Promoting Sun Healthy Behaviors in the Sunshine State to Achieve Clinical Learning

Exposure to sunlight can be pleasant and healthy; however, too much sun exposure can be dangerous. Skin cancer is the most common cancer with over 5 million cases diagnosed each year in the United States. Northwest Florida has ultraviolet indices ranging from 2-3 in December and January to 10+ in the summer months. Additionally, the panhandle has seen an increase in the rate of melanoma from 2004-2014 and have higher incidences than the state. Overexposure can have serious health consequences, including skin cancer and other skin disorders, retinal damage and cataracts, and immune system suppression. The Centers for Disease Control and Prevention reported that U.S. teens had rates of sunscreen use at only 7-13% during more than an hour of exposure on a sunny day, and had sunburn rates at approximately 33% during the past year. Florida school-aged children can spend an abundant amount of time outdoors during recess, physical education classes, and extracurricular activities. Thus, sun protection education is needed since unprotected exposure during youth places them at an increased life-time risk for skin cancer. The purpose of this project was to promote sun healthy behaviors to local elementary and middle school students utilizing evidence based messaging and achieve clinical course learning outcomes for pre-licensure students.

Partnering with two local elementary schools and one middle school, the School of Nursing planned a one day event at each school to promote sun healthy behaviors which was executed by 150 undergraduate students in the clinical course. Reinforcing the school district’s Vision 2020 which supports creativity, collaborative work, student-driven learning, interactive learning, and technology, the School of Nursing implemented the National Environmental Education Foundation (NEEF) SunWise Program to 1500 local school children. Created to help educators foster healthy sun behavior and raise sun safety awareness, the program provides activities which encourage students to explore, assess, and understand factors that affect their health, especially sun behaviors. The pre-licensure nursing students demonstrated proper sunscreen application, played educational games including a relay race, dance station, and Frisbee station, provided handouts, hats, sunscreen, and lip balm to each student as well as a magnet and brochure to be shared with family members.

Clinical learning outcomes achieved in the sun healthy behavior project were: (1) understanding and application of an ecological perspective to practice, (2) incorporation of evidence-based practice to aid in health promotion, (3) use of environmental factors of health to enable student to work effectively with vulnerable populations, (4) integration of vital statistics and population data in planning health services in the community setting, and (5) identification of team strategies, both interdisciplinary and transdisciplinary, that would improve community health.

The sun healthy behavior project provided students a unique clinical learning environment that promoted successful achievement of student learning outcomes. Student reflection revealed increased awareness and need of sun healthy behaviors, resourcefulness, autonomy, flexibility, and positivity with the unique clinical experience. Challenges encountered during the project included age appropriate content, lack of resources, and adequate preparation for alternative clinical experiences. Future recommendations for the sun healthy behavior project include a simulated practice round, small rewards for students winning an activity, formal nursing student job description with station rotations, and improved games to target ages and number of participants. This project demonstrates that clinical learning outcomes can be achieved via education in alternative learning environments.