Infusing Informatics and Genetics/Genomics in a Graduate Nursing Telehealth Immersion

The AACN Essentials (2021) calls for nursing students, in all levels of degree attainment, to attend to patient care by understanding the concepts of technology assisted care beyond the scope of healthcare settings to reach patients in various environments. Telehealth services, especially post-COVID-19 pandemic, are more essential to patient-centered care than ever before. The needs of nursing students necessitate the knowledge of and experiences with telehealth technologies to communicate with patients and the healthcare team, deliver health information and preventative care, enlist remote patient monitoring skills, and provide focus on the delivery needs of informatics in diverse communities and settings, along with equipment, broadband, and literacy needs of their clients.

With technological advances in healthcare, the use of genetics/genomics and the increased use of personalized healthcare are apparent in today’s healthcare setting. Nurses are at the forefront to assist patients in their understanding of genomic test results, gene mutations and disease likelihoods, and potential sharing of these disease transmissions to family members. Gaps in academic programs have exposed the lack of genetic and genomic education for the nursing population at the time of school programming. Immersive experiences, beyond textbook knowledge, to prepare and engage students for transition to practice, allow for a richer and deeper learning format.

An immersive telehealth simulation was created, utilizing a trained standardized patient, for both prelicensure and post-licensure masters’ degree nursing students. Within this scenario, students engage in telehealth services, providing counseling for clients post-genetic testing (assisting with result questions and health literacy) and remote monitoring of patient’s vital signs, needs, and home equipment usage. Students are provided all necessary equipment, and there are assignments of teams of 2-3 students per simulated session, with prework inclusive of telehealth basics (equipment usage, background assessment, camera etiquette, volume and presence for patient needs) and the patient’s electronic health record (utilizing a standardized simulated EHR), which is inclusive of patient history, background, labs, and genetic test results. The simulation is sectioned out within the semester so that several weeks of knowledge in informatics and post-genetic/genomics readings, lectures, and activities have previously occurred; basic information is introduced to each student before immersion activity.

The immersion has been a student satisfier in their academic trajectory. Student feedback shows an increase in knowledge and self-assessment with a further sense of critical thinking, including an understanding of the needs of the technological practicum and in patient interaction that would not occur in the clinical unit for a student, would be strictly observational, or would be shared by preceptor nurse story-telling alone. Post-telehealth immersion feedback in a debriefing session was shown to be most helpful in accentuating all experiences and learning within the immersion activity. The feedback from the standardized patient proved to be profoundly beneficial to student confidence levels and transferred over into personal reflection and within practice post-graduation (per evaluative survey findings).