Evidence from the GP Synergy NSW & ACT Research and Evaluation Unit – each month we present findings from our work that may be of interest to registrars and their supervisors.
Dermoscopy has been demonstrated to improve accuracy of melanoma diagnosis by trained primary care physicians. And dermoscopy is a skill that GP registrars are expected to acquire by the end of general practice vocational training.
In a study led by academic registrar Georgie Whiting (1), and nested within the ReCEnT project, we aimed to establish prevalence of dermatoscope use by general practice registrars when performing skin and pigmented lesion checks, and to identify factors associated with dermatoscope use. We also sought to explore implications of dermatoscope use for registrars’ making skin lesion diagnoses and for their confidence in diagnosis.
During two six-monthly rounds of ReCEnT data collection we collected data on dermatoscope use by registrars during office-based consultations. Dermoscopy was used in 61% of consultations involving skin or pigmented lesion checks. Dermatoscope use changed provisional diagnosis in 22% of instances and increased diagnostic confidence in 55%. In examining the context for this use, we found 49% of registrars reported having dermoscopy training.
Dermatoscope use was more likely with the registrar being in terms 2 or 3 compared to term 1 and varied by region, but not by latitude.
We interpreted our findings as being that registrars perform dermoscopy in a modest proportion of skin and pigmented lesion checks (given that dermoscopy is considered best-practice in assessing skin lesions). We also concluded that dermoscopy is of utility, given that it influences registrars’ diagnoses and increases their confidence in their diagnoses.
(1) Whiting G, Stocks N, Tapley A, van Driel M, Holliday E, Morgan S, Henderson K, Ball J, Spike N, McArthur L, Davey A, Magin P. General practice trainees’ use of dermoscopy: prevalence, associations and influence on diagnosis and diagnostic confidence. 2019. Australian Journal of General Practice. 48(8). 547-553. doi: 10.31128/AJGP-11-18-4773
If you would like further information, please contact Parker Magin.