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e21004 Background: Community teams managing basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) report variation in risk stratification, referrals, and integration of systemic therapy. Methods: A mixed-methods needs assessment (survey n = 62; interviews n = 12; Dec 2024-Feb 2025) informed two ACCME-accredited, online enduring CME activities (1.5 total credits) plus targeted microlearning. Outcomes included participation and pre/post knowledge (3 items), confidence, case-based competence, and intended practice change. Post-activity qualitative interviews are planned to assess perceived educational impact and workflow change (eg, multidisciplinary coordination, referral pathways, and systemic therapy/immune-related AE monitoring). Results: Survey respondents (90% community practice; 55% dermatologists/Mohs surgeons, 45% oncologists) managed a mean of 27 BCC and 26 cSCC patients/month; > 30% managed > = 40/month. Multidisciplinary involvement was inconsistent (15% always, 34% often) and only 34% reported access to cutaneous/dermatologic oncologists. Barriers to integrating systemic therapy included coordinating multi-specialty appointments (61%), lack of clinical guidelines (50%), and patient travel (40%). Challenges included evaluating recurrence/metastasis risk (63%) and referral to oncology when curative surgery/radiation were not feasible (45%). Interviews highlighted heterogeneous definitions of high-risk disease, selective imaging/molecular testing, limited standardized surveillance, and fragmented referral/communication pathways; dermatologists often deferred immune checkpoint inhibitor (ICI) adverse-event monitoring to oncology and requested practical algorithms and patient materials. Education reached 4,041 clinicians (834 enduring CME; 3,207 microlearning). Mean knowledge improved 32% to 63% and confidence identifying ICI-eligible patients improved 19% to 36%. Case-based competence improved for metastatic BCC primary systemic treatment selection (41%-56% gains), borderline resectable cSCC neoadjuvant therapy selection (46%-49% gains), and delayed immune-related adverse-event timing (39%-43% gains); baseline underestimation of delayed events was common (77% dermatology, 81% oncology). Seventy percent of intended learners planned practice changes. Conclusions: Mixed-methods assessment identified actionable community gaps in coordinated BCC/cSCC care. An aligned education initiative improved knowledge and decision-making; planned post-activity interviews will further evaluate perceived practice impact and implementation.
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White et al. (2026) studied this question.
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