Educating Primary Care Providers Nurse Practitioners and Physicians About Sexual Health Care Among Breast Cancer Survivors Using Virtual Simulation: A Feasibility Study

Abstract

Background: Primary Care Providers' (PCP) involvement in breast cancer survivorship care has evolved in recent years. However, PCPs have knowledge gaps, particularly related to psychosocial issues such as sexual health disturbance, that can be to be addressed through educational interventions. Purpose: To develop a virtual simulation game and evaluate its feasibility and impact on PCPs’ perception of knowledge related to sexual health disturbance among breast cancer survivors. Methods: Multi-phase study consisting of three phases: (1) a scoping review to map the literature on how simulation has been used to educate nurses and physicians about cancer care; (2) the development of a virtual simulation game focused on educating PCPs about sexual health disturbance in breast cancer survivors; (3) quantitative pretest and posttest design survey to explore the feasibility of the virtual simulation game. Results: In phase 1, the scoping review included 19 papers that brought evidence that simulation can improve the knowledge and skills of nurses and physicians in cancer care. Still, simulation education requires a significant allocation of resources to be developed and that may negatively impact its feasibility. In phase 2, a virtual simulation game was developed based on best-practice guidelines, existing frameworks, and the input of an expert panel. During phase 3, 60 primary care providers responded to the pretest and posttest surveys. Participants perceived the game as potentially effective and feasible. The intervention also elicited a statistically significant improvement in providers’ perception of knowledge when comparing the pretest and posttest measures (z=-1.998, p=.046); participants in the pretest had a mean score of 6.39 (SD=4.425) and in the posttest a mean score of 7.33 (SD=3.287) both out of 10. Finally, professional background and previous exposure to sexual health training were predictors of knowledge perception. Conclusion: Following a rigorous process, including a scoping review of the literature and the use of various guidelines, a virtual simulation game was developed to help support PCPs while caring for sexual health disturbances among breast cancer survivors. The participants considered the intervention feasible, acceptable, appropriate, and effective; and there was an improvement in their perception of knowledge.