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Nurse Program Reimagines Diagnostic Training for Online Students

When officials at the University of Cincinnati’s College of Nursing opted in 2009 to move portions of its master’s program for nurse practitioners online, they did so with a purpose.

“We are really trying to reach students who want to go that next step in patient care and accountability and responsibility, but don’t have access to an education system nearby or the time,” Christine L. Colella, a nurse practitioner and director of the program, says of the distance-education format. ”We are really trying to open up the availability to get more nurse practitioners because we need them.”

Health experts have warned that the United States faces a looming shortage of nurses as baby boomers age and more people gain access to medical care under the new health-care law.

Still, Ms. Colella notes, online students in her differential-diagnosis course—which trains nursing students not only to gather relevant patient data but also to make diagnoses—faced not being able to work with “standardized” patients. The interaction involves paid actors who “exhibit” specific symptoms of disorders and diseases that student nurses are then responsible for deciphering and diagnosing.

Teaming up with an instructional designer and an information technologist, Ms. Colella set about building an interactive, web-based program to replicate the training for her distance-education students.

The result was a sequence of videos from the view of a nurse practitioner as he or she assesses a patient. It is interlaced with questions and prompts at which the video pauses and the student nurse is required to describe the interaction and symptoms. At the end, the student nurse is asked to propose the three most likely diagnoses, just as those participating in an in-person role-playing session are required to do.

Ms. Colella tested the program with multiple classes through the spring of 2013, comparing quantitatively and qualitatively the performance of traditional students and their distance-education counterparts. There was little difference. In fact, many of the online students said the program helped to raise their confidence and called for it to be expanded, Ms. Colella says.

“It was so funny because so many of the students actually said, ‘This was a great hands-on experience,’” Ms. Colella says.

In July the Health Resources and Services Administration at the U.S. Department of Health and Human Services awarded Ms. Colella and her colleagues an $875,000 grant to continue the work. They have developed three of what will eventually be 15 interactive case studies focusing on three patient populations—pediatric, adult, and geriatric.

Ms. Colella plans additional testing this spring and hopes to fully integrate the modules into the nursing program’s distance-learning curriculum in the fall. They will be used by graduate nursing students as well as by third- and fourth-year medical students at the university’s College of Medicine, she says.

“I would like to see this move out of just nursing and be utilized in any discipline where you want to show a student how to do something,” Ms. Colella says. “It is that role-modeling piece that we were hoping to get at, and we didn’t expect it to come through so loud in our data.”

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