Written by Hannah Harp
Spoon Feed
When trained on a web-based educational program of common pediatric dermatologic conditions, trainees and attendings saw significant improvement in their ability to identify concerning conditions, rash morphology, and specific diagnoses.
I’m itching to learn more
Rashes, am I right? There are so many types and so many variations. Most are harmless, but some are deadly! And where was my dermatology rotation in residency? Skin concerns are a leading complaint in pediatric outpatient clinics and emergency rooms, but outside of about 15 conditions that we see regularly, there is a lot of room for diagnostic uncertainty. Is there a place for virtual education, rather than bedside education, when it comes to pediatric dermatologic presentations?
This prospective cross-sectional study evaluated whether a web-based dermatologic image training tool could enhance pediatricians’ diagnostic accuracy. Among 185 participants, diagnostic performance improved significantly across tasks: identifying concerning cases (+19.2%, 95%CI 17.7–20.6), morphologic category (+17.9%, 95%CI 16.5–19.3), and specific diagnosis (+25.2%, 95%CI 23.4–26.7). Participants achieved an 85% performance standard after a median of 142 cases and about one hour of time. However, accuracy was lower for patients with darker skin (ORs 0.87–0.96), indicating persistent diagnostic disparities. The applications of the study are limited by the intervention’s web-based nature. We don’t know yet if competency in the learning program correlates to competency at bedside, and we don’t know how long these knowledge gains last.
How will this change my practice?
I get so tired of seeing the same stock photos for certain skin conditions. I would love to give this program a try just to see 16 variations of scabies and 6 of erythema multiforme (authors, call me!), especially if it limits the number of times I say to parents, “Let’s start with this cream and see how things go.”
Source
Rash Decisions: Improving Pediatrician Skills in Dermatologic Diagnosis. J Pediatr. 2025 Mar;278:114436. doi: 10.1016/j.jpeds.2024.114436. Epub 2025 Jan 15. PMID: 39674540
