A systematic review of reviews of the effectiveness of training primary care practitioners in dermoscopy to detect skin cancers

Abstract Background Training primary care practitioners (PCPs) in dermoscopy may improve the early detection of skin cancers. However, evidence on the effectiveness and sustainability of different training approaches remains inconsistent. This systematic review of reviews aimed to synthesise the quality and findings of existing systematic and scoping reviews on dermoscopy training for PCPs, and to identify implications for implementation and future research. Methods Searches were conducted from database inception across the Cochrane Library, CINAHL, EMBASE, and MEDLINE in August 2023 and updated in September 2025. Peer-reviewed systematic and scoping reviews available in English were included. Methodological quality was assessed with the Critical Appraisal Tool for Health Promotion and Prevention Reviews, with overlap between reviews evaluated using pairwise Corrected Covered Area analysis. Findings were synthesised narratively. Results Of the 622 records screened, 8 met the inclusion criteria (systematic n = 4, scoping n = 4). Most reviews were very low or low quality (88%) with substantial overlap of primary studies. Reviews consistently reported that dermoscopy training was associated with improvements in diagnostic accuracy (estimates across the reviews ranged from sensitivity 70–95%, specificity 65–90%) and practitioner confidence, particularly when delivered through live, interactive, and multi-modal approaches. Whilst outcome measures were heterogeneous, follow-up periods typically short, and standardised assessment frameworks were lacking, the available evidence suggests that refresher training materials are needed for longer-term skill retention. However, these recommendations are based on a small proportion of studies and limited evidence. There was insufficient evidence to determine the optimal type and frequency of training, and evidence relating to cost-effectiveness was very limited. Conclusions Dermoscopy training appears to improve confidence and diagnostic performance among PCPs. However, uncertainty remains regarding how training should be delivered and maintained to achieve sustained improvements in practice. Confidence in these findings is limited by the low quality of the reviews, overlap within the review-level evidence base, and heterogeneous outcomes and follow-up duration. Future research should establish standardised outcome measures and longer-term evaluation frameworks, including economic assessment, to support implementation and inform policy and funding decisions in primary care. Protocol registration The systematic review of reviews is registered in PROSPERO (CRD42023396276).