1
|
Kolcun K, Zellefrow C, Karl J, Ulloa J, Zehala A, Zeno R, Tornwall J. Identifying best practices for virtual nursing clinical education: A scoping review. J Prof Nurs 2023; 48:128-146. [PMID: 37775227 DOI: 10.1016/j.profnurs.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 06/26/2023] [Accepted: 07/02/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND COVID-19 forced nurse educators across the world to rapidly shift clinical experiences from face-to-face to the virtual world without identification of best practices to guide this transition. PURPOSE The purpose of this review was to identify best practices in virtual clinical experiences for undergraduate and graduate nursing students using the Community of Inquiry model as a framework. METHOD A scoping review was conducted using the Joanna Briggs Institute Scoping Review process. Ten databases were searched systematically for literature related to virtual nursing student clinical experiences. The 36 articles retained for review were appraised using evidence-based rapid critical appraisal tools. RESULTS The literature suggests virtual clinical experiences may positively impact clinical reasoning and judgement; knowledge gain, retention, and application; affective learning; communication and teamwork; competence; engagement; confidence; and satisfaction. However, increased anxiety, frustration with technology and access, difficulty asking questions, and increased cost were reported. Additional considerations included appropriate faculty training, student support, and accreditation and board certification requirements. Standards related to virtual clinical experiences and simulation for advanced practice registered nurses needs further study. CONCLUSION Virtual clinical experiences resulted in positive student learning outcomes. Through the provision of quality virtual clinical experiences, nurse educators have the potential to maximize student learning and professional growth.
Collapse
Affiliation(s)
- Kaitlyn Kolcun
- The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, United States of America.
| | - Cindy Zellefrow
- Helene Fuld Health Trust National Institute for Evidence Based Practice in Nursing and Healthcare at The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, United States of America.
| | - Joyce Karl
- 2050 Carriage Rd., Powell, OH 43065, United States of America
| | - Jodi Ulloa
- The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, United States of America.
| | - Anita Zehala
- The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, United States of America.
| | - Rosie Zeno
- The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, United States of America.
| | - Joni Tornwall
- The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, United States of America.
| |
Collapse
|
2
|
Bacon R, Hopkins S, Georgousopoulou E, Nahon I, Hilly C, Millar C, Flynn A, Smillie L, Chapman S, Brown N. While allied health students prefer face-to-face clinical placement, telehealth can support competency development: results from a mixed-methods study. Front Med (Lausanne) 2023; 10:1151980. [PMID: 37256090 PMCID: PMC10226666 DOI: 10.3389/fmed.2023.1151980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/21/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Student clinical placements are a mandatory requirement within most accredited health programs. During the COVID-19 pandemic, many health settings that had traditionally provided placements cancelled their offerings. Telehealth services however, increased and emerged as an alternative placement setting. Aim To compare the learning experiences for allied health students provided by telehealth and face-to-face accredited health placements. Methods Health students, from a university clinic between March to December 2020, delivering both face-to-face and telehealth consultations, were invited to complete a telephone survey with 3 demographic questions; and 10-items comparing their telehealth and face-to-face learning experiences. Pearson's chi-squared/Fisher's exact test was used to examine the association between each item and consultation setting. Qualitative survey data was thematically analysed using a descriptive approach. Results 49 students from 2 universities and 5 disciplines completed the survey. Students rated their face-to-face experiences significantly higher than their telehealth experiences across all items (all p-values <0.01). Across 9 items students reported positive learning experiences in both settings. Students had greater opportunities to work in a multidisciplinary team in a face-to-face setting. Four themes were generated: (1) placements can vary in quality regardless of setting; (2) telehealth can provide valuable learning experiences and support competency development; (3) enablers for telehealth placements and (4) barriers for telehealth placements. Conclusion While telehealth can support student learning and competency development, in this study students preferred face-to-face experiences. To optimise telehealth placements consideration needs to be given to barriers and enablers such as technological issues and university curricula preparation.
Collapse
Affiliation(s)
- Rachel Bacon
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Sian Hopkins
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | | | - Irmina Nahon
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Catherine Hilly
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - CaraJane Millar
- College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Allyson Flynn
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Linda Smillie
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Sarah Chapman
- Allied Health Clinical Education Unit, Canberra Health Services, Garran, ACT, Australia
| | - Nicholas Brown
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| |
Collapse
|
3
|
Taylor PH, Coulter K. Exploring the Effectiveness of Telehealth Simulation in a Standardized Patient Scenario. J Nurs Educ 2023; 62:162-166. [PMID: 36881889 DOI: 10.3928/01484834-20230109-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND This study evaluated transitioning face-to-face standardized patient (SP) competencies for nurse practitioner (NP) students to telehealth SP (TSP) competencies. Given the effects of coronavirus disease 2019 on clinical nursing education, faculty need evidence-based strategies that offer flexibility and high-quality learning experiences for students. METHOD SP grade rubrics for NP students (n = 53) who completed either face-to-face or TSP examinations were compared to determine whether there were any differences in overall mean score, history taking, physical examination, final diagnosis, and documentation between the two groups. RESULTS A two-tailed independent sample t test examined whether the mean scores for the variables differed between face-to-face SP and TSP competencies. CONCLUSION Overall results indicated the SP competencies were similar between the two groups. This confirms that both options of SP competencies for family NP students are acceptable. [J Nurs Educ. 2023;62(3):162-166.].
Collapse
|
4
|
Giuffrida S, Silano V, Ramacciati N, Prandi C, Baldon A, Bianchi M. Teaching strategies of clinical reasoning in advanced nursing clinical practice: A scoping review. Nurse Educ Pract 2023; 67:103548. [PMID: 36708638 DOI: 10.1016/j.nepr.2023.103548] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/17/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023]
Abstract
AIM/OBJECTIVE To report and synthesize the main strategies for teaching clinical reasoning described in the literature in the context of advanced clinical practice and promote new areas of research to improve the pedagogical approach to clinical reasoning in Advanced Practice Nursing. BACKGROUND Clinical reasoning and clinical thinking are essential elements in the advanced nursing clinical practice decision-making process. The quality improvement of care is related to the development of those skills. Therefore, it is crucial to optimize teaching strategies that can enhance the role of clinical reasoning in advanced clinical practice. DESIGN A scoping review was conducted using the framework developed by Arksey and O'Malley as a research strategy. Consistent with the nature of scoping reviews, a study protocol has been established. METHODS The studies included and analyzed in this scoping review cover from January 2016 to June 2022. Primary studies and secondary revision studies, published in biomedical databases, were selected, including qualitative ones. Electronic databases used were: CINAHL, PubMed, Cochrane Library, Scopus, and OVID. Three authors independently evaluated the articles for titles, abstracts, and full text. RESULTS 1433 articles were examined, applying the eligibility and exclusion criteria 73 studies were assessed for eligibility, and 27 were included in the scoping review. The results that emerged from the review were interpreted and grouped into three macro strategies (simulations-based education, art and visual thinking, and other learning approaches) and nineteen educational interventions. CONCLUSIONS Among the different strategies, the simulations are the most used. Despite this, our scoping review reveals that is necessary to use different teaching strategies to stimulate critical thinking, improve diagnostic reasoning, refine clinical judgment, and strengthen decision-making. However, it is not possible to demonstrate which methodology is more effective in obtaining the learning outcomes necessary to acquire an adequate level of judgment and critical thinking. Therefore, it will be necessary to relate teaching methodologies with the skills developed.
Collapse
Affiliation(s)
- Silvia Giuffrida
- Department of Cardiology and Cardiac Surgery, Cardio Centro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland.
| | - Verdiana Silano
- Nursing Direction of Settore Anziani Città di Bellinzona, Bellinzona, Switzerland.
| | - Nicola Ramacciati
- Department of Pharmacy, Health and Nutritional Sciences (DFSSN), University of Calabria, Rende, Italy.
| | - Cesarina Prandi
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
| | - Alessia Baldon
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
| | - Monica Bianchi
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
| |
Collapse
|
5
|
Comparing satisfaction and outcomes in on-campus versus virtual education for nurse practitioner students. J Am Assoc Nurse Pract 2023; 35:135-141. [PMID: 36649531 DOI: 10.1097/jxx.0000000000000826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/02/2022] [Indexed: 01/19/2023]
Abstract
ABSTRACT This article highlights the development and implementation of interactive training experiences for graduate nursing students as part of specialty training in endocrinology. Emphasis was placed on accomplishing the shift from on-campus to virtual training while maintaining fidelity and student satisfaction. A total of 106 graduate nursing students from five cohorts submitted evaluations. Student satisfaction remained high regardless of whether the content was delivered in person or virtually. Most students in the virtual cohorts evaluated the online training positively. Student presentation grades were highest with on-campus delivery. Transitioning in-person training to a virtual environment can be an effective method of delivering nurse practitioner education while promoting student satisfaction. Recommendations for optimizing hybrid learning experiences are offered based on adult learning principles.
Collapse
|
6
|
Smith SK, Benbenek MM, Bakker CJ, Bockwoldt D. Scoping review: Diagnostic reasoning as a component of clinical reasoning in the U.S. primary care nurse practitioner education. J Adv Nurs 2022; 78:3869-3896. [PMID: 35986584 PMCID: PMC9805128 DOI: 10.1111/jan.15414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/26/2022] [Accepted: 08/03/2022] [Indexed: 01/09/2023]
Abstract
AIMS Diagnostic Reasoning (DR) is an essential competency requiring mastery for safe, independent Nurse Practitioner (NP) practice, but little is known about DR content included in NP education programs. The aims of this study were to identify whether and how the concept of DR is addressed in NP education. DESIGN We conducted a scoping review on DR-related content and teaching innovations in U.S. primary care NP education programs, with implications for NP education programs worldwide. Concepts and principles with global applicability include: conducting focused and hypothesis-directed histories and exams, generating the problem statement, formulating the differential diagnosis, appropriate and relevant diagnostic testing, determining the working diagnosis and developing evidence-based, patient-centred management plans. DATA SOURCES N = 1115 articles retrieved from Medline, Embase, PsycINFO, and CINAHL for the period 2005-2021. Forty-one scholarly articles met inclusion/exclusion criteria. REVIEW METHODS Data were extracted, synthesized and grouped by theoretical frameworks, content included, educational interventions and assessment measures. RESULTS Most articles provided descriptions of approaches for teaching NP clinical or diagnostic reasoning. Ten papers directly referenced the current science and theory of DR. CONCLUSION The US NP education literature addressing DR is limited and demonstrates a lack of shared conceptualizations of DR. Whilst numerous components of DR are identifiable in the literature, a robust teaching/learning scholarship for DR has not yet been established in the US NP education literature. IMPACT Whilst primary care NP education programs are beginning to incorporate DR education into their curricula, little research has been conducted to demonstrate the effectiveness of educational outcomes. Increased integration of DR content into NP education is needed, including increased educational research on teaching DR competencies. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was included in this review, as the public is generally not familiar with DR or its teaching approaches.
Collapse
Affiliation(s)
- Sheila K. Smith
- School of NursingUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | | | - Denise Bockwoldt
- School of NursingUniversity of Illinois ChicagoChicagoIllinoisUSA
| |
Collapse
|
7
|
Griffith PB, Mariani B, Kelly MM. Diagnostic Reasoning Outcomes in Nurse Practitioner Education: A Scoping Review. J Nurs Educ 2022; 61:579-586. [DOI: 10.3928/01484834-20220803-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
8
|
Boardman C, Knight EP, Gavilanes JS, MacMillan C, Chatelain T, Vick E, D'Aubrey J, Saville Allard B. Disseminated Tele-OSCE During a Pandemic: One University's Experience. J Nurs Educ 2022; 61:107-110. [PMID: 35112945 DOI: 10.3928/01484834-20211128-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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.].
Collapse
|
9
|
Luke S, Petitt E, Tombrella J, McGoff E. Virtual Evaluation of Clinical Competence in Nurse Practitioner Students. MEDICAL SCIENCE EDUCATOR 2021; 31:1267-1271. [PMID: 34055459 PMCID: PMC8143741 DOI: 10.1007/s40670-021-01312-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 05/21/2023]
Abstract
All in-person nurse practitioner (NP) student clinical activities were suspended in the spring of 2020 due to COVID-19. This posed a unique summer semester challenge, as students needed to complete an objective structured clinical examination (OSCE). The traditional face-to-face OSCE was revised into a virtual format using a teleconferencing platform and included the following learning objectives: obtain the medical history, describe a focused physical examination, formulate differential diagnoses, and develop an appropriate plan of care. Together with the Health Education Center, students met with a standardized patient (SP) virtually. All elements of the virtual OSCE were the same as the traditional OSCE, except students were required to demonstrate their clinical assessment skills by verbalizing to faculty what they would examine if the visit were in-person. When finished, all participants were invited to complete a survey about their experience. Survey findings revealed that most faculty and students considered the interactive virtual OSCE an extremely effective tool for assessing communication and history taking skills, differential diagnosis, and management of patients. All SPs felt comfortable communicating with the students and felt that the virtual OSCE was a very effective way to assess their interpersonal skills of students. The virtual OSCE also served as an opportunity to incorporate telehealth competencies into a simulation experience for students. This innovative distance learning activity facilitated effective virtual evaluation of clinical competence in NP students and all stakeholders expressed satisfaction with the experience. Most faculty and students strongly agreed that they wanted to continue using the virtual OSCE platform.
Collapse
Affiliation(s)
- Sheba Luke
- School of Nursing & Health Education Center, University of Texas Medical Branch, Galveston, TX USA
| | - Elizabeth Petitt
- School of Nursing & Health Education Center, University of Texas Medical Branch, Galveston, TX USA
| | - Josie Tombrella
- School of Nursing & Health Education Center, University of Texas Medical Branch, Galveston, TX USA
| | - Erin McGoff
- School of Nursing & Health Education Center, University of Texas Medical Branch, Galveston, TX USA
| |
Collapse
|
10
|
LaManna JB, Eckhoff DO, Duncan J, Anderson M. Nurse Practitioner Student Perceptions of a Pilot Simulated Gerontologic Telehealth Visit. J Nurs Educ 2021; 60:408-413. [PMID: 34232822 DOI: 10.3928/01484834-20210616-10] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Recently published nurse practitioner (NP) education organization recommendations and telehealth equipment acquisition necessitated integration of telehealth simulation into NP curricula at a large, public university. The COVID-19 pandemic and associated rapid uptake of telehealth accelerated the need for evidence-supported research in tele-health simulation in NP education. METHOD A formative gerontologic simulation scenario using telehealth robot technology was developed by synthesizing best practice guidelines for simulation and telehealth delivery. The simulated telehealth visit used standardized patients and embedded participants. Primary care NP students' perceptions of simulation effectiveness, situational realism, and telehealth robot usability were evaluated using three quantitative tools. RESULTS Thirty-three primary care Doctor of Nursing Practice students participated in this gerontologic telehealth simulation. Students found the simulation to be effective and realistic, and found the telehealth robot technology to be usable. CONCLUSION NP students positively evaluated this telehealth simulation experience. Additional research is needed on evidence-based teaching strategies to guide faculty in teaching and evaluating telehealth content. [J Nurs Educ. 2021;60(7):408-413.].
Collapse
|
11
|
Knight EP, Prettyman AV. Rural Telehealth Team Education for Baccalaureate and Nurse Practitioner Students. J Nurs Educ 2020; 59:274-277. [DOI: 10.3928/01484834-20200422-07] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/18/2019] [Indexed: 11/20/2022]
|
12
|
Posey L, Pintz C, Zhou Q(P, Lewis K, Slaven-Lee P. Nurse Practitioner Student Perceptions of Face-to-Face and Telehealth Standardized Patient Simulations. JOURNAL OF NURSING REGULATION 2020. [DOI: 10.1016/s2155-8256(20)30012-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|