DE07 Dermatology Dungeons and Dragons: simulation in dermatology education

Abstract It has been shown that dermatology is poorly understood among medical students and doctors of all grades (Chiang YZ, Tan KT, Chiang YN et al. Evaluation of educational methods in dermatology and confidence levels: a national survey of UK medical students. Int J Dermatol 2011; 50: 198–202). A scoping review within dermatology showed better learning effects when the interventions activate students, involve feedback, and are built on case-based learning (Bernges F, Zielbauer S, Weberschock T, Ochsendorf F. Teaching dermatology to medical students: a scoping review of published interventional studies. J Dtsch Dermatol Ges 2022; 20: 1077–87). Unlike more rigid direct case-based teaching, simulation learning allows the student to help build the zone of learning and explore areas of education that may not have previously considered. A novel approach is currently being utilized with year 3 medical students. There are approximately 12 students in each 2.5-h session. They are split into three or four groups, with students with previous dermatology experience allowed to ask fewer questions and those with no previous dermatology experience allowed to ask unlimited questions. Each group is asked to roll a 10-sided die to choose their case. They are then given a clinical scenario that includes a brief history and clinical photographs. The facilitator acts as the patient answering the students’ questions. The clinical scenarios cover the commonly encountered conditions in dermatology. When the students reach a certain point in the decision-making process, they again roll a die to determine the outcome of that choice. This demonstrates the element of chance and multiple potential outcomes in real-life decision making within clinical practice. The students can come up with any of many appropriate management plans, but their success is left up to chance. The crucial step is that the students then follow up that case again and evaluate the consequences of their decision making and the rationale for success or failure. This can be repeated as many times as the session allows, and other students learn from watching their colleagues. The students are provided with feedback forms at the end of the session to gain insight into the positive and negative aspects and whether they felt the session improved their knowledge of diagnosing and managing dermatology conditions. Feedback has been consistently positive including, ‘That is the best teaching I have ever had’. The freedom to make errors is vital and allows the student to reach the highest level of Maslow’s hierarchy. The consequences then ground this in learning.