (survey 3). These featured multiple choice questions gathering data regarding participant knowledge and questioned confidence and competence. Multiple-choice questions were normed by 15 external trainees to ensure suitable difficulty. Presession, 64% participants felt that, on completion of specialty training, they would be competent in treating patients with ethnic skin. Ninety-three per cent believed that formal outcomes related to ethnic dermatology should be included in the curriculum. Postsession, 42% strongly agreed that the teaching course would change their practice. Fifty per cent felt that the teaching content was ‘somewhat new’. Average knowledge scores demonstrated an initial rise then fall (survey 1: 5·67/10; survey 2: 7·83/10; survey 3: 6·36/10). Despite an innovative TEL education session, trainee knowledge did not significantly improve and improvement did not prove sustainable 6 weeks after teaching. Trainees were not confident in adopting newly acquired knowledge on skin of colour into their practice. Results show that the benefit of providing TEL education on ethnic dermatology may prove transient, and there is disparity in the perceived and actual benefit of ethnic dermatology education. Systemic solutions may be warranted, combining both education and human factors, including tackling systemic injustices and social inequalities.