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

Kelly M. Heslin, Graciela E. Silva, Lois J. Loescher, Myra L. Muramoto

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)78-84
Number of pages7
JournalJournal of Cancer Education
Issue number1
StatePublished - Feb 2023


  • E-training
  • Health promotion
  • Simulation
  • Skin cancer prevention
  • Training assessment

ASJC Scopus subject areas

  • Oncology
  • Public Health, Environmental and Occupational Health


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