Kyra Diehl ^1* Elizabeth Stoos ¹ Alyssa Becker ¹ Victoria E. Orfaly ¹ Jacob Nelson ¹ Jordan Gillespie ¹ Justin Ng ¹ Tayler Tobey ^1,2 Emile Latour ^1,3 Joanna Ludzik ¹ Elizabeth G. Berry ¹ Alan C. Geller ⁴ Heidi Jacobe ⁵ Justin Leitenberger ¹ Danielle Mcclanahan ¹ Jessica Tran ¹ Smriti Prasad ¹ Stephanie Mengden-Koon ¹ Kelly C. Nelson ⁶ Ryan Petering ⁷ Alex Verdieck ⁷ Stephanie Savory ⁵ Emily H. Smith ⁸ Susan Tofte ¹ Martin A. Weinstock ^10,9 Kevin White ¹ Oliver Wisco ^11,9 Clara Curiel-Lewandrowski ¹² Susan M. Swetter ¹³ Alexander M. Witkowski ¹ Laura Ferris ¹⁴ Samantha Black ⁵ Rebecca Xu ¹⁵ Shuai Xu ¹⁶ Sancy Leachman ^1,17*

• ¹ Department of Dermatology, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States
• ² School of Medicine, Oregon Health and Science University, Portland, Oregon, United States
• ³ Biostatistics Shared Resource, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA, Portland, United States
• ⁴ Department of Social and Behavioral Sciences, School of Public Health, Harvard University, Boston, Massachusetts, United States
• ⁵ Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA, Dallas, United States
• ⁶ Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, USA, Houston, United States
• ⁷ Department of Family Medicine, Oregon Health & Science University, Portland, United States
• ⁸ Department of Dermatology, University of Missouri, Columbia, Missouri, Columbia, United States
• ⁹ Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, United States
• ¹⁰ Providence Veteran Affairs Health Care System, Providence, RI, USA, Providence, United States
• ¹¹ Dermatology Health Specialists, Bend, United States
• ¹² Department of Dermatology, University of Arizona College of Medicine, Tucson, United States
• ¹³ Department of Dermatology, Stanford University Medical Center and Cancer Institute, Palo Alto, United States
• ¹⁴ Department of Dermatology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
• ¹⁵ Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
• ¹⁶ Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
• ¹⁷ Knight Cardiovascular Institute, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States

Introduction: Primary care providers or clinicians (PCPs) have the potential to assist dermatologists in screening patients at risk for skin cancer, but require training to appropriately identify higher-risk patients, perform skin checks, recognize and biopsy concerning lesions, interpret pathology results, document the exam, and bill for the service. Very few validated dermatology training programs exist for PCPs and those that are available focus primarily on one emphasis area, which results in variable efficacy and single-topic limited scope. Methods: We have created a free, online, continuing education program (Melanoma Toolkit for Early Detection, MTED) that allows learners to choose from a variety of multimedia tools (image recognition, videos, written material, in-person seminars, self-tests, etc.) that suits their learning style and time availability. Here we present the toolkit, the development and validation of the curriculum, and report on one-year outcomes of a nested survey study. Because the goal of the program is to maximize participation by allowing PCPs to tailor their experience to their own needs and interests, the majority of participants did not complete every element of the program. Results: A total of 8,683 PCPs have accessed at least one element of the toolkit from 2019-2024. Participants completed a pre-survey, online training module, and post-survey that included selfreported screening behaviors, changes in confidence, and malignant and benign lesion categorization based on clinical images. A total of 139 pre-surveys and 92 post-surveys were completed, including 55 matched participants that completed both the pre-and post-training surveys. There were significant improvements in PCP confidence (P < 0.001) and malignant (P < 0.001) and benign image (P = 0.029) identification respectively. Discussion: PCPs may serve as a valuable aid in skin cancer screening efforts, but additional studies are needed to evaluate the impact of these curricula in clinical practice.