Inside the Learning Curve for Dermatology NP Fellows

Victoria Garcia-Albea, NP, serves as director of the dermatology nurse practitioner training program at Lahey Clinic outside Boston, Massachusetts, where she has practiced medical dermatology since 2006. She is also a lead nurse practitioner in the hospital's Hansen's disease clinic and serves on the Elevate Derm leadership board and as co-medical director of the Elevate Derm fall meeting, scheduled for November in Austin, Texas.

In a recent Dermatology Times interview, Garcia-Albea discussed the steep learning curve facing fellows entering dermatology and how the cycle of learning throughout their training parallels the continued evolution of the specialty.

A Steep Learning Curve for Dermatology NP Fellows

Fellows entering the dermatology NP training program typically come from primary care or urgent care backgrounds and have limited experience with dermatology, according to Garcia-Albea. That creates a steep initial learning curve as trainees encounter diseases and clinical presentations they may have never seen before.

“It's like a really steep learning curve, and it's so satisfying because you can see their brain expanding and their eyes opening as they learn about diseases they didn't know about,” Garcia-Albea said.

Watching fellows develop a broader understanding of dermatology is one of the rewarding aspects of training clinicians in the specialty, she said.

Learning Does Not Stop With Experience

As fellows become more comfortable with dermatology, Garcia-Albea said their learning curve begins to level off. That confidence can quickly be challenged, however, when they encounter an unfamiliar disease or unexpected adverse effect, beginning another period of learning.

She described the process as a repeating pattern of growth and plateaus rather than a learning curve that eventually ends.

Garcia-Albea sees a similar process in her own practice. Despite nearly 2 decades in medical dermatology, advances in the specialty require her to continually learn about treatment options, patient monitoring, and disease assessment.

“I have to keep learning new treatment options and new ways of monitoring patients, new tools for assessing severity of disease,” Garcia-Albea said.

Fellow Growth Parallels an Evolving Specialty

For Garcia-Albea, the recurring learning gaps experienced by fellows mirror the broader evolution of dermatology. As treatment options expand and clinicians incorporate patient experiences into practice, both trainees and experienced clinicians must continue adapting.

“I think the learning gaps of the fellows parallel the evolution of the field,” Garcia-Albea said.

That evolution is particularly apparent in how fellows' perceptions of dermatology change during training. Garcia-Albea said many initially enter the program thinking primarily of acne, warts, and fungus before discovering the breadth of diseases encompassed by the specialty.

As their training progresses, that understanding expands.

“It's a very, very vast specialty, which is what is so fun about it,” Garcia-Albea said.