Educational interventions for primary care providers to improve clinical skin examination for skin cancer

Abstract

Background and Purpose: Skin cancer, the most commonly diagnosed cancer in the United States, is a serious health care concern. Early skin cancer detection improves prognosis; most common early detection approach is a comprehensive clinical skin examination (CSE). A CSE consists of skin cancer risk assessment, head-to-toe skin examination, and skin lesion assessment. Nurse practitioners (NPs) currently lack adequate training and confidence to conduct CSE. The goal of this systematic review was to learn more about published interventions targeting CSE training for primary care NPs and/or other primary care providers. The findings were categorized based on the established procedures for intervention development. Methods: The databases PubMed, Google Scholar, CINAHL, and Web of Science were searched. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 10 articles were selected for data extraction. Conclusions: There is a paucity of articles that report rigorously developed interventions aimed at educating primary care NPs to conduct CSE. Existing CSE interventions were not tested for efficacy or effectiveness, and the implementation methods were weak or not reported. A synthesis of the review findings revealed inadequately reported sample characteristics, vague intervention goals, unspecified frequency or duration of interventions, and lack of standardized intervention protocols. Implications for practice: This review builds a foundation for more rigorously developed interventions to improve CSE and provides guidance for NPs to select education on CSE and other clinical foci. Future research will guide the development and evaluate the effectiveness of CSE education, which ultimately could improve skin cancer prognosis interventions and lack of standardized intervention protocols.

A qualitative descriptive study of a novel nurse-led skin cancer screening model in rural Australia

“…In a study describing tobacco control measures, implementing a new policy influenced attitudes, beliefs, and behaviours, which in turn influenced health outcomes [32]. Description of a new model at an early stage of implementation is unusual, and addresses the issue that methods of skin cancer initiative implementation are rarely described, as has been raised previously [19]. Member checking with the key stakeholders utilised the logic model as a visual aid.…”

“…Consumer self-examination with the naked eye or mobile teledermoscopy have also been trialled [ 18 ]. A recent systematic review highlighted that primary care provider clinical skin examination interventions are rarely evaluated for efficacy or effectiveness, and implementation methods tend to be poorly described [ 19 ].…”

An Educational Initiative for Family Nurse Practitioners to Detect Melanoma Skin Cancer

“…According to the literature, educational interventions may increase knowledge regarding skin cancer and melanoma detection. However, Stratton and Loescher (2020) performed a systematic review to identify published interventions that pertained to clinical skin examination for skin cancer identification by primary care nurse practitioners. They reviewed 10 articles and found that existing educational interventions regarding skin cancer were not tested for efficacy or effectiveness.…”

Effectiveness of Cutaneous Melanoma Education on Knowledge, Confidence, and Practice Intent Among Graduate Nursing Students

“…Moreover, the confidence of both practitioners and students increases with exposure to educational programs promoting skin cancer prevention and detection (Bort, 2021; Chen et al, 2015; Guégan et al, 2021). However, access to educational programs on skin cancer detection and treatment for current and future primary care providers continues to be limited (Eide et al, 2013; Hartnett & O'Keefe, 2016; Stratton & Loescher, 2020).…”

“…The incidence of melanoma is increasing, and mortality from late-stage diagnosis continues to be a concern. Primary care providers face barriers to early detection and prevention of cutaneous cancers in daily practice and include a lack of training in full skin examinations (FSEs), lesion recognition, and treatment options (Azima, 2016; Herath et al, 2018; Stratton & Loescher, 2020). Research suggests that targeted educational programs for primary care providers on skin cancer can improve knowledge, confidence, and clinical skills (Hartnett & O'Keefe, 2016; Loescher et al, 2018).…”