Implementing the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis: Long-term effect of a simple educational intervention

Lisa M Reisch; Hannah Shucard; Andrea C Radick; Megan M Eguchi; David E Elder; Raymond L Barnhill; Michael W Piepkorn; Stevan R Knezevich; Kathleen F Kerr; Joann G Elmore

doi:10.1016/j.jdin.2023.01.025

Implementing the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis: Long-term effect of a simple educational intervention

JAAD Int. 2023 Mar 12:11:211-219. doi: 10.1016/j.jdin.2023.01.025. eCollection 2023 Jun.

Authors

Affiliations

¹ Department of Biostatistics, University of Washington, Seattle, Washington.
² Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California.
³ Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
⁴ Department of Translational Research, Institut Curie, Paris Sciences and Lettres Research University, and University of Paris UFR of Medicine, Paris, France.
⁵ Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
⁶ Dermatopathology Northwest, Bellevue, Washington.
⁷ Pathology Associates, Clovis, California.

Abstract

Background: A standardized pathology management tool for melanocytic skin lesions may improve patient care by simplifying interpretation and categorization of the diverse terminology currently extant.

Objective: To assess an online educational intervention that teaches dermatopathologists to use the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx), a schema collapsing multiple diagnostic terms into 5 classes ranging from benign to invasive melanoma.

Methods: Practicing dermatopathologists (N = 149) from 40 US states participated in a 2-year educational intervention study (71% response rate). The intervention involved a brief tutorial followed by practice on 28 melanocytic lesions, with the goal of teaching pathologists how to correctly use the MPATH-Dx schema; competence using the MPATH-Dx tool 12-24 months postintervention was assessed. Participants' self-reported confidence using the MPATH-Dx tool was assessed preintervention and postintervention.

Results: At preintervention, confidence using the MPATH-Dx tool was already high, despite 68% lacking prior familiarity with it, and confidence increased postintervention (P = .0003). During the intervention, participants used the MPATH-Dx tool correctly for 90% of their interpretations; postintervention, participants used the MPATH-Dx tool correctly for 88% of their interpretations.

Limitations: Future research should examine implementing a standardized pathology assessment schema in actual clinical practice.

Conclusion: Dermatopathologists can be taught to confidently and competently use the MPATH-Dx schema with a simple educational tutorial followed by practice.

Keywords: continuing medical education; dermatopathology; intervention study; melanocytic skin lesion; standardized histology schema.