June 23, 1998 Over 50 per cent of family physicians in Ontario lack confidence in recognizing malignant melanoma, according to a recent study published in the journal American Academy of Dermatology.
"Melanoma is relatively easy to detect and, when diagnosed early, is curable," says the study's lead investigator Professor Lynn From of U of T's department of medicine and head of the division of dermatology at Women's College Hospital. "However, people at highest risk for melanoma may not be receiving information about early detection that could help decrease the incidence and mortality of melanoma."
The study showed that while family physicians are well informed on factors affecting prognosis, they did not recognize some important and sometimes unexpected risk factors such as working indoors or multiple moles. Doctors also lack knowledge about the history of and physical examination for melanoma. "The incidence of melanoma in Ontario has increased 178 per cent from 1969 to 1988, a factor that increases the importance of a family physician's role in screening for suspicious-looking brown spots," From says.
The study, conducted to assess the learning needs of family physicians to create effective education programs, involved mailing a questionnaire to 750 randomly selected Ontario doctors. A total of 355 physicians (a 46 per cent response rate that represents nine per cent of family physicians in the province) completed the survey. Respondents included university- and non-university-associated physicians from urban and rural areas.
Although the investigators recommend further education on melanoma, they were unable to identify the most effective program. "The only method rated highly by the majority was hands-on teaching," says From, noting this is not an efficient way to educate large numbers of physicians. "A user-friendly interactive learning program would be an alternative, more effective method but only 30 per cent rated this as very or extremely useful."
Collaborating on the study with From were Dr. Adrianne Cohen and Jane Tipping of U of T's continuing medical education office and Dr. Anne Stephenson, a former U of T medical student. Funding for the research was supported in part by a continuing medical education grant from U of T's Faculty of Medicine.
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