Belmont University Research Symposium (BURS)

Publication Date

2025

College

Health Sciences & Nursing, Gordon E. Inman College of

Department

Nursing, School of

BURS Faculty Advisor

Laura Gray

Presentation Type

Poster Presentation

Abstract

BACKGROUND: People with skin of color face worse health outcomes than their light-skinned peers. According to the literature, graduate nursing programs lack skin tone inclusive curricular content (Shue-McGuffin & Powers, 2022). This contributes to disproportionate racial and ethnic health disparities. Skin tone inclusive online dermatology modules have been shown to improve diagnostic accuracy and self-confidence amongst medical students and residents (Trinh et al., 2021; Salava & Salmela, 2022; Wang et al., 2020). They may be an effective approach for graduate nursing students as they prepare to evaluate skin disease across the skin tone spectrum.

METHODS: This quality improvement proje\ct utilized a mixed methods convergent design using quantitative pre- and post-surveys including qualitative descriptive methodology. Participants were 25 graduate nursing students enrolled in a Bachelor of Science to Doctor of Nursing Program with an Advanced Practice/Family Nurse Practitioner concentration. The Plan-Do-Study-Act (PDSA) model for continuous improvement was applied for two cycles.

INTERVENTION: In PDSA cycle one, student participants took a baseline diagnostic accuracy pretest and baseline self-confidence survey, completed LearnDerm by VisualDx, viewed a 75–90-minute curated web-based lecture using VisualDx-provided imagery, and took a diagnostic accuracy posttest and a post-intervention self-confidence survey. In PDSA cycle two, student participants took a baseline diagnostic accuracy pretest and baseline self-confidence survey, reviewed VisualDx’s LearnDerm Companion, viewed three 20-minute curated web-based lectures using VisualDx-provided imagery, and took a diagnostic accuracy posttest and a post-intervention self-confidence survey.

RESULTS: In the posttests, PDSA cycle one revealed a 7% decrease in mean diagnostic accuracy and 25% increase in overall diagnostic self-confidence. Statistical significance was demonstrated in PDSA cycle two with a 29% overall increase in mean diagnostic accuracy and 61% increase in overall diagnostic self-confidence.

CONCLUSION: Skin tone inclusive online dermatology modules may be an effective way to improve diagnostic accuracy and self-confidence in evaluating skin disease amongst graduate nursing students. Implications for graduate nursing education include improved knowledge of skin disease, including diagnostic distinctions of diverse skin tones. Broadly, skin tone inclusive education supports diverse and equitable patient care, improves health outcomes as a result, reduces disparities for individuals with skin of color, and future inclusive quality improvement initiatives.

Keywords: skin of color, dermatology, education, nurse practitioner, graduate nursing, disparities

References

Shue-McGuffin, K., Powers, K. (2022). Dermatologic simulations in nurse practitioner education: Improving skin cancer knowledge, confidence, and performance. American Association of Nurse Practitioners, 34(3), advance online ahead of print. https://pubmed.ncbi.nlm.nih.gov/34537796/

Trinh, D., Wanat, K., Roth, G., Young, K., & Humphrey, S. (2021). Efficacy of medical students’ virtual dermatology curriculum. The Journal of the American Academy of Dermatology, 86(6). https://www.jaad.org/article/S0190-9622(21)00996-8/pdf

Wang, D., Petitt, C., Goel, N., Ash, M., & Mervak, J. (2020). Confidence and competency in the use of dermoscopy among new first-year dermatology residents: A repeated-pairs pre- /postassessment study of an online learning module, The Journal of the American Academy of Dermatology, 85(6), https://www.jaad.org/article/S0190-9622(20)33061- 9/fulltext

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