The purpose of creating telehealth scenarios and the implementation of COVID-19 training was to prepare undergraduate nursing students for the future of primary healthcare and the delivery of that care using telehealth modalities and COVID simulators. Students were provided the opportunity to engage in the following simulation activities:
• Assessing a client using telehealth communication techniques
• Utilizing communication strategies to overcome client barriers to encourage participation and responses during telehealth encounters
•    Identify outcomes for an individualized plan of care for a telehealth client
•    Develop active listening skills during a telehealth encounter with a client
•    Practicing of the use of correct nasal swabbing for the collection of COVID-19 screenings
•    Assessing lung sounds of a COVID-19 client

Students in groups of 4-8 completed four stations that included: telehealth patient intake, patient education, COVID-19 testing, and a patient admission with risk factors of COVID-19.

Students were provided patient demographics for the telehealth encounter. Additionally, students were given CDC guidelines for COVID-19, education points for quarantine and stay-at-home guidelines, and a telehealth algorithm to assist as a telehealth nurse. By completion of the scenario each student was able to:
•    Interview a client via telehealth
•    Assess signs and symptoms of a client via telehealth
•    Implement COVID-19 algorithm via telehealth
•    Educate the client about the signs and symptoms of COVID-19, quarantine guidelines, and when to call provider
•    Demonstrate correct testing on the COVID-19 simulator

By the completion of high-fidelity simulation students were able to:
•    Recognize signs and symptoms of acute infectious respiratory illness
•    Perform a primary assessment of a client with signs and symptoms of an acute respiratory illness
•    Practice interdisciplinary team collaboration and safety
•    Apply appropriate PPE standards
•    Communicate with the interdisciplinary team using SBAR.

Survey results for the telehealth scenarios (N=72) indicated that post-scenarios, the majority of nursing students were:
•    Comfortable to very comfortable: using telehealth technology, assessing clients using telehealth communication techniques, identifying outcomes for an individualized plan of care, and using strategies to overcome client barriers to participate and respond during telehealth encounters. Moreover, the students indicated they can now effectively engage in telehealth encounters as a future practicing nurse.

Survey results for the training related to the use of the COVID-19 simulators (N=47) indicated post-scenarios/training, the majority of nursing students were:
•    Comfortable to very comfortable: performing nasal swabbing for the collection of COVID-19 screenings, and the assessing of lung sounds of a COVID-19 client.

Nursing education needs to embrace the use of technology in the preparation of students for the current and future delivery of primary healthcare. By the utilization of telehealth scenarios and COVID-19 simulators, nursing students were provided “real-life” application of knowledge and skills in a controlled environment. The delivery of nursing education has rapidly changed over time. The current pandemic has accelerated these changes in terms of using technology with a focus on primary healthcare. In order to continue to meet the challenges of preparing holistic healthcare providers, innovative learning strategies and technological modalities will need to be embraced.

Jene Hurlbut RN, MSN, MS, PhD, CNE

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