Development and implementation of an e-visit objective structured clinical examination to evaluate student ability to provide care by telehealth

Abstract

The provision of care through telehealth is emerging as a strategy to meet the challenges of a changing health care system; however, educational experiences associated with telehealth are limited in nursing curricula. In 2018, the National Organization of Nurse Practitioner Faculties (NONPF) recommended incorporating telehealth modalities in nurse practitioner education, including clinical skills assessment. Objective structured clinical examinations (OSCEs) have been used as formative and summative evaluations of health science students since the 1970s to assess application of didactic learning in clinical practice. Although few studies have investigated integrating OSCEs, virtual simulation, or telehealth in distance education, those that exist demonstrate significant improvement in clinical decision making. This article describes the development and implementation of an OSCE at a large Midwestern university delivered via web conferencing to evaluate online family nurse practitioner (FNP) students' abilities to deliver care using telecommunication technology. An e-visit notification listing the types of symptoms available for treatment by telehealth served as a content list. Students completed a 15-minute e-visit assessing and managing the care of a standardized patient presenting with a recent onset of dysuria. The video conference included the FNP student, standardized patient, and faculty evaluating in real time using a rubric incorporating NONPF competencies for telehealth. Structured group debrief, an integral part of the learning process in clinical simulations, followed the e-visit OSCE using free conference calling. Faculty and student feedback and evaluations of this summative OSCE implemented for three cohort groups (103 students) positively reflect the importance of preparing students for practice in a transformed health care system.

Remote OSCE Experience: What First Year Pharmacy Students Liked, Learned, and Suggested for Future Implementations

“…Recently, VanLangen and colleagues found virtual skills-based assessments to be an appropriate mechanism to assess student communication skills; however, they did not observe a strong preference for virtual skills-based assessments in the future [8]. Similar research from nursing and medicine describes telehealth OSCE simulation yet fails to explore student perspectives [9,10].…”

Assessment methods and the validity and reliability of measurement tools in online objective structured clinical examinations: a systematic scoping review

“…Additionally, the issues of assessing physical examinations could be overcome by using an assessment configuration wherein the examinee and simulated patient occupy the same room, with the examiner situated remotely. In a broader context, modeling the teleOSCE on telemedicine consultations may additionally prepare students to function more effectively as future clinicians in an environment that encourages humans to work harmoniously with technological innovations to meet growing healthcare demands [ 3 ]. Although teleOSCEs may theoretically have many benefits, they must be proven practical before they can be widely adopted.…”

Exploring the perceptions and barriers of nurses working in remote areas on tele-educational delivery of pharmacy knowledge in Henan, China: a qualitative study

“…Open access interaction and absence of a strong learning atmosphere have been noted in video conference learning. 8 Although telemedicine in China started relatively late, originated in the mid-1980s, it has developed rapidly. 9 At present, 'video conference' has become a common means of continuing education for remote county-level nurses in China.…”

“… 7 Compared with the traditional model, video conference training is efficient, saving both time and money. 8 Under this new model, close cooperation and alliance relationships between county-level and higher-level medical institutions can be established. With video conference learning, learners have the option to attend real-time or conduct home study through watching recorded lectures.…”

“…Despite these advantages, a lack of classroom interaction and absence of a strong learning atmosphere have been noted in video conference learning. 8 …”