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How Graduate Nursing Schools Like FNU Are Taking In-Person Clinics Online

Virtual school during the pandemic has been a struggle for nearly everyone, but especially when it comes to education that requires hands-on learning such as nursing school. 

Without the ability to hold in-person educational clinics, nursing higher education institutions like Frontier Nursing University (FNU) had to take drastic measures to ensure that advanced practice nursing students got the best education possible without risk of spreading the disease. Dr. Kevin Scalf, psychiatric-mental health nurse practitioner and regional clinical faculty at FNU, explained how FNU’s innovative virtual learning program helped students throughout the pandemic — and may even have had advantages of its own. 

“With the advent of COVID, we were really forced to think outside the box, and it really forced us to become creative in a lot of ways,” Scalf says. “Students were already getting didactic information online at our university because that’s what we do, but how could we provide good clinical experiences for students in the virtual environment during that transition period. What can we do to really support them as they learn to apply their clinical skills?”

Finding creative solutions

Nursing isn’t a profession you can do from home, which means that nursing school curriculums needed to find a way to teach students to perform in-person tasks from afar. Scalf says that his university found a way to develop virtual clinics for students. “These virtual clinics include professional actors who play the role of the patient,” he explains, ”and so, students receive a clinic schedule at the beginning of the day, and that clinic schedule shows the patient’s name, what time they’re coming in for their appointment, who’s going to be the provider for the day, and that kind of thing.” 

In this way, the school was able to simulate the clinic environment. “We see patients back-to-back just like you would in-clinic, and the patients present with a variety of symptoms and problems. They each bring a different energy to the room just like we would see during regular clinic days.” In these simulations, the student acts as the healthcare provider, and afterwards, faculty and students come together to debrief about the interaction. 

While the virtual clinics started as a response to a need brought on by COVID, Scalf says that the ability to include feedback from the actor “patients” has been a new and useful way to get the perspective of patients. ”We really talk about that a lot, because sometimes as providers, we get in our own minds and we have our own agenda, so we kind of forget, ‘how does the patient see this?’” he notes. “Students have been very receptive of this experience and they like the feedback that the patients have to give them.”  

The future of medicine

In addition to nursing education, the global pandemic has also changed the nursing profession itself, namely through increased use of telehealth. That’s why FNU has also created virtual telehealth clinics. “We’ve started to incorporate material about telehealth into our curriculum so that students will be more familiar with this type of care delivery after graduation,” Scalf says. “But also, we have a telehealth clinic, and this again is virtually staffed by professional actors, and students can go back to this telehealth clinic as part of their clinical experience.”

The virtual telehealth clinics, Scalf says, allow students and faculty to work together and become better providers. “They can refine and improve their skills. If faculty pick up on student learning opportunities that maybe a student is weak in a particular area, they can go back to this telehealth clinic and work on those skills,” he explains. “We then follow up with the preceptor to gain additional feedback about overall clinical performance.” Students can participate in the virtual telehealth clinic to continually improve their skills and get one-on-one feedback from faculty members. “It’s just overall a great way for the student to gain clinical insight and also confidence as they work with the clinical portion of the educational program.”

Virtual clinics don’t just offer students the opportunity to simulate interactions with patients, Scalf says. At FNU, they’ve developed simulations that help students learn to work with other healthcare providers. “One of the things that we highlight is teamwork, because in healthcare, it’s all about the team, right?” Scalf says. “We have developed inter-professional simulations as well, where patients come in and need to be referred to other services. So they may come into the mental health provider’s office with one problem, but we have to refer and collaborate with primary care about a particular issue that came up. So, we really start the process of thinking about those team dynamics early on.” 

Online learning has a bad reputation for being isolating, but Scalf emphasizes that one thing the FNU team learned through creating virtual clinics is that online education doesn’t have to be lonely. “Not only does it increase access to education and graduate education, but it also allows students to have more diverse experiences with other people across the nation. One thing that we have learned throughout all of this is that online education can still be very personable and intimate for the students,” he says. “With an online learning model, I think it really prepares students for entering into a technology-driven world.” 

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