Dermatologic simulations in nurse practitioner education: Improving skin cancer knowledge, confidence, and performance.

Abstract

The rising incidence of skin cancer continues to be a significant public health concern in the United States. Nurse practitioners (NPs) have a key role in early detection of skin cancer. However, NP students currently demonstrate low levels of knowledge related to skin cancer assessments and recognition of skin lesions. The aim of this pilot study was to determine if simulations with standardized patients wearing three-dimensional (3D) prosthetic skin lesions improved NP students' knowledge, self-confidence, and observed simulation performance with regard to assessing, diagnosing, and managing patients with nonmalignant versus malignant skin lesions. A quasi-experimental approach was used with a convenience sample of 39 NP students. Students participated in three consecutive simulations, each followed by a debriefing. Performance was assessed during the simulations using a rubric. Knowledge and self-confidence were measured immediately before and after the simulation. Correct responses on knowledge items increased for 14 of the 18 items. Self-confidence significantly improved from pretest to posttest. There was a statistically significant improvement in performance from the first to third simulation encounter. Simulation with standardized patients wearing 3D lesions can enhance NP students' knowledge, self-confidence, and performance of skin cancer assessments. Nurse practitioner programs can consider using simulation to prepare students for dermatologic care and to help improve the probability of early detection of skin cancer in various health care settings.