Dermatology EducationOral presentationsDE01 Exploring the use of an instructional dermatology surface model within a dermatology-focused medical student objective structured clinical examination station
Authors: Natalie Eraifej, Tayha Jupe, Alexander Grundmann, Andrew Blythe, David Rogers, Stephen De Souza, Hannah Wainman
Journal: British Journal of Dermatology (2024)

Abstract Dermatology-focused objective structured clinical examination (OSCE) stations are challenged by difficulties in standardizing patients due to the fluctuating appearance of chronic conditions and the necessity for urgent removal of cancerous lesions. Photographs of skin lesions can be used instead but have been criticized for poor authenticity and hindering consultation flow. Instructional dermatology surface models (IDSMs) are transfers of dermatoses, often three dimensional, that can be applied and removed within minutes. They have been found to be realistic and reliable assessment tools (Gormley, Menary A, Layard B et al. Temporary tattoos: a novel OSCE assessment tool. Clin Teach 2013; 10: 251–7). However, there is minimal literature investigating students’ views on the use of IDSMs within dermatology examinations. We sought to explore third-year medical students’ experiences using a three-dimensional IDSM of a malignant melanoma within a summative dermatology-focused OSCE station. After the exam, an online questionnaire was distributed containing free-text and yes-or-no questions, and Likert scales focused on the IDSM’s realism, usefulness for formulating a diagnosis, and impact on communication. Ethical approval was discussed with the local university ethics board and deemed unnecessary. Overall, 30% (n = 80) of students who sat the exam completed the questionnaire. Data from binary questions and Likert scales were analysed using simple descriptive statistics. Free-text answers were analysed with sentiment ana­lysis. The most favourable aspect of the IDSM was realism, with 96% of students agreeing that the IDSM looked realistic. The most common sentiment describing the IDSM was ‘realistic’, used three times more frequently than the next most common sentiment ‘good’. In total, 91% preferred the IDSM over a printed photograph, and 94% of students found the IDSM helped them make the diagnosis, emphasizing the importance of visual and tactile assessment within the speciality. Overall, 96% perceived that the IDSM helped their consultation skills. However, students highlighted that they should be told whether an IDSM is being used, as some mistakenly asked for a photograph, which was perceived to negatively impact consultation skills. In total, 92% of students passed the station, and the station’s mean score was the highest in the 16-station OSCE. Informal examiner feedback after the exam contained positive comments about use of the IDSM, but highlighted drawbacks including the model’s high cost, its potential unrealistically large size, and that reapplication was required midexam for some standardized patients. Overall, the IDSM was positively perceived by students and examiners. The British Association of Dermatologists offers an excellent opportunity to share our results with other dermatology educators and to explore how IDSMs may be useful in future undergraduate and postgraduate high-stakes dermatological assessments.