| 1
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“I was really pleased that this app was offered as I was afraid I would have had limited knowledge on these topics. Now I did get assigned a workplace in the dermatology department during the clerkship, but imagine that this had not been the case, I would say the app is very useful for gathering basic knowledge in this field. It's like I said, there is very little attention for this discipline in the pre-clinical phase of the undergraduate training. These cases in the app are just very accessible in terms of questions and time you need to spend on it”. (Interview 6, male, age 22 years) |
| 2
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“I do not know yet what discipline I would like to do [in post-graduate training], but I do know that skin disorders are frequently seen among patients. Perhaps I want to be a general practitioner (Family medicine), and then I would see all kinds of patients with skin conditions. Through the app, I could boost my knowledge in dermatology, because I knew I would not have a workplace in the dermatology department during the clerkship or more lectures on these topics”. (Interview 5, male, age 21 years)
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| 3
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“Often, I used the e-learning program during the evening, and I did a couple of cases at once. I have not really tracked how long I worked on it. By just reading the cases at my own pace, I tried to learn”. (Interview 3, female, age 21 years) |
| 4
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“The quality was fine, although sometimes pictures were not sharp enough. Some images moved when enlarging images on the screen of the mobile phone and then I got stuck in the whole process”. (Interview 1, female, age 21 years) |
| 5
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“Questions are asked in a certain order, in steps. You first hear the history of the patient and then a certain change is introduced, and you get the question: ‘What do you think now?’ Through these questions, you are encouraged to look at the problem from a dermatological perspective. Also, you become more acquainted with the steps that you have to take”. (Interview 1, female, age 21 years) |
| 6
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"I think…as the cases from the app were constructed in a certain order, this defined what I was going to study, and I was comfortable with that. By using a book including enormous amounts of information and names of diseases, I thought ‘where am I going to start?’ In this application, receiving selected cases just makes you start” I got more structured. Just like when you see a patient in the clinic, and later on you will focus your study on the patient, now you get a case and use that as a focus for study, this works well for my retention of knowledge”. (Interview 3, female, age 21 years) |
| 7
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"I think the written [text] information and history of the patient is more useful for me because there are also things like 'is it light-sensitive?" Or "did it fade away quickly?" which is more useful for me than a picture. Often, I’m faced with red rash, for example, which can still indicate a lot of different things and be very divergent". (Interview 2 female, age 22 years) |
| 8
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“If I don’t know the answers, then the presentations of the various diagnoses in the program are quite practical. If you don't know the answer based on images, you are forced to think beyond that and go through several options. We don’t have that much knowledge to actually construct differential diagnosis ourselves. Otherwise, we have to go over all skin disorders”. (Interview 7, female, age 21 years) |
| 9
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“I used the program especially when I gave the wrong answer on a question, and did not understand why. Then I used the link to check the website”. (Interview 2, female, age 22 years) |
| 10
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“It's a bit like the progress test [=longitudinal knowledge test], I think, you might know what the answer is, but if you do not know why you remain on the same level. So, you want to simply sort out the other options”. (Interview 9, male, age 21 years) |
| 11
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“I kept a document for myself in which I underlined the headlines of cases and questions, and added information from the external websites. Then I remembered it better because I could link the information together with the case and its question”. (Interview 4, female, age 22 years) |
| 12
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“Often I had some time to work on the cases and questions during my clerkship. There were also several people I could ask for help, like the residents from the internal medicine department. Today I asked someone for the question on the diagnosis in the case of lupus, which was great”. (Interview 5, male, age 21 years) |
| 13
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"I noticed that many students do not really know much about dermatology and that such an app would provide an effective solution in this situation, especially since those questions always come back in the progress tests. I also noticed this when we were discussing these questions; then they would say 'oh, okay, now I know I see how it works, now I get it”. (Interview 6, male, age 22 years) |
| 14
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“When I encounter this disease in practice, then it hits me, oh wait, I recognize this, for example in the case with the seborrheic keratosis and basaliomas. These are images that are very common, and sometimes this type of seborrheic keratosis is also not quite "typical" as it looks. So, when I saw it in real-life, I had to doubt it, but then with the use of the app, I realized that I still noticed features that could be seen in images that I did not see in practice. So, I used this to switch from one to another”. (Interview 1, female, age 21 years) |