Partnering With Massage Therapists to Communicate Information on Reducing the Risk of Skin Cancer Among Clients: Longitudinal Study

Incorporating Decision Simulation Technology in a Skin Cancer Prevention E-Training for Massage Therapists

Decision simulation technology is known to augment health practitioner education and training; little is known about its use for educating lay health practitioners about cancer prevention. We report the development and evaluation of a decision simulation component of a skin cancer risk reduction electronic training (e-training) for massage therapists (MTs). Simulation facilitated tracking and analysis of MTs' selected dialog options leading to client-focused helping conversations (MT conversations intended to encourage client pro-health behavior) regarding skin cancer risk reduction. The tracking also enabled further assessment of the e-training competencies. We constructed five decision simulation cases in the DecisionSim™ online platform, mimicking MT-client encounters pertaining to skin cancer risk reduction, allowing MTs to apply training knowledge to initiate a helping conversation. We scored each simulation by tracking conversation pathways via selected dialog options (optimal, feedback required, suboptimal), analyzing total scores and real time spent on each case. MTs rated satisfaction with the simulations on a 5-point Likert scale. Eighty-one MTs completed the simulations in an average of 2.7 min. Most (91%) MTs selected feedback required or suboptimal dialog options for at least one of the five cases, often incorrectly choosing conversation statements reflecting their own feelings. The majority (86%) agreed/strongly agreed that they enjoyed the simulations (mean score 4.31); 92% found the simulations helpful to include in the training (mean score 4.36). Decision simulations integrated into e-training are useful for assessing lay practitioners' practical application of cancer risk reduction knowledge and skills and use of appropriate helping conversations.

Skin cancer knowledge, attitudes, and practices among non-medical skin care professionals: A narrative review of cross-sectional and interventional studies

BACKGROUND

Skin cancers are the most common malignancies in the United States. Total body skin examination by a physician, especially a dermatologist, is the gold standard for detecting suspicious lesions that may require further evaluation. Non-medical professionals (NMPs) including massage therapists, estheticians, hairdressers, and cosmetologists have the unique opportunity to frequently examine their client's skin outside of a clinical setting. By evaluating their knowledge of and comfort with evaluation of suspicious lesions, multiple studies have gauged the utility of patient encounters with NMPs for skin cancer detection. Several studies have also focused on assessment of intervention strategies for assessing and improving NMPs ability to detect suspicious lesions and to refer for physician evaluation when necessary.

AIMS

To conduct a narrative review of skin cancer knowledge, attitudes, and practices among NMPs.

PATIENTS/METHODS

A systematic search of the databases yielded 16 studies for review. A total of 8 cross-sectional studies examined the knowledge and attitudes of NMPs toward skin evaluation, and 8 studies assessed interventional strategies for improving NMPs' ability to assess skin lesions for consideration of physician referral.

RESULTS

This review finds that NMPs are open to the idea of examining the exposed body surfaces relevant to their work with clients and are willing to refer for physician evaluation when needed. Multiple interventional strategies have demonstrated success with educating NMPs on the importance of skin surveillance and the characteristic physical examination findings associated with skin cancers.

CONCLUSION

Strengthening the readiness of NMPs to examine their client's skin offers an opportunity to reduce time to skin cancer diagnosis, improve patient outcomes, and lower healthcare-associated costs of skin cancer treatment.