The level of certainty of the evidence for skin cancer detection by advanced practice nurses and their impact on the skin cancer problem remain low. These nurses would benefit from accessible and efficacious CSE and lesion training.

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Purpose To conduct a pilot survey to assess acceptance of mobile teledermoscopy (MTD) by primary care nurse practitioners (NPs) working in Arizona. Data sources Sixty‐two participants recruited from NP and academic listservs in Arizona completed an online survey prefaced by a MTD definition, device photographs, and a practice case, followed by 33 items measuring Teledermatology Technology Acceptance Model (TeleTAM) constructs. Conclusions Participants were highly interested in using MTD to assess skin lesions. They perceived MTD utility to greatly improve diagnosis and positively impact their practice. Most participants had never used MTD, but had high mean scores for MTD attitude and moderate scores for MTD perceived ease of use, perceived use, and facilitators of MTD. They had moderate scores for intention to use MTD. The construct facilitators (organizational infrastructure) were most strongly associated with intention to use MTD. Cronbach alphas were 0.70 or higher for all subscales except compatibility and habit. Implications for practice Moderate acceptance of MTD may reflect NPs’ knowledge of the technology, self‐confidence for using it, or MTD financial constraints. Future research will address these factors to foster use of MTD by NPs, thereby improving patients’ access to early skin lesion assessment and diagnosis.

BACKGROUND Skin cancer is the most common cancer; survival of the most serious skin cancer, malignant melanoma, depends on early detection. Early detection relies on accessibility to clinical skin examination (CSE). Primary care nurse practitioners (PCNPs) are well-positioned to conduct CSE; however, they require further education on CSE and have time constraints for continuing education. A digital intervention grounded in microlearning is a promising approach to deliver new information over a brief timespan. OBJECTIVE To develop and explore the feasibility of implementing a 1-week online video intervention with content on CSE skills (defined as melanoma risk assessment, head-to-toe skin examination and pigmented lesion assessment) for PCNPs. Specific aims were 1) to develop three theory-based, brief skin cancer videos containing content on CSE and were suitable for online delivery to PNCPs and 2) to determine intervention enrollment, retention and adherence, and acceptability and usability of the intervention. Aim 1 focused on content validity, integration of the videos and surveys into Research Electronic Data Capture (REDCap) for digital delivery. Aim 2 focused on feasiblity testing. METHODS For Aim 1, the principal investigator (PI) created storyboards for videos that ¬addressed each CSE skill. A dermatology expert panel reviewed the storyboards and videos for relevance, comprehension, and clarity assessed using a Content Validity Index (CVI). The panel evaluated usability of delivery of the video intervention by REDCap and Vimeo using Brooke’s System Usability Scale (SUS) and technical video production using Beaudin’s Quality Evaluation of Video. Vimeo, which is an online platform and community developed to create, upload and share videos.[1] For Aim 2, the videos were delivered to a sample of 10 PCNPs recruited statewide. Enrollment and retention rates were based on metrics from previous studies of CSE in the literature, and intervention adherence. Usability and acceptability were assessed using the SUS and the Attitudes toward Web-based Continuing Learning survey (AWCL). RESULTS CVI scores indicated relevance and clarity for each video (M range 3.79 to 4; 4, high relevance). The integration of REDCap and Vimeo was rated usable (SUS = 95; 0-100, worst to best). The digital delivery of the videos was exceptional on all five technical items (M = 5, poor [1] to exceptional [5]). Of the 22 PCNPs recruited, 12 were enrolled (35%) and 10 (83%) were retained in the study. Intervention adherence was ≥ 50%. Participants rated the usability as “better” (M = 85.8, SD = 10.6; better=70-90) and favorably ranked acceptability of AWCL’s constructs of perceived usefulness (M = 5.26 SD =0.08, strongly agree = 7)), perceived ease of use (M = 5.40 SD =0.41), behavior (M = 5.53 SD =0.12) and affection (M = 5.77 SD =0.04). CONCLUSIONS The video intervention was feasible to deliver to PCNPs using an online, microlearning approach. The findings provide support for using the videos for an intervention in a future pilot randomized trial targeting behavioral CSE outcomes in PCNPs and other primary care providers.

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.

Purpose The aim of this study was to educate primary care providers (PCPs), including family nurse practitioners (FNPs), about clinical skin examination (CSE) for melanoma in underserved patients using a digitally delivered video intervention. CSE was defined as melanoma risk assessment, head-to-toe skin examination, and skin lesion assessment. Background Skin cancer is the most common cancer in the United States; melanoma is the deadliest type. PCPs do not typically perform CSE. Little is known about how PCPs learn about or conduct CSE for their underserved patients. Methods The information–motivation–behavioral skills (IMB) model guided this quality improvement project. All 14 PCPs employed in one federally qualified health center's six regional clinics were recruited. Participants completed an online pretest of the IMB model, the intervention (four brief videos covering melanoma in underserved populations and CSE), and an identical posttest 2 weeks postintervention. Results Data were analyzed using descriptive statistics. Six (42.9%) participants enrolled: All were FNPs (mean age = 39.83 years, mean years of PCP experience = 3.33). Scores for the IMB model all improved on posttest. Participants reported increased CSEs in practice (mean = 1.33–9.50). Conclusion The results show strong potential for a brief video intervention to improve FNPs' CSE skills and motivate them to use those skills with underserved patients.

We have developed a portable confocal microscope (PCM) that uses an inexpensive near-infrared LED as the light source. Use of the spatially incoherent light source significantly reduced the speckle contrast. The PCM device was manufactured at the material cost of approximately $ 5000 and weighed only 1 kg. Lateral and axial resolutions were measured as 1.6 and 6.0 µm, respectively. Preliminary in vivo skin imaging experiment results showed that the PCM device could visualize characteristic cellular features of human skin extending from the stratum corneum to the superficial dermis. Dynamic imaging of blood flow in vivo was also demonstrated. The capability to visualize cellular features up to the superficial dermis is expected to facilitate evaluation and clinical adoption of this low-cost diagnostic imaging tool.

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