Telehealth Professionalism Education for Advanced Practice Nursing Students

Abstract

Telehealth professionalism is an often-overlooked element when performing telehealth visits, but it is one that can impact patient and provider satisfaction with this health care delivery modality. This article describes a telehealth professionalism activity that was integrated into the education of advanced practice registered nursing students as one part of their telehealth education. Attainment in knowledge with this activity, in conjunction with positive student feedback, shows promise regarding the impact of the educational intervention and its sustainability.KEY WORDS Depression -Telehealth Etiquette -Telehealth Professionalism -Telepsychiatry W ith the rapid adoption of telehealth as a modality to provide quality health care at a distance, measures need to be in place to ensure that remote care affords patients with the same sense of well-being as in-person visits. Barriers to the utilization of telehealth include the loss of personalization and therapeutic communication (Cowan et al., 2019;Kocsis & Yellowlees, 2018;Wiljer et al., 2019). To combat these barriers, telehealth providers must be educated on the interpersonal skills and environmental requirements that are needed during a telehealth visit. These are known as telehealth professionalism or telehealth etiquette.It is important to note that telehealth professionalism not only encompasses therapeutic communication with the patient but also addresses several areas that contribute to a seamless telehealth visit at both the originating and distant sites (Gustin et al., 2020;Maheu et al., 2018;Rutledge et al., 2017). This article describes how one graduate nursing program combined a telehealth professionalism activity with telepsychiatry training in an existing clinical course for advanced practice registered nurses (APRNs). Reports of a pretest-posttest are presented, along with student comments from debriefing and a short essay evaluation.

Changes in Telehealth Experienced by Advanced Practice RNs During COVID-19

“…Incorporate telehealth professionalism, including therapeutic communication 48 and ethical practice, into education and continuing education curricula 8 …”

Digital Health Education and Training for Undergraduate and Graduate Nursing Students: Scoping Review

“…Other students experienced telehealth during a clinical rotation [44] or as part of a clinical experience [67]. Telehealth education was delivered utilizing a variety of educational modalities or strategies including: didactic education (online modules and lectures, reading materials, videos, narrated lectures, self-directed modules) with simulation scenarios and standardized patients [41][42][43]45,47,49,50,53,55,56,[60][61][62][65][66][67][68]70]; asynchronous and synchronous simulation using teleconferencing tools and interactivities with or without didactic education [49,50,56,57,61,63,69]; telehealth self-paced learning with discussion [46]; guest speaker lectures with self-paced modules, lectures, and video conferencing demos [64,123]; simulation with a telehealth robot with an iPad and or a telehealth cart [52,53,62]; simulation with students acting as patients or providers [52,53,56,58]; telehealth as a clinical rotation [44,70]; telehealth OSCEs and clinical exams [45,61,63...…”

“…Researchers designed the interventional studies using different methods including mixed methods [41,53], pre/post design [69], descriptive design [52], quasi-experimental design [42,48], formative and summative evaluation introduced as educational activities [43,46,49,51],…”

“…program evaluations [44,45,47,54,61,63,67], pilot studies [41,50,53,55,57,58,60,62,65,66], and quality improvement projects [56,64,69]. Some studies applied pre/posttest or pre/post surveys to measure a variety of outcomes including knowledge, beliefs, confidence and comfort level, interest in telehealth, attitudes, preparedness, and satisfaction with the learning [42][43][44][45][46]48,50,54,62,64,66,70], proficiency and competence in performing skills, clinical decision making, working collaboratively with members of the health team, communication, providing care virtually, opinions, and experience of learning. In addition, some researchers evaluated the usability of telehealth technologies applied in simulation and/or simulation effectiveness [53].…”

“…Most studies in all the interventions reported below enhanced the intervention design by incorporating theoretical and pedagogical frameworks such as Bandura's self-efficacy theory [64,68], Kolb's Cycle of Experiential Learning [47,70], Ericsson's and Smith Expertise theory[66], the Ottawa Model for Research[69], the Plan-Do-Study-Act (PDSA) cycle[64], the Technology Acceptance Model[58], Roy's Adaptation Model[57], Problem-based Learning[60], Bloom's Taxonomy[64,89], Adult Learning Theories[87], Nursing Education Healthcare Informatics Framework (NEHI)[90], Technology Informatics Guiding Education Reform (TIGER) Competencies[90], and/or professional standards and competencies, telehealth competencies, and best practices for simulation-based research[41-43,45,47,49-51,53-57,59,61- 63,65,70,81,82,89].Interventions Focused on Telehealth Education. Integration was mostly as a stand-alone intervention, a good number of studies reported integration as part of an existing theory or clinical course[42,43,45,46,48,49,51,[59][60][61]64,66,70]; theory courses included health policy, role transition course, advanced health assessment course, and Bio-physical and Integrated Clinical Diagnosis course. Of note, only a few studies engaged students in their final clinical…”