Digital photographs in clinical teaching of dermatology: What is their proper place?

Dear Sir

Despite the wide use of digital photographs in dermatology teaching, the relevance of this facility is rarely assessed. During our randomized controlled study, eligible medical students were divided into two groups: group A (n=54) was provided traditional clinical teaching and group B (n=54) benefited for a digital photograph-based teaching. Each group was subdivided in small subgroups comprising three students each. Then, we adopted a 3-week rotation. During this rotation, one subgroup from group A (three students) attended dermatology outpatient department once weekly. Each time, five real cases were discussed. In alternative days, a subgroup from group B was exposed to the same clinical cases using a projection of digital photograph slides. At the end of every 3-week rotation, an evaluation comprising two sections was administered to the two subgroups:

• A subjective section using a 5-point- Likert-scale questionnaire.

• An objective section which is to achieve correct diagnoses of suggested clinical cases.

Regarding the number of correct diagnoses provided by each student of different groups, the analysis of variance has shown that the different groups do not differ statistically between themselves (F = 1.25; p = 0.29). As for the Likert-scale questionnaire, Cronbach's alpha value was 0.607. We noted especially that the majority of students agreed or strongly agreed that digital photograph teaching is better than the traditional clinical teaching, as well it encouraged them to learn more about the discussed conditions.

Digital photograph-based teaching is a considerable solution to overcome the main issues encountered during conventional dermatology clinical teaching: shortage of trained faculty and inadequate teaching time (Kaliyadan et al. 2008). Using this educational method, the teacher has the possibility to choose the topics to be discussed during each session, and to replicate the same for other groups. It is also relevant to note that digital photograph-based teaching obeys a major criterion of an effective teaching since it encourages students to learn more about the discussed conditions. On the other hand, digital photographs represent the basic tool of many modern educational methods (online dermatology courses, problem-based learning), and may have a place in teledermatology (Whited et al. 1998).

Despite these advantages of digital photograph-based teaching, we emphasize that this modality is not a substitute for formal clinical teaching; it is rather a good supplement.