Evaluating Dermatology Learning Outcomes and Experiences Among Family Medicine Residents During a Two-Week Dermatology Rotation ^†

Formal dermatology exposure during family medicine residency training is often limited. Although focused rotations exist, programs are not always rigorously evaluated for their educational effectiveness. Using the Plan-Do-Study-Act (PDSA) framework, this study aims to collect data to inform ongoing dermatology education and rotation improvement. Objectives include assessing residents’ self-assessment of learning and changes in self-reported confidence, as well as evaluating learner experiences and perceptions of a two-week dermatology program rotation.

This mixed methods study uses post-rotation surveys (n = 20) and semi-structured interviews (n = 5) to evaluate the educational experiences of family medicine residents who have completed a two-week dermatology rotation from December of 2022 to March of 2026. Self-assessment of learning was analyzed, using a Likert scale measuring changes in self-reported confidence in ten distinct dermatologic topics around diagnosis, management, and procedural skills. Learner experience was also analyzed using a Likert scale around five distinct topics concerning teaching style and case exposure during the rotation. The interviews included more in-depth analysis of the objectives with additional questions prompting students to share opportunities for perceived improvement. For quantitative analysis, individual questions and overall changes in reported confidence were assessed using Wilcoxon signed-rank test, as the pre- and post-rotation scores were paired and derived from a 5-point Likert-scale (ordinal data), for which a non-parametric test is most appropriate. Bonferroni correction was applied to the individual questions analysis. Mean scores and percent agreement scores for evaluation of the elective post-rotation were calculated. For qualitative analysis, two researchers analyzed transcribed interviews, triangulated qualitative findings from the survey, and engaged in inductive thematic analysis identifying overarching themes and emerging patterns within the data.

Results of the Wilcoxon signed-rank test for overall change in confidence demonstrated a statistically significant increase in confidence from pre-rotation to post-rotation, with median confidence scores increasing from 2.3 to 4.0 on a 5-point Likert scale (p < 0.001) and a large effect size (r = 0.87), indicating a strong and meaningful improvement in confidence following the rotation. This is consistent with the finding that 95% of students have a positive change in their confidence from pre-rotation to post-rotation. Learners evaluated their experience with a mean overall score of 4.06/5, with 60% of students rating ≥4/5 (stating they agree or strongly agree). Qualitative data from short answers in the survey (n = 18) and interviews (n = 5) include themes of: effectiveness of rotation—improved confidence and application into practice; exceptional teaching quality—specific teaching style and objective setting; and areas of improvement—high clinic volume, lack of practical family medicine relevance, and lack of formal dermatology teaching in both FM curriculum and rotation.

These results create opportunities for improvement including but not limited to: supporting students in the fast-paced environment via structured teaching and reflection time slots; improving formal teaching in both the family medicine curriculum and pre-rotation, with a focus on general family medicine principles and areas of identified low confidence. The results and opportunities for improvement will be shared with the dermatology education committee and incorporated into curriculum development efforts, supporting ongoing enhancement of dermatology teaching within family medicine training programs.