The aim of this study was to determine whether a brief Internet-based educa
tion programme could improve physicians' abilities to manage pigmented skin
lesions. A pre-test-post-test assessment was used of subjects' knowledge o
f skin cancer, confidence in their management abilities and actual ability
to recommend appropriate treatment for 20 hypothetical patients with pigmen
ted skin lesions. The setting was the general medicine service of an academ
ic medical centre. Seventeen volunteer medical students, house officers and
faculty members took part in the study. Following the pre-test, subjects c
ompleted a 1-hour computer-based educational programme, distributed via the
Internet, presenting a guideline for recognizing and managing potentially
malignant pigmented skin lesions. The guideline was based on the ABCD rule
and the Glasgow seven-point checklist. The educational programme had a posi
tive effect on the subjects' overall skin cancer knowledge and had signific
antly positive effects on their confidence and ability to apply the managem
ent guideline. Based on the guideline criteria, the subjects made the corre
ct management decision on the clinical scenarios 63.2% of the time before t
he programme and 74.1% of the time after the programme (P = 0.002). We were
able to teach melanoma management guidelines to physicians and medical stu
dents using a brief, interactive computer programme distributed via the Int
ernet. Such an approach is more cost-effective than classroom teaching and
could be used to improve the clinical skills of practising physicians to re
cognize and manage early melanomas. This approach to distributed learning c
ould also be used to teach other clinical guidelines to physicians.