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Evaluating a Telehealth
Simulation for APRN students

Heather Jones DNP, Beth Ammerman DNP, Kevin Joiner PhD, Deborah Lee PhD, April Bigelow PhD, Elizabeth Kuzma DNP

BACKGROUND & SIGNIFICANCE
The broad expansion of telehealth as a care delivery model dramatically
increased since the beginning of the COVID-19 pandemic. As health care
delivery changes, providers must learn to use telehealth technology safely,
effectively, and confidently. Nurse educators need to prepare APRN
students to meet the challenge of managing this important mode of care
delivery.

PURPOSE

METHODS/DESIGN

• A single group comparison study was conducted.
• Participants were recruited from among APRN students of an Advanced

Health Assessment course.
• An intervention that included telehealth didactic content and a telehealth

simulation was performed.
• The design of this study entailed:
o A pre and post-test survey about their beliefs of the value of

telehealth and their confidence in performing telehealth as a
method of care delivery.

o A required multimodal telehealth instruction between the pre
and post test surveys.

o A formative graded assignment where faculty evaluated a
telehealth simulation involving application of the learned
concepts with Standardized Patients.

• Data was used from the surveys to evaluate a simulated telehealth SP
experience.

• Domains of beliefs and confidence regarding telehealth were described
using univariate statistics.

• Wilcoxon signed rank sum test was used to explore the difference
between individual item and summary scores pre- and post- simulated
telehealth standardized patient experience.

RESULTS

• Several areas were without any significant change in students’ beliefs
regarding telehealth

o all of these areas were rated high pre-intervention
• Several areas showed significant positive change (all with p<0.0001) in

student outcomes post-intervention including:
o overall confidence related to providing telehealth
o understanding the rules and regulations for providing telehealth
o understanding how to document the necessity of telehealth services
o feeling prepared to provide telehealth service
o feeling comfortable providing telehealth services

CONCLUSION/LESSIONS LEARNED

FUTURE APPLICATIONS and NEXT STEPS

This innovative telehealth simulation and didactic content for APRN
students provided the opportunity to demonstrate use of telehealth
equipment and develop telehealth competencies. Simulation is one
strategy available to expose students to telehealth and improve telehealth
skills. With adequate formal education and training in telehealth APRN
students will be well-positioned to provide telehealth care services for
patients in their future practice settings, further expanding access to care.

Integration of telehealth into the nursing curriculum is essential to instill
confidence as health care technology advances. Since most students did
not feel comfortable prior to the multimodal telehealth instruction but felt
very comfortable after the instruction and demonstrating a simulated
telehealth SP experience, we feel this intervention was very effective. We
felt it affirmed the need to use this learning tool in the upcoming
advanced health assessment courses to instill confidence in performing
telehealth.

Explore students’ beliefs about the value of telehealth and confidence
performing telehealth

HYPOTHESIS
With adequate formal educational and training in telehealth, APRN
students will be well positioned to provide high quality telehealth care.