Cutaneous Melanoma
Conditions
Keywords
MelaMEd, General Practitioners, Primary Care Physicians, Medical Education, E-Learning, Melanoma Detection, Diagnostic Accuracy, Skin Lesion Triage, Continuing Medical Education
Brief summary
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.
Detailed description
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.
Interventions
BEHAVIORALMelaMEd Online Training Program
The intervention was a free, self-paced asynchronous e-learning course titled "Early Diagnosis and Management of the Therapeutic Diagnostic Pathway of Melanoma," integrated with the MelaMEd multimedia platform. The course included video lectures and interactive clinical cases covering melanoma risk factors, sun exposure and photoprotection, skin examination, clinical recognition rules such as the ABCDE rule, the EFG rule, and the "Ugly Duckling" sign, histopathological diagnosis, surgical and medical treatment, staging, prognosis, and referral decision-making. The linked MelaMEd platform provided clinical, dermoscopic, and histological images, interactive educational resources, and access to guidelines and scientific literature.
Sponsors
Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRST S.r.l. IRCCS
Intergruppo Melanoma Italiano
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
All participants were assigned to the same MelaMEd educational intervention. The study used a single-group before-and-after design, with no control or comparison arm. Training effectiveness was assessed by comparing available paired responses to questionnaires completed before and after the intervention.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Licensed general practitioners, general practitioners in training, or pediatricians working in the healthcare system areas served by participating Italian Melanoma Intergroup centers. * Voluntary agreement to participate in the study evaluation. * Confirmation that the participant had read and understood the information on personal data processing. * Authorization for the processing of personal data in accordance with European Union Regulation 2016/679.
Exclusion criteria
* No formal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Diagnostic Performance Across 10 Skin Lesion Cases | Pre-training baseline and post-training assessment within 10 days of completion of the online course | Diagnostic performance was assessed using 10 clinical images of melanocytic and non-melanocytic skin lesions. For each case, participants classified the lesion as benign or malignant and selected the most likely diagnosis from four options. The percentages of correct benign or malignant classifications and correct diagnoses were calculated before and after training using matched responses. Pooled sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were also calculated. Higher values indicate better diagnostic performance. |
| Change in Dermatology Referral Decisions for Skin Lesions | Pre-training baseline and post-training assessment within 10 days of completion of the online course | Using the same 10 clinical cases, participants indicated whether the person should be referred to a dermatologist for specialist assessment and possible excision. For each case, the percentage of participants selecting referral was calculated before and after training using matched responses. Changes were interpreted according to the reference diagnosis, with the aim of increasing referral of malignant lesions and reducing unnecessary referral of benign lesions. |
| Change in Melanoma Knowledge After MelaMEd Training | Pre-training baseline and post-training assessment within 10 days of completion of the online course | Melanoma knowledge was assessed using seven multiple-choice questions covering ultraviolet radiation, complete skin examination, the ABCDE rule, the EFG rule, the Ugly Duckling sign, dermoscopy, and Breslow thickness. For each question, the percentage of participants selecting the correct answer was calculated before and after training using matched responses. Higher percentages indicate better melanoma knowledge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Self-Reported Confidence in Melanoma Prevention and Detection | Pre-training baseline and post-training assessment within 10 days of completion of the online course | Participants rated their confidence in three domains: counseling on melanoma prevention, guiding patients in skin self-examination, and recognizing lesions suspicious for melanoma. Each domain was rated on a 5-point Likert scale from 1, not confident, to 5, very confident. Pre-training and post-training ratings were compared using matched responses. Higher scores indicate greater confidence. |
| Participant Satisfaction and Perceived Usefulness of the MelaMEd Training | Post-training assessment within 10 days of completion of the online course | After training, participants completed five items assessing the perceived usefulness, usability, and clinical value of the MelaMEd program. Each item used a 5-point Likert scale from 1, strongly disagree, to 5, strongly agree. Responses were summarized as numbers and percentages. Higher scores indicate a more favorable evaluation of the training. |
Countries
Italy
Contacts
PRINCIPAL_INVESTIGATORIgnazio Stanganelli, MD
Skin Cancer Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori"
Outcome results
None listed