A systematic review and synthesis of qualitative and quantitative studies evaluating provider, patient, and health care system-related barriers to diagnostic skin cancer examinations

Najmi, Maleka; Brown, Ashley E.; Harrington, Sarah; Farris, David; Sepulveda, Sarah; Nelson, Kelly C.

doi:10.1007/s00403-021-02224-z

Cited by 17 publications

(16 citation statements)

References 61 publications

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“…10 Studies have reported that many PCPs do not perform full-body skin exams, even in patients at high risk for skin cancer. 11,12 Barriers to performing skin cancer screening by PCPs include lack of confidence in diagnostic ability in addition to reimbursement, time, and patient-related barriers. 11 Educational interventions offer an opportunity to address PCP's diagnostic abilities and thus lessen the disparities in skin cancer morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Skin Cancer Education Interventions for Primary Care Providers: A Scoping Review

et al. 2022

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Primary care physicians (PCPs) are often the first line of defense against skin cancers. Despite this, many PCPs do not receive a comprehensive training in skin conditions. Educational interventions aimed at skin cancer screening instruction for PCPs offer an opportunity to detect skin cancer at earlier stages and subsequent improved morbidity and mortality. A scoping review was conducted to collect data about previously reported skin cancer screening interventions for PCPs. A structured literature search found 51 studies describing 37 unique educational interventions. Curriculum elements utilized by the interventions were divided into categories that would facilitate comparison including curriculum components, delivery format, delivery timing, and outcome measures. The interventions varied widely in design, including literature-based interventions, live teaching sessions, and online courses with durations ranging from 5 min to 24 months. While several interventions demonstrated improvements in skin cancer knowledge and competency by written exams, only a few revealed positive clinical practice changes by biopsy review or referral analysis. Examining successful interventions could aid in developing a skin cancer detection curriculum for PCPs that can produce positive clinical practice and population-based changes in the management of skin cancer.

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Section: Introductionmentioning

confidence: 99%

Skin Cancer Education Interventions for Primary Care Providers: A Scoping Review

et al. 2022

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“…Education for providers is lacking regarding skin cancer assessment. A systematic review of 48 studies found 89.4% of primary care providers cited lack of dermatology training as the largest barrier to melanoma skin cancer screening examinations (Najmi et al, 2021). In a qualitative study of nine nurse exemplars, Azima (2016) found a need for increased education regarding dermatology and skin cancer assessment in nurse practitioner programs.…”

Section: Available Knowledgementioning

confidence: 99%

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

Heathcotte

Swenty

Schaar

2023

Journal of the Dermatology Nurses' Association

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BACKGROUND: Skin cancer is the most common type of cancer in the United States. Melanoma skin cancer is the deadliest form of skin cancer. In the United States, the rates of melanoma skin cancer continue to rise more than any other type of cancer. LOCAL PROBLEM: Nurse practitioners play an important role in early detection of skin cancer; however, minimal time is spent on dermatology training in current nurse practitioner programs to sufficiently prepare nurse practitioners to identify melanoma skin cancer. Early detection of melanoma skin cancer leads to decreased mortality. METHODOLOGY: There were approximately 75 family nurse practitioners eligible to participate. The potential participants were asked to complete the online demographic survey and a pretest questionnaire. After intervention, the participants were asked to complete a posttest questionnaire. INTERVENTION: A web-based educational tool regarding identification of melanoma skin cancer was developed. The family nurse practitioners viewed the web-based educational module regarding melanoma skin cancer. RESULTS: A comparison of pretest and posttest means from the questionnaire was analyzed using a t test. Thirtythree family nurse practitioners showed statistically significant improvements in knowledge after the educational intervention. In addition, confidence increased in their ability to detect melanoma skin cancer. CONCLUSIONS: This project has shown that a web-based educational module can improve family nurse practitioners' ability and confidence to detect melanoma skin cancer. This educational module was statistically effective and provides an educational framework that can be adopted by other healthcare organizations to improve nurse practitioner knowledge surrounding melanoma detection.

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“…Before this study, no formal consensus existed on the fundamental competencies that PCPs should have with respect to dermoscopy for skin cancer detection. 19,20 While a foundational dermoscopy proficiency standard has been developed for dermatology residents, 21 the practice needs of PCPs differ from those of dermatologists, warranting a focused effort tailored to the primary care context. Therefore, the objective of this study was to develop an expert consensus statement on proficiency standards for PCPs learning or using dermoscopy.…”

Section: Introductionmentioning

confidence: 99%

Expert Consensus Statement on Proficiency Standards for Dermoscopy Education in Primary Care

Tran

Cyr²,

Verdieck³

et al. 2023

J Am Board Fam Med

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Background: Primary care providers (PCPs) frequently address dermatologic concerns and perform skin examinations during clinical encounters. For PCPs who evaluate concerning skin lesions, dermoscopy (a noninvasive skin visualization technique) has been shown to increase the sensitivity for skin cancer diagnosis compared with unassisted clinical examinations. Because no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy for skin cancer detection, the objective of this study was to develop an expert consensus statement on proficiency standards for PCPs learning or using dermoscopy.Methods: A 2-phase modified Delphi method was used to develop 2 proficiency standards. In the study's first phase, a focus group of PCPs and dermatologists generated a list of dermoscopic diagnoses and associated features. In the second phase, a larger panel evaluated the proposed list and determined whether each diagnosis was reflective of a foundational or intermediate proficiency or neither.Results: Of the 35 initial panelists, 5 PCPs were lost to follow-up or withdrew; 30 completed the fifth and last round. The final consensus-based list contained 39 dermoscopic diagnoses and associated features.Conclusions: This consensus statement will inform the development of PCP-targeted dermoscopy training initiatives designed to support early cancer detection.

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A systematic review and synthesis of qualitative and quantitative studies evaluating provider, patient, and health care system-related barriers to diagnostic skin cancer examinations

Cited by 17 publications

References 61 publications

Skin Cancer Education Interventions for Primary Care Providers: A Scoping Review

Skin Cancer Education Interventions for Primary Care Providers: A Scoping Review

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

Expert Consensus Statement on Proficiency Standards for Dermoscopy Education in Primary Care

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