Acta Dermato-Venereologica 99-2CompleteContent

133 REVIEW ARTICLE Digital Education for Health Professions in the Field of Dermatology: A Systematic Review by Digital Health Education Collaboration Xiaomeng XU 1 , Pawel Przemyslaw POSADZKI 1 , Grace E. LEE 2 , Josip CAR 1,3 and Helen Elizabeth SMITH 4 1 Centre for Population Health Sciences (CePHaS), 4 Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, 2 School of Computer Science and Engineering, Nanyang Technological University, Singapore, Singapore, and 3 Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK Digital health education is a new approach that is re- ceiving increasing attention with advantages such as scalability and flexibility of education. This study em- ployed a Cochrane review approach to assess the evi- dence for the effectiveness of health professions’ di- gital education in dermatology to improve knowledge, skills, attitudes and satisfaction. Twelve trials (n = 955 health professionals) met our eligibility criteria. Nine studies evaluated knowledge; of those two reported that digital education improved the outcome. Five stu- dies evaluated skill; of those 3 studies stated that di- gital education improved this outcome whereas 2 sho- wed no difference when compared with control. Of the 5 studies measuring learners’ satisfaction, 3 studies claimed high satisfaction scores. Two studies reported that when compared with traditional education, digital education had little effect on satisfaction. The eviden- ce for the effectiveness of digital health education in dermatology is mixed and the overall findings are in- conclusive, mainly because of the predominantly very low quality of the evidence. More methodologically robust research is needed to further inform clinicians and policymakers. Key words: review; dermatology; education. Accepted Oct 15, 2018; E-published Oct 15, 2018 Acta Derm Venereol 2019; 99: 133–138. Corr: Josip Car, Centre for Population Health Sciences, 11 Mandalay Road, Level 18 Clinical Sciences Building, Singapore 308232. E-mail: josip.car@ ntu.edu.sg T here is a growing burden of skin conditions among the general population (1–3). Several studies have shown that up to 7% of primary care consultations are for skin related complaints (4–6). At the same time, there is an increasing worldwide shortage of healthcare professionals, including dermatologists and dermatology nurses (7). The world is short of 17.4 million health- care professionals (8) and this shortage is projected to remain, with a deficit of 14 million in 2030 (9). This shortage may be further accentuated by inadequate dermatology education; it is estimated that the formal dermatology education in the undergraduate medical and nursing curriculum represents only 0.24–0.3% of teaching time. Nonetheless, according to the American Academy of Dermatology’s (AAD) 2007 practice profile survey, dermatology practices have tended increasingly SIGNIFICANCE Digital education is a promising new approach with advan- tages such as scalability, flexibility, portability and adap- tability of education. This study synthesized effectiveness evidence for health professions’ digital education in derma- tology, and assessed whether it can improve knowledge, skills, attitudes and satisfaction as compared to traditional learning. We found 12 studies involving in total 955 health professionals. The main learning outcomes were compa- rable in terms of knowledge improvement, skills enhance- ment and satisfaction, suggesting the potential of digital health education to be used as a complementary or alter- native method to traditional learning in dermatology. It has the potential to address the increased demand for derma- tology education but requires further rigorous research to maximise its potential. to employ dermatology nurse practitioners in order to augment dermatology care services (10, 11). As for medical students, one survey claimed that they received no more than 18 h of dermatological education in medical schools (10). This paucity of dermatology training is of concern as patients with skin problems are encountered in many clinical specialties including general medicine, paediatrics, venereology and general practice. To fulfill the increasing need for dermatology educa- tion, it is necessary to provide high-quality teaching among pre- and post-registration health professionals (12). A recent study highlighted the potential for di- gital health education (DHE) in dermatology (13). In that study, digital education was found to significantly increase the effectiveness of dermatology learning, en- hance the quality of education, and improve the teacher’s resources. DHE (also known as eLearning) is a broad construct that includes digital technology delivered or improved approach to teaching and learning in health care which encompasses many different modalities offline and online, including virtual patient (VP), virtual reality environment (VRE), mobile learning (mLearning or mobile digital education), psychomotor skill trainers (PST), digital game-based learning (DGBL), Virtual Learning Environments (VLEs), Learning Management Systems (LMSs) and Massive Open Online Courses (MOOCs) (14). DHE, compared to traditional intervention, has ad- vantages such as flexibility, portability and especially, This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica. doi: 10.2340/00015555-3068 Acta Derm Venereol 2019; 99: 133–138

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