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

Background: 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. Purpose: 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. Methodology: 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. Results: 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. Conclusion: Simulation with standardized patients wearing 3D lesions can enhance NP students' knowledge, self-confidence, and performance of skin cancer assessments. Implications: 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.