Preparing online Nurse Practitioner students with the advanced knowledge and skills needed to collaborate interprofessionally and effectively coach patients with chronic conditions requires opportunities for authentic practice. This presentation will share the design and outcomes of an eLearning program that immerses learners in authentic, video-based decision-making scenarios with real-world consequences.
Background: Effective education of Nurse Practitioner (NP) students requires providing them with frequent and multiple opportunities for authentic practice of clinical skills. One key area of clinical skills development involves preparing NPs to care for the growing population of patients with multiple chronic conditions such as diabetes, obesity, heart disease, and/or cancer. In addition to development of diagnostic reasoning skills needed to make decisions about patient care, to achieve optimal outcomes for these patients, NPs must develop the coaching skills needed to help these patients better manage their own diseases and motivate them to adopt healthy behaviors. Patients with complex chronic conditions commonly receive care from an interprofessional team of care providers, so students must also develop effective collaboration and conflict management skills.
Preparing students with this complex skill set requires opportunities for guided, authentic practice. This can be especially challenging when educating students at a distance. Although students may work with patients with multiple chronic conditions through local clinical placements with experienced providers, they generally do not have opportunities to practice coaching patients over time or to collaborate with an interprofessional team in making clinical decisions and coordinating care.
To address this need, the US Health Resources & Services Administration (HRSA) funded the GW School of Nursing (GWSON) to develop a set of open-access training materials targeting the development of skills needed to promote patient engagement and self-management of multiple chronic conditions within interprofessional teams. The heart of these materials is an eLearning course titled Interprofessional Care of Individuals with Multiple Chronic Conditions. The interactive multimedia content covers essential topics such as coaching techniques, motivational interviewing, behavior change facilitation, care coordination, interprofessional teamwork and conflict management. The course culminates with an immersive “day in the life of an interprofessional team” module through which learners practice collaborating with the team to care for a diverse group of patients with multiple chronic conditions. The use of video scenarios featuring professional actors creates a realistic context that immerses learners in making decisions about how to respond in challenging coaching or teamwork situations, experiencing the consequences of these decisions, and receiving instructive feedback.
This presentation will (1) demonstrate the eLearning course and immersive video scenarios; (2) share the instructional design and flow of the decision-making interactions; (3) share the results of a pilot study examining students’ satisfaction and perceived learning; and (4) discuss the value of rich-media scenarios in creating a context for deep mental involvement (i.e., immersion).
Methods: The eLearning course was pilot tested with a convenience sample of 99 NP students enrolled in GWSON’s Health Assessment course during the Spring, 2015 semester. Students completed pre- and- post evaluation surveys to measure satisfaction and perceived learning. Statements related to students’ learning experiences were rated on a 5-point Likert scale (1=Strongly Disagree to 5=Strongly Agree). Before and after completing the course, students also rated their perceived level of knowledge related to each of three core competencies: (1) applying the Chronic Care Model; (2) coaching for patient self-management; and (3) interprofessional collaboration skills on a 5-point Likert scale (1=Poor to 5=Excellent).
Results: A large majority of students agreed or strongly agreed that they would be able to directly apply their learning to clinical practice (92%) and that the content was presented in a way that would help them learn (91%). Results also indicated a significant difference in perceived knowledge between pre and posttest as follows: applying the Chronic Care Model to clinical practice, t = -11.67, df = 98 ρ<.0001, coaching patients for self management, t = -9.46, df = 98 ρ<.0001, interprofessional collaboration skills, t = -2.40, df = 98 ρ<.0001. These results were further supported by students’ agreement or strong agreement that the modules improved their competence related to caring for people with multiple chronic illnesses (93%) and interprofessional practice (93%). Qualitative findings indicate a high level of satisfaction with the video-based decision-making experience, with 55% of the students noting either the scenarios or the interactivity as the best part of the course.
Conclusion: This open-access eLearning course provides online educators with an engaging and self-directed means of preparing NP students to care for patients with multiple chronic conditions in interprofessional settings. Findings indicate that students' were highly satisfied with the learning experience, that their perceived knowledge increased after completing the modules, and that they found the immersive video scenarios to be the best feature of the course. The results of this study support investment in high-end interactive multimedia education that increases realism and immerses learners in complex decision-making with real-world consequences.