In this presentation, the authors will discuss the differences between the Remote Skills Acquisition (RSA) model versus on-ground models, review initial RSA model pilot program design and parameters, and share initial outcomes and qualitative learners’ experience feedback using the RSA learning modality.
In alignment with the College’s mission and the goal of increasing geographic, demographic, and socioeconomic access to prelicensure nursing education, the College developed and implemented a learning delivery model accessible to learners in any setting. The College’s prelicensure nursing programs’ full-distance curriculum provides for a lock-step mechanism of didactic learning and initial skills acquisition with virtual simulation learning activities and supervised on-ground field experiences. Online instruction occurs asynchronously via the College’s learning management system, supported remotely by faculty through video conferencing technologies. These educational models are designed to provide for greater opportunity and access to nursing education as we work to serve diverse communities and close educational equity gaps.
With the National Academies of Medicine reports in the last 20 years (NAM, 2020, 2010), there have been consistent calls to diversify the nursing profession as a means of improving health equity outcomes. Research suggests health outcomes improve when those providing care reflect the communities they serve (Hanover Research, 2020). However, a brief overview of the nursing profession compared to the general population demonstrates significant gaps exist. According to the US Census Bureau in 2020 the US population breakdowns, along with data from the current NSCBN data on current nursing demographic breakdowns, noting some limitations in the data that report subpopulations differently, there are still significant differences to be noted. Hispanic or Latino populations remain the lowest represented group overall, while Asian grouping show as overrepresented in the population proportionally. White populations, while not fully represented proportionally, remain the largest portion of the nursing profession. Yet these reports also do not fully highlight the scope of geographic discrepancy, as nursing schools and subsequent work placements are often located in larger population centers leaving rural communities often bereft of qualified personnel and role models, or the socioeconomic disparities that can make performance-based admissions processes due to enrollment caps often a by-product of economic disparity-based opportunity preparation.
Where such disparities exist, the current normative educational model can further exacerbate these inequalities. Traditionally, on-ground nursing programs skills acquisition occurs in a one-to-many setting, which encourages passive observation with limited hands-on engagement. Necessary materials for ample practice leading to process improvement and intuitive skill recall are limited in availability during lab time. While this type of model may fulfill clock-hour requirements for a course, the approach provides minimal opportunity for individual practice and demonstration of skill acquisition within the scheduled timeframe. Learners with the least prior academic preparation and performative skill knowledge who may not be as socialized to this form of learning may fall further behind without additional time, practice, and support.
The College’s remote skills-acquisition (RSA) model ameliorates these downfalls of traditional large group laboratory settings by providing numerous opportunities for faculty-supported repetitive hands-on practice without the limitations of an on-ground setting in a many to one style model. Learners receive skills kits each semester aligned to each experiential learning course. Corresponding modules provide instruction via reading material, images, quizzes, and in-depth demonstration videos. The skills kits contain supplies to simulate the skill, providing the learners opportunities for tactile comprehension and practice. Checklists and rubrics are available to assist learners in navigating the step-by-step process of each individual skill. After ample hands-on practice, learners are required to record their skill demonstration and submit the recording for assessment by faculty. Consistent, repeated, and individualized opportunities to practice in a safe environment allows disadvantaged and advantaged learners more time and space to individually practice to confident competency.
Initial evaluation of the use of RSA compared to traditional skills laboratories included cost mitigation and return on investment (ROI). The use of the RSA model eliminated to need for traditional skills laboratories, thus decreasing the cost associated with lab initial set up and maintenance. Other non-tangible benefits include decreased real estate costs related to facility space needed for a traditional skill laboratory. RSA is conducted remotely, allowing users to participate from different locations, thereby reducing travel costs for participants and provides scalability in terms of accommodating more learners without the need for additional physical resources. The RSA model provides an immersive and interactive learning experience, enabling learners to practice skills and scenarios realistically. This can lead to improved learning outcomes, enhanced skill retention, and increased learner confidence. This translates into improved academic performance, clinical reasoning, potentially reduced errors, and an overall positive impact on the program's ROI.
In this presentation, the authors will discuss the differences between the RSA versus on-ground models, review initial RSA model pilot program design and parameters, and share initial outcomes and qualitative learners’ experience feedback using the RSA learning modality.