MelaMEd Online Training for General Practitioners to Improve Melanoma Detection and Management

Overview

The goal of this trial was to learn whether the MelaMEd online training program could improve doctors' skills in the early detection and management of melanoma, the most aggressive type of skin cancer. The participants were primary care physicians, including general practitioners, general practice trainees, and pediatricians. The main questions were: Did the training improve doctors' ability to identify skin lesions that might be melanoma? Did the training improve their knowledge of melanoma prevention, diagnosis, and management? Did the training help doctors make better decisions about referring patients to a dermatologist? Participants first completed an online questionnaire. It included questions about melanoma and images of skin lesions. Participants then completed the MelaMEd online training course. After the training, participants completed a second questionnaire with the same main questions. They also answered questions about their confidence in managing melanoma and their experience with the course. Researchers compared each participant's answers before and after the training. There was no separate comparison group.

MelaMEd, which stands for Melanoma Multimedia Education, is an online educational program developed by the Italian Melanoma Intergroup. The program was designed mainly for general practitioners and other primary care physicians involved in melanoma prevention, early detection, and referral. The educational intervention consisted of a free asynchronous e-learning course titled "Early Diagnosis and Management of the Therapeutic Diagnostic Pathway of Melanoma." The course included video lessons, clinical images, interactive cases, and switches between video lectures and the IMI MelaMEd multimedia atlas on the MelaMEd Platform. The educational content covered melanoma risk factors, sun exposure and sun protection, skin examination, clinical recognition rules, differential diagnosis, referral decisions, histopathology, staging, and treatment. Clinical recognition rules included the ABCDE rule, the EFG rule, and the "Ugly Duckling" sign. The study used a prospective, single-group, before-and-after design. Eligible participants were general practitioners, general practitioners in training, and pediatricians working in the healthcare areas of participating Italian Melanoma Intergroup centers. Participation was voluntary. Before the training, participants completed an online questionnaire. The questionnaire included seven multiple-choice questions about melanoma knowledge and 10 images of skin lesions. For each image, participants were asked to: classify the lesion as benign or malignant; select the most likely diagnosis; decide whether referral to a dermatologist was appropriate. After completing the training, participants received a post-training questionnaire. It repeated the main knowledge and clinical case questions. It also included questions about confidence in melanoma prevention, skin self-examination counseling, recognition of suspicious lesions, and satisfaction with the course. Each participant received a numerical code that allowed the researchers to match pre-training and post-training answers. The main outcomes were changes in melanoma knowledge, diagnostic performance, and referral decisions. Additional outcomes included changes in self-reported confidence and participants' views on the usefulness and usability of the educational program. Paired pre-training and post-training responses were compared using statistical methods for matched data.