Assessing chiropractic students' ability to detect and manage melanomas using standardized patients and moulage

Introduction: The aim of the study was to explore the screening skills and dermatological practices of 6th trimester chiropractic student’s in the detection of melanoma during a non-dermatologic simulated patient encounter with an incidental finding of a suspicious melanoma on the back of the neck.

Methods: The study was a retrospective analysis of WebSP data during two standardized patient encounters. A malignant melanoma moulage was applied to the base of the cervical spine on the lower right side of standardized patient’s (SP) participating in a neck pain scenario during a required clinical skills examination. Standardized patient checklists were reviewed for evidence on the student’s ability to detect the suspicious skin lesion and to manage appropriately. The study was approved by the institutional review board.

Results: The cohort’s consisted of a total of 27 chiropractic students in 6th trimester; the detection rate was 41 % for noticing the skin lesion and 15% managing the skin lesion appropriately. The majority of student’s attention focused towards the standardized patient’s chief complaint of neck pain and less exploration of the melanoma that was visibly noticeable.

Conclusions: The study low detection rate and the lack of appropriate management for a malignant melanoma is a significant teachable moment for chiropractic student’s in the 6th trimester even though they are given a mandatory 1 credit hour course in dermatology in the 5th Trimester. Further studies need to be conducted on chiropractic students in the detection of melanomas during a non-dermatologic simulated patient encounter.