Efficacy of Using Evidence-Based, Microlearning Tools To Educate Nurse Practitioners for Skin Cancer Screening in Underserved Communities: A Quality Improvement Project

Abstract

This quality improvement project aimed to increase early skin cancer detection by educating primary care nurse practitioners (PCNPs) providing care to an underserved patient population at a rural health care clinic in Arizona. Background: Skin cancer is the most common malignancy worldwide, with early detection significantly improving patient outcomes and survival rates. Skin cancer, including melanoma, basal cell carcinoma, and squamous cell carcinoma, is a growing public health concern, with over 5 million cases diagnosed annually in the United States (American Cancer Society, 2025). Despite its prevalence, routine screening for skin cancer in primary care remains underutilized, often due to provider knowledge gaps and the lack of practical tools for implementation. Research indicates that incorporating simple, evidence-based screening protocols into wellness visits can significantly enhance early detection and treatment outcomes. Rural and underserved communities encounter unique challenges, including limited access to specialty care and higher rates of late-stage diagnoses, underscoring the need for targeted interventions in these areas. Conceptual Framework: This project was guided by the Information-Motivation-Behavioral Skills (IMB) model and microlearning principles. The IMB model posits that behavior change requires access to accurate information, motivation to act, and the development of specific behavioral skills (Chang et al., 2014). These components provide PCNPs with targeted education on skin cancer detection, fostering motivation through awareness of its clinical importance and equipping them with practical skills for integrating screening into patient care. Microlearning is ”bite-sized” learning with specific content that promotes engaging in small but conscious steps (Hug & Friesen, 2010). Microlearning principles are employed to design brief, focused educational sessions that minimize disrupting busy clinical workflows while maximizing retention and applicability. Purpose: This quality improvement project aimed to educate PCNPs on early skin cancer detection and prevention through simple, evidence-based screening assessments that can be seamlessly integrated into physical wellness evaluations across the lifespan. A particular focus was placed on addressing the needs of underserved communities, tailoring interventions to reduce disparities in access and outcomes for adults and pediatric patients. Interventions included educational sharing with professionals working in primary care facilities within the Marana Health Center network in southern Arizona. Methods: A post-survey intervention design to assess the impact of a microlearning educational program on PCNP’s knowledge, confidence, and screening practices. The intervention consisted of an interactive PowerPoint workshop covering epidemiology, risk factors, lesion recognition (e.g., the ABCDE criteria) with hands-on screening techniques, supplemental microlearning modules delivered via email to reinforce key concepts with visual aids and clinical-decision-making scenarios, and vetted educational materials from reputable sources such as the Skin Cancer Foundation with access to clinical decision support tools. Descriptive statistics were employed to measure outcomes by post-intervention knowledge assessments, and self-reported confidence surveys were used to guide future integration of these tools into PCNPs practice.