Our Methodology

How we teach dermoscopy — and why we teach it this way.

Last updated: 2026-03-24

The core question

Most dermoscopy education is designed for dermatologists. It is comprehensive, detailed, and aimed at diagnosis. But primary care clinicians face a different question.

A dermatologist asks: What is this lesion?

A GP asks: Does this lesion need specialist review?

These are not the same question. They require different knowledge, different depth, and different training approaches. BorelliScopie is built around the second question — the screening question — because that is what primary care actually needs.

TADA: The algorithm we teach

The Triage Amalgamated Dermoscopic Algorithm (TADA) is an evidence-based screening methodology developed specifically for non-specialist clinicians. It emerged from research asking a practical question: can we create a dermoscopy framework that is both sensitive enough to catch melanomas and simple enough to teach quickly?

The answer was yes.

What makes TADA different

Traditional dermoscopy training often starts with exhaustive pattern analysis — dozens of features, complex scoring systems, diagnostic categories. This works for specialists who see hundreds of lesions weekly and need precise diagnoses.

TADA takes a different approach. It asks three questions in sequence:

Can I confidently identify this as benign? — specifically, seborrhoeic keratosis, cherry angioma, or dermatofibroma
If not, is the lesion organised or disorganised?
Are any high-risk features present? — starburst pattern, blue-black or grey colour, shiny white structures, atypical network, ulceration, polymorphous vessels, or peppering

Each question either resolves the assessment or advances to the next level. The algorithm does not tell you what a lesion is — it helps you decide what to do.

The evidence

TADA has been validated across multiple studies. Key findings include high sensitivity for melanoma detection, improved specificity compared to naked-eye examination alone, and rapid teachability to non-expert clinicians.

This last point matters most for primary care. A method is only useful if busy clinicians can actually learn and retain it.

Limitations we acknowledge

TADA is optimised for common presentations on typical body sites. It is less reliable for acral skin (palms and soles), nail unit lesions, amelanotic melanoma, and mucosal surfaces.

We teach these limitations explicitly. Knowing when not to apply a framework is as important as knowing how to use it.

ORAR: How we structure learning

The curriculum follows the ORAR framework — a learning sequence designed for skill acquisition:

Observe

Before you can recognise patterns, you need to see clearly. The first module teaches systematic examination technique: how the dermatoscope works, how to interpret the magnified view as three-dimensional structures rather than flat images, and how depth cues and lighting affect perception.

This is perceptual training. It is about teaching your eyes and brain to extract information from an unfamiliar visual environment.

Recognise

With observation skills in place, you start building a pattern library. We teach recognition in a specific order:

Normal first — you learn what healthy skin looks like across different body sites, ages, and skin tones before you see any pathology
Benign patterns next — the common lesions you will encounter most often: seborrhoeic keratosis, cherry angioma, and dermatofibroma
Concerning features last — the signs that warrant further evaluation

This sequence mirrors how expertise actually develops. Experts do not just know what is abnormal — they have a rich internal library of normal that makes abnormality obvious by contrast.

Apply

Recognition without application is trivia. The TADA modules teach you to use your pattern knowledge in a structured decision-making framework. You practise moving through the algorithm with worked examples, and the interactive simulator builds the mental habits that make systematic assessment automatic.

Reflect

The clinical context module and the TADA simulator complete the cycle. The simulator lets you test your reasoning against known teaching scenarios, identifying gaps in your mental library and reinforcing correct pattern-action links. The clinical context module grounds everything in the reality that the dermatoscope is never the whole picture — patient history, risk factors, and clinical judgement always matter.

This is not assessment — it is calibration. The goal is helping you understand your own learning edges.

Pedagogical principles

Several principles guide how we present content:

Foundation first

We teach perception before pathology. Most dermoscopy courses jump straight to "here is what melanoma looks like." We start with "here is how to see what the dermatoscope shows you" and "here is what normal skin looks like."

This is not slower — it is faster. Building foundations reduces the cognitive load of later learning.

Progressive terminology

Medical terminology is precise but can be alienating. We introduce concepts in plain language first, using analogies and descriptions. Technical terms come second, attached to understanding you have already built.

You will learn that "milia-like cysts" are the small white pearls you can see in seborrhoeic keratosis — not the other way around.

Visual learning

Dermoscopy is a visual skill. You cannot learn it from text alone. Our curriculum uses extensive imagery with interactive annotations to build visual intuition alongside conceptual knowledge.

Low-stakes practice

The TADA simulator presents educational scenarios, not diagnostic tests. There is no pass or fail, no time pressure. The goal is building pattern recognition through repeated exposure, not proving competence.

Real competence develops over time, with real patients, under appropriate supervision. We provide the foundation — clinical experience builds the expertise.

What we do not teach

Being clear about scope prevents misunderstanding:

We do not teach diagnosis. TADA produces triage categories, not diagnostic labels.
We do not teach comprehensive dermoscopy. Advanced pattern analysis, rare lesions, and specialist techniques are beyond our scope.
We do not teach clinical decision-making. Dermoscopy is one input to clinical judgement, alongside history, examination, patient preferences, and local pathways.
We do not replace supervision. New skills should be developed under appropriate clinical oversight.

BorelliScopie teaches screening-level dermoscopy. It is the beginning of a learning journey, not the destination.

Standards alignment

Our content aligns with internationally recognised dermoscopy standards and clinical guidelines. Where specific recommendations vary between regions, we teach the underlying principles and encourage learners to follow their local pathways.

All clinical content is traceable to peer-reviewed sources, reviewed by named clinical editors, and version-controlled with documented update cycles.

See Clinical Editors for governance details.