Derms can earn online credits playing melanoma video game

Editor's note: To access Terra Derma, an educational video game about malignant melanoma, click on the following link, then look under "Interactive eCME Games" at the bottom of the page: cyberounds.com

National report - Dermatologists who earn online continuing medical education (CME) credits playing Terra Derma, an interactive video game about malignant melanoma, may have to remind themselves that they’re not playing Super Mario Brothers.

In fact, they’re working toward nine free CME hours and learning from renowned melanoma specialists.

Terra Derma is the 15th eCME game and the first geared to dermatologists by Cyberounds.com, a website accredited by Albert Einstein College of Medicine, New York, whose audience now exceeds 550,000 physician users worldwide.

Terra Derma “is our foray into the dermatology world. But we’ve been making these games (in other areas of medicine) for about seven or eight years,” says Harry A. Levy, M.D., M.P.H., executive editor, Albert Einstein College of Medicine-Cyberounds.

Dr. Levy, a preventive medicine specialist and Cyberounds’ editor since it launched in 1996, says the idea to offer CME via a video game format came from the site’s users, who said they were bored with traditional CME.

"The games are extraordinarily popular, almost seductive,” he says. “Physicians are constantly writing me, asking: 'What new games do you have?'"

The making of a game
Users indicated that melanoma and dermatology would be important areas to pursue. Dr. Levy agreed.

“We are regularly looking at emerging trends and therapies across the medical spectrum, and melanoma … is unfortunately a disease of rising incidence,” he says. “We noted in the literature that there was increasing hope that new therapies were emerging for the disease, so we wrote a grant and reached out to several companies, hoping somebody might give us an educational grant. Bristol-Myers Squibb did.”

Dr. Levy and Cyberounds colleagues began the search for authors and editors for what would become Terra Derma, an eCME game about the biology, genetics and emerging treatments for melanoma. They looked at physician contributions to the scientific literature on the topic and consulted about their findings with doctors at Albert Einstein.

“We looked for authors who would be considered by everyone involved as experts in … the treatment of melanoma,” Dr. Levy says. “With that in mind, we gave those we chose the mandate: ‘Let’s make something exciting for dermatologists, oncologists, family practitioners and internists … who first encounter cases of melanoma and don’t know exactly what their options are.’”

Three authors and two editors were involved in creating the content for Terra Derma. All are oncologists.

The authors are Mario Sznol, M.D., professor of internal medicine, Yale University School of Medicine, New Haven, Conn.; Jeffrey S. Weber, M.D., Ph.D., director of the Donald A. Adam Comprehensive Melanoma Research Center, Moffitt Cancer Center, and professor of Oncologic Sciences, University of South Florida School of Medicine, Tampa, Fla.; and Jedd D. Wolchok, M.D., Ph.D., associate attending physician at Memorial Sloan-Kettering Cancer Center, New York.

Jeffrey Weber, M.D., Ph.D.

The editors are F. Stephen Hodi, M.D., director of the Melanoma Disease Center, assistant professor of medicine, Harvard Medical School, and Robert G. Lerner, M.D., professor and vice chairman, department of medicine, and professor of pathology, New York Medical College, New York.

Rich resource
Dr. Sznol, who is co-director of Yale’s melanoma program, wrote the background sections and questions covering initial diagnosis and management, staging, adjuvant treatment, standard treatment for metastatic disease, basic immunologic concepts, and overview of emerging treatments, including targeted therapies.

Mario Sznol, M.D.

“Terra Derma provides an overall review of clinical issues beginning with initial diagnosis, and covers management of the patient from the time of diagnosis through treatment of metastatic disease,” he says. “There is a specific focus on immunotherapy and ipilimumab, which recently was shown to prolong survival of patients with metastatic disease and is being studied in the surgical adjuvant setting.

“The game materials highlight the unique aspects of ipilimumab response kinetics and management of toxicity,” he says.

Ipilimumab and the targeted agents will likely change the standard of care in the very near future, Dr. Sznol says.

Physician-friendly games
Cyberounds’ games, including Terra Derma, have two features in addition to the questions and answers. One, Dr. Levy explains, is educationally significant; the other is emotionally rewarding.

The games shine educationally, he says, because they feature preparation materials designed to help test-takers better understand the questions and derive correct answers. Doctors can click material specific to each question.

“If you read the prep material before answering the questions, you have a pretty good chance of understanding the questions and the answers. Some people are macho and don’t want to read the prep material, but we prefer, educationally, that you read the content,” he says.

The emotional drive - what makes doctors play these games, according to Dr. Levy - is the “top scores” function. Physicians can click on that and immediately find their standings compared to their colleagues.

“There’s a competition, and it’s real-time,” Dr. Levy says. “It’s tracking and comparing you to everyone else.”

Other features include the capability for a player to stop and restart the game where it was left off.

At press time, between 400 and 500 Cyberounds users had played Terra Derma. Each game usually has several thousand players by the end of its three-year run, Dr. Levy says.

Derms needed
There are no current plans for additional dermatology games. Dr. Levy says that’s because he and his staff can only do so much. But he has issued an open invitation to interested dermatologists to contact him.

“We had to make a choice at the very beginning of Cyberounds - how many things we could editorially support. Dermatology, I feel, is very important. … The only problem is that we can’t do everything,” he says. “Maybe a dermatologist reading this will say, ‘Gee, I’d like to be the editor for dermatology,’ and contact us.”

Dr. Levy can be reached at (212) 876-5727 or through e-mail at levy@cyberounds.com.

For more information: cyberounds.com