J Am Assoc Nurse Pract. 2021 Feb 24;34(1):153-159. doi: 10.1097/JXX.0000000000000567.

Teleprecepting: A timely approach to clinical education during COVID-19.

Journal of the American Association of Nurse Practitioners

Deborah Johnson, Elizabeth Gatewood, Amanda Ling, Angel Chen Kuo

PMID: 33660623 DOI: 10.1097/JXX.0000000000000567

Abstract

ABSTRACT: Clinical training is a key component of nurse practitioner (NP) education. The rapid shift to telehealth necessitated by the pandemic has also created a need for socially distanced education and precepting. This article presents teleprecepting as a modality for clinical opportunities and connecting students to previously limited experiences, such as training in small specialties, in rural areas, and with interdisciplinary teams. Precepting NP students using telehealth follows similar principles as in-person teaching, but some modifications and additional considerations are needed to transition to the virtual environment. At a time when many NPs have swiftly adapted to telehealth in practice, this article will offer a brief "how-to" for teleprecepting. Prior to COVID-19, teleprecepting was piloted with less than 2% of NP students in the school's pilot teleprecepting project. Seven months after the initial surge of cases and restrictions, 72% of students (n = 151) in the family nurse practitioner, psychiatric mental health nurse practitioner, and pediatric nurse practitioner specialties had transitioned to teleprecepting. This project was implemented rapidly during the pandemic, and thus, evaluations comparing competency outcomes and experiences of students and preceptors are still in process. Additionally, feasibility of this educational model may change as telehealth regulations continue to evolve. COVID-19 poses challenges for both patient care and clinical training of NP students across specialties. With some adaptation, clinical placements can be transitioned to the virtual environment of telehealth. Future studies should examine student competencies based on teleprecepting experiences and preceptor training to support teleprecepting roles.

Copyright © 2021 The Authors. Published by Wolters Kluwer on behalf of the American Association of Nurse Practitioners.

Conflict of interest statement

References

1. California Telehealth Resource Center. (n.d.). Direct to patient telehealth. https://www.caltrc.org/knowledge-center/direct-to-patient. - PubMed
2. Center for Connected Health Policy. (2020). State telehealth laws and reimbursement and policies. https://www.cchpca.org. - PubMed
3. Drayton-Brooks S. M., Gray P. A., Turner N. P., Newland J. A. (2017). Building clinical education training capacity in nurse practitioner programs. Journal of Professional Nursing, 33, 422–428. https://doi.org/10.1016/j.profnurs.2017.02.002. - PubMed
4. Fitzgerald C., Kantrowitz-Gordon I., Katz J., Hirsch A. (2011). Advanced practice nursing education: Challenges and strategies. Nursing Research and Practice. https://doi.org/10.1155/2012/854918. - PubMed
5. Gatewood E., De Gagne J. C. (2019). The one-minute preceptor model: A systematic review. Journal of the American Association of Nurse Practitioners, 31, 46–57. https://doi.org/10.1097/JXX.0000000000000099. - PubMed
6. Gibson N., Arends R., Voss J., Marckstadt S., Nissen M. K. (2020). Reinforcing telehealth competence through nurse practitioner student clinical experiences. Journal of Nursing Education, 59, 413–417. https://doi.org/10.3928/01484834-20200617-12. - PubMed
7. Jain V., Waghmare L., Shrivastav T., Mahakalkar C. (2018). SNAPPS facilitates clinical reasoning in outpatient settings. Education for Health, 31, 59. https://doi.org/10.4103/1357-6283.239052. - PubMed
8. Johnson D. S., Ling A., Melino K. (2020). Exploring readiness for teleprecepting in psychiatric mental health nurse practitioner training. Journal of the American Psychiatric Nurses Association. https://doi.org/10.1177/1078390320948127. - PubMed
9. Lefroy J., Watling C., Teunissen P. (2015). Guidelines: The do's, don’ts and don't knows of feedback for clinical education. Perspectives in Medical Education, 4, 284–299. https://doi.org/10.1007/s40037-015-0231-7. - PubMed
10. Myers K., Chou C. L. (2016). Collaborative and bidirectional feedback between students and clinical preceptors: Promoting effective communication skills on health care teams. Journal Midwifery & Womens Health, 61:22–27. https://doi.org/10.1111/jmwh.12505. - PubMed
11. National Consortium of Telehealth Resource Centers. (2020). Resources. https://www.telehealthresourcecenter.org/resources/. - PubMed
12. Neher J. O., Gordon K. C., Meyer B., Stevens N. (1992). A five-step “microskills” model of clinical teaching. Journal of the American Board of Family Practice, 5, 419–424. https://doi.org/10.3122/jabfm.5.4.419. - PubMed
13. Obeso V., Brown D., Aiyer M., Barron B., Bull J., Carter T., Emery M., Gillespie C., Hormann M., Hyderi A., Lupi C., Schwartz M.L., Uthman M., Vasilevskis E.E., Yingling S., Phillipi C. (Eds.). (2017). Core EPAs for entering residency pilot program: Toolkits for the 13 core entrustable professional Activities for entering residency. Association of American Medical Colleges. www.aamc.org/what-we-do/mission-areas/medical-education/cbme/core-epas/publications. - PubMed
14. Pitts C., Padden D., Knestrick J., Bigley M. B. (2019). A checklist for faculty and preceptor to enhance the nurse practitioner student clinical experience. Journal of the American Association of Nurse Practitioners, 31, 591–597. https://doi.org/10.1097/JXX.0000000000000310. - PubMed
15. Rutledge C., Kott K., Schweickert P., Poston R., Fowler C., Haney T. (2017). Telehealth and eHealth in nurse practitioner training: Current perspectives. Advances in Medical Education and Practice, 8, 399–409. https://doi.org/10.2147/AMEP.S116071. - PubMed
16. Totten A. M., Womack D. M., Eden K. B., McDonagh M. S., Griffin J. C., Grusing S., Hersh W. R. (2016). Telehealth: Mapping the evidence for patient outcomes from systematic reviews. Agency for Healthcare Research and Quality (US). http://www.ncbi.nlm.nih.gov/books/NBK379320/. - PubMed
17. Tyson R. L., Brammer S., McIntosh D. (2019). Telehealth in psychiatric nursing education: Lessons from the field. Journal of the American Psychiatric Nurses Association, 25, 266–271. https://doi.org/10.1177/1078390318807967. - PubMed
18. U.S. Department of Health & Human Services. (2020a). Telehealth: Healthcare from the safety of our homes. https://telehealth.hhs.gov/providers. - PubMed
19. U.S. Department of Health & Human Services. (2020b). Telehealth: Delivering care safely during COVID-19. https://www.hhs.gov/coronavirus/telehealth/index.html#waivers. - PubMed
20. Winship J. M., Falls K., Gregory M., Peron E. P., Donohoe K. L., Sargent L., Slattum P. W., Chung J., Tyler C. M., Diallo A., Battle K., Parsons P. (2020). A case study in rapid adaptation of interprofessional education and remote visits during COVID-19. Journal of Interprofessional Care, 34, 702–705. https://doi.org/10.1080/13561820.2020.1807921. - PubMed
21. Wosik J., Fudim M., Cameron B., Gellad Z. F., Cho A., Phinney D., Curtis S., Roman M., Poon E. G., Ferranti J., Katz J. N., Tcheng J. (2020). Telehealth transformation: COVID-19 and the rise of virtual care. Journal of the American Medical Informatics Association, 27, 957–962. https://doi.org/10.1093/jamia/ocaa067. - PubMed
22. Wynn S. T. (2019). Limited mental health clinical sites: Telehealth is the answer. Journal of Nursing Education, 58, 187. https://doi.org/10.3928/01484834-20190221-14. - PubMed

Publication Types

• Journal Article