A pilot project in distance education: nurse practitioner students' experience of personal video capture technology as an assessment method of clinical skills

Meeting the AACN's Essentials for Competency-Based Education With Hands-Free Video-Recorded Skills Assessment

BACKGROUND

In the American Association of Colleges of Nursing's updated Essentials, competency-based education (CBE) is the expected standard for nursing curricula. CBE approaches include observation, practice repetition, demonstration, and video supervision guided by a framework of competency, feedback, and self-reflection.

METHOD

The promotion of skills competency among nursing students was facilitated by self-regulated learning using video skills-based competency testing. Video surveillance enabled students to practice and self-test their competency skills.

RESULTS

Self-videotaping by students provided a comfortable learning environment for repeated practice and fostered clinical judgment and accountability. Students reported increased confidence, decreased anxiety, and improved performance. Students developed skills and attitudes regarding self-reflection and self-remediation. Additionally, faculty reported improved visibility, a more efficient workload, and greater achievement of student outcomes.

CONCLUSION

Integrating CBE and incorporating video technology during skills testing enhances the opportunity for students to demonstrate skills competency and gain comfort in their own skills acquisition. [J Nurs Educ. 2023;62(12):733-736.].

Using Technology Adoption Theories to Maximize the Uptake of E-learning in Medical Education

INTRODUCTION

While the use of e-learning tools in medical education is guided by robust literature on their design and evaluation, there is sparse literature on strategies that maximize their adoption among trainees.

METHODS

In this scoping review, we searched Web of Science for studies on technology adoption theories as applied to education, using a final censoring date of August 1, 2021.

RESULTS

Based on our findings, we identified three representative theories: (1) technology acceptance model, (2) technology adoption life cycle, and (3) domestication theory.

DISCUSSION

We describe these theories in detail, examine their prior applications, and propose specific uses within medical e-learning.

Disseminated Tele-OSCE During a Pandemic: One University's Experience

BACKGROUND

Due to coronavirus disease 2019 (COVID-19), in-person educational activities were suspended across the globe throughout 2020. In health care education, this required a swift, creative response to maintain the flow of trained clinicians into the workforce without compromising the integrity of core learning outcomes. Early during the pandemic, remote synchronous simulation emerged as a compelling focus of the overall strategy.

METHOD

At one large health sciences university in the northwestern United States, family nurse practitioner faculty worked closely with the Simulation Operations team to plan, deliver, and assess a pilot tele-OSCE (objective structured clinical examination).

RESULTS

In postevent debriefs and surveys, both standardized patients and students affirmed that the activity was generally safe, accessible, and high value.

CONCLUSION

With appropriate planning, consensus building, and technology readiness assessment, tele-OSCEs can play a critical role in sustaining the flow of health care students into the workforce during a pandemic. [J Nurs Educ. 2022;61(2):107-110.].

Student Self-Assessments and Peer Assessments of Video Recordings of Physical Examination Practicums in a Physical Diagnosis Course

PURPOSE

Self-assessments and peer assessments of video recordings of performance have been used in a variety of educational and professional training programs; however, there is no literature on the application of such performance assessments in physician assistant (PA) education. The purpose of this pilot study was to both explore the feasibility of adding video recordings of existing practicum examinations to a physical diagnosis course and evaluate students' self-assessments and peer assessments of the activity.

METHODS

Fifty first-semester students who were enrolled in a 7-semester PA program participated. Three 15-minute practicums were recorded on students' personal smartphones and uploaded to a private YouTube channel. Students completed self- and peer-review questionnaires after each practicum, as well as a separate reflective questionnaire at the end of the course to garner their feedback of the video-recorded practicums on their physical examination (PE) performance.

RESULTS

Students assessed their peers' performances more favorably than their own. Students reported increased awareness of their own verbal and nonverbal communication strengths and weaknesses with the use of video-recorded practicums, as well as increased motivation to practice. The majority of students found these sessions to have improved their performance and decreased their anxiety with performing a complete PE at the end of the course.

CONCLUSIONS

The use of periodic video recordings of PE practicums with both self-assessments and peer assessments increased the students' level of practice of these important skills, enhanced students' awareness of nontechnical aspects of patient examination, was well received by the majority of students, and may be implemented with minimal expense.

Factors contributing to undergraduate nursing students' satisfaction with a video assessment of clinical skills

BACKGROUND

Clinical skill assessment via Objective Structured Clinical Assessment (OSCA) has many challenges for undergraduate nursing students. These include high levels of anxiety that can compromise performance during the assessment, inconsistency with assessor reliability and is inconsistent with clinical skills performance in the real world. The implementation of a Video Assessment of Clinical Skills (VACS) that integrates formative feedback may be a way to address the challenges posed by OSCA assessment.

OBJECTIVES

The aim of this study was to examine the acceptability, utility, and nursing student satisfaction with a formative feedback strategy - the Video Assessment of a Clinical Skill (VACS).

DESIGN

A cross sectional survey.

SETTINGS

Undergraduate Bachelor of Nursing degree students from a large Australian University.

PARTICIPANTS

Third year undergraduate nursing students (final year) enrolled in a Bachelor of Nursing Program.

METHODS

Participants were recruited via purposive sampling. A pre-survey (prior to VACs assessment) and post-survey (after VACS assessment) were completed. This paper reports on the open-ended responses in the post-survey that explored students' insights and perceptions into formative feedback and its impact on their learning for the VACS assessment.

RESULTS

A total of 731 open-ended responses were analysed with findings being organised into 3 major themes; (i) Flexibility and reflexivity, (ii) Editing and repeated attempts, and (iii) Working together.

CONCLUSIONS

Video Assessment of a Clinical Skill has demonstrated good utility, acceptability, and satisfaction among undergraduate nursing students.

Literature review of audiovisual practices in Nursing education

ABSTRACT Objective: to carry out a literature review to characterize the production in the Nursing area about the use of movies and videos in Nursing education, related to underlying communication assumptions and contents taught. Method: integrative bibliographic review carried out in the PUBMED databases, CAPES journal portal, and SCIELO online library, with studies from 2007 to 2016. Results: 36 articles were included, in which audiovisual resources are part of the research subject. There are predominance of validation and effectiveness studies, in which audiovisual resources are used mostly as a reproduction of reality, mainly to develop clinical skills, with the purpose of illustrating procedures or bringing students closer to real contexts of action. Final considerations: the results point to a weak theoretical support of most of the studies. It is suggested that more empirical research be conducted to offer more consistent contributions to Nursing teaching.

Postgraduate clinical physiotherapy education in acute hospitals: a cohort study

Background: Junior physiotherapists require satisfactory clinical skills to work effectively within the acute hospital setting for service quality and consistency. Objective: To investigate the effects of stream-specific clinical training on junior physiotherapist self-efficacy, self-rated confidence, and self-rated ability to work independently during weekend shifts. Design: Prospective cohort study. Participants: Eighteen junior physiotherapists. Methods: Physiotherapists undertook 8 h of stream-specific education in: pediatrics, women's health, neuro-medical, musculoskeletal, cardiorespiratory, and critical care over 8 weeks. Learning objectives were evaluated using a self-efficacy (0-100) scale and self-rated confidence was measured with a 4-point Likert scale (not confident to independent). Self-rated ability to independently work weekend shifts was measured dichotomously (yes/no). Results: Participants completed an average of three stream-specific programs in the study period. Post-training, mean improvement in self-efficacy across objectives ranged from 2.9 (95% CI -8.7 to 14.5) to 43.3 (95% CI 4.8-81.8) points, p < 0.05 for 80% of objectives. Self-rated confidence scores improved for 45.6% of stream-specific learning objectives; 52.8% were unchanged and 1.7% reported a decrease in confidence. Self-rated ability to work stream-specific weekend shifts increased from 56-70%, but no stream achieved a significant increase in staff able to independently work weekend shifts (p range 0.10 to 1.0). Conclusions: A stream-specific education program increased junior physiotherapists' self-efficacy and self-rated confidence but not perceived ability to work independently on weekends. Results were non-randomized and actual practice change was not assessed. Future studies could investigate different educational structures in a blinded, randomized manner on clinical practice change.

Designing an oral health module for the Bachelor of Midwifery program at an Australian University

Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.

A feasibility study to improve practice nurses' competence and confidence in providing care for mothers and infants

BACKGROUND

Postnatal care is best provided in primary health care settings, yet Practice Nurses (PNs) lack relevant training and report difficulty in providing postnatal care.

AIM

To evaluate the feasibility of a pilot educational intervention in improving PN competence and confidence to care for mothers and infants in the first postnatal year.

DESIGN

A feasibility study.

METHODS

PNs were recruited from selected general practices Queensland, Australia to undertake the pilot educational intervention that included a pre-intervention survey, two-day education program, program evaluation and completion of a practice journal.

RESULTS

Thirteen PNs from three general practices participated, with 31% completing all study components. Evaluation of the intervention was positive and all participants reported increased confidence and competence in providing postnatal care. Following detailed consideration of feasibility (process, resource, management and scientific assessment) we propose that changes to intervention delivery and data collection should be incorporated into a larger trial.

Consensus on an Australian Nurse practitioner specialty framework using Delphi methodology: results from the CLLEVER 2 study

AIM

The aim of this study was to achieve profession-wide consensus on an Australian nurse practitioner specialty framework.

BACKGROUND

Since its introduction in 1998, the Australian nurse practitioner profession has grown to over 1300 endorsed practitioners, representing over 50 different specialties. To complement better a generalist learning and teaching framework with specialist clinical education, prior research proposed a broad framework of Australian nurse practitioner specialty areas termed metaspecialties.

DESIGN

This study employed an online three-round modified Delphi method.

METHOD

Recruitment using purposive sampling and snowballing techniques identified an eligible sample from a population of nurse practitioners with at least 12 months' postendorsement experience (n = 966). Data were collected using online survey software from September 2014-January 2015 and analysed using descriptive statistics and content analysis. The Content Validity Index and McNemar's Test for Change were used to determine consensus on the nurse practitioner metaspecialties.

RESULTS

One-fifth of the total eligible population completed the study. Participants achieved high consensus on four metaspecialties, including: Emergency and acute care, primary health care, child and family health care and mental health care. Two metaspecialties did not achieve consensus and require further investigation.

CONCLUSION

A large sample of nurse practitioners achieved consensus on an Australian metaspecialty framework, increasing the likelihood of widespread acceptance across the profession. This technique may be appropriate for use in jurisdictions with smaller populations of nurse practitioners. Ongoing research is needed to re-evaluate the metaspecialties as the profession grows.

Building a digital application for teaching vital signs

OBJECTIVE

To describe the steps in creating a digital application directed to teaching vital signs for nursing students.

METHOD

This is a methodological study, conducted from March to October 2014, in which have followed the stages of analysis, design and development of technological tool, based on the theoretical framework of Galvis-Panqueva. We conducted a narrative review of the literature on the subject, and then picked up the best platform for application hosting.

RESULTS

Once the steps proposed in the theoretical framework were followed, the analysis outlined the content and technological infrastructure. As for the design, it provided the assessment of the environment and its interface and operation, and finally the development materialized the projection of the design and interactive features proposed in previous steps.

CONCLUSION

The application is an interactive support in the training of nursing students, and it is suggested that validation of content be performed for further practical application.

Innovative uses of technology in online midwifery education

Women's health care in the United States is at a critical juncture. There is increased demand for primary care providers, including women's health specialists such as certified nurse-midwives/certified midwives, women's health nurse practitioners, and obstetrician-gynecologists, yet shortages in numbers of these providers are expected. This deficit in the number of women's health care providers could have adverse consequences for women and their newborns when women have to travel long distances to access maternity health care. Online education using innovative technologies and evidence-based teaching and learning strategies have the potential to increase the number of health care providers in several disciplines, including midwifery. This article reviews 3 innovative uses of online platforms for midwifery education: virtual classrooms, unfolding case studies, and online return demonstrations of clinical skills. These examples of innovative teaching strategies can promote critical and creative thinking and enhance competence in skills. Their use in online education can help enhance the student experience. More students, including those who live in rural and underserved regions and who otherwise might be unable to attend a traditional onsite campus, are provided the opportunity to complete quality midwifery education through online programs, which in turn may help expand the women's health care provider workforce. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.