P46 - Undergraduate Nursing Students and Telehealth Competency in COVID-19 Triage: Learning from Actors in Virtual Simulation

Objective: In this presentation, we describe the process of using standardized patients (SPs) during a virtual telehealth-enabled COVID-19 triage simulation in a pre-licensure nursing program, and the effectiveness of the simulation on the students’ confidence and competence.

Background: Simulation-based learning experiences (SBLEs) have long-been recognized as an effective educational tool in BSN education (Aebersold, 2018). The addition of standardized patients (SPs) who have training in providing the most realistic possible scenario adds additional benefit to the simulation experience. SPs have been used extensively in medical education and more recently in nursing education (Speeney, Kameg, Cline, Szpak, & Bagwell, 2018).

For this simulation, the university school of nursing collaborated with the school of medicine to obtain actors who had served as SPs in their program. These actors were provided with the script for the simulation well in advance, and provided a level of realism not possible when those roles were played by faculty or non-professional volunteers.

Funding for the use of SPs was provided to the school of nursing through a supplemental grant by the Health Resources and Services Administration to strengthen telehealth training to address COVID-19 care in primary care. Use of telehealth and COVID-19 triage protocol via virtual simulation is one way for nursing schools to prepare nurses to provide telehealth-enabled COVID-19 care to the community.

Method: 89 students in an ambulatory care course during the last semester of their pre-licensure bachelor of science in nursing degree program participated in a 2.25-hour virtual telehealth simulation. The course faculty modified a previous telephone triage in-person simulation to include a COVID-19 exposure scenario and added a team of actors who were experienced simulation educators to act as SPs. These SPs were provided with the script and background information for their role, and after each individual simulation they offered feedback to the participating students.

Using Zoom as a virtual learning platform, learners participated in a 45-minute pre-briefing, where they learned about the use of telehealth in nursing practice and about COVID-19 telephone triage and care protocol (CDC, 2020). They then participated in a 30-minute, one-on-one simulation with the SPs in a Zoom breakout room, including feedback from SPs and faculty, before joining a one-hour structured debriefing session. Change in the learners’ knowledge and confidence in providing telehealth-enabled COVID-19 care was measured with a 19-item pre- and post-survey.

Outcomes: The students completed a pre- and post-simulation survey assessment of their perceived confidence and competence in telehealth encounters related to COVID. These included question items such as confidence in assessment, triage, treatment and referral, patient education, and other factors. Analysis of the survey results indicates that the students perceived a significant increase in both confidence and competence in managing clients with possible COVID infection through a telehealth platform. Comments were generally positive about the experience.

Conclusion: The use of SPs provided a consistency in delivery of the telehealth simulation experience, and the structure and delivery of the simulation improved the students’ perceived confidence and competence in telehealth delivery of COVID care.