Bridging the Gap: Preparing Nursing Students for Telehealth Encounters

Assistant Professor Katherine Chike-Harris, DNP, APRN, CPNP-PC, FNP-BC, CNE has always embraced the importance of preparing MUSC College of Nursing students for the variety of situations that they will encounter during practice, with telehealth being at the forefront of her work. Now, her forward-thinking project expands the possibilities of telehealth education not only for the College of Nursing but also for the entirety of MUSC.

Last fall, Chike-Harris was named an awardee for the 2022-23 MUSC Education Innovation Fund, which seeks out innovative educational approaches, techniques and programs to provide one-time funding for piloting or further evaluation. Her plan is to provide a scope, curriculum and actionable ways for embedding the work of telehealth into the College of Nursing’s courses, with an emphasis on scenarios and experiential learning. Chike-Harris stressed the need for undergraduate students to become comfortable with these interactions, especially with the recent and rapid acceleration of telehealth and the demand for students to be proficient in this area.

“I wanted to develop a simulated visit where our Bachelor of Science in Nursing students will have the experience of working with the telehealth cart, troubleshooting the cart and then presenting patients to our Doctor of Nursing Practice students,” she noted. Exposing students to these scenarios is key to making sure that they are equipped for practice and ready to take on any situation that they encounter. “Being exposed to this education will prepare students to help practices integrate,” she explained. “Especially for the undergraduate students, having that experience in the classroom will translate to post-graduation, because telehealth is here to stay.”

Chike-Harris’s efforts to create a rich, embedded curriculum on telehealth has provided numerous opportunities for the project to evolve. Considering what the project looks like moving forward, Chike-Harris provided this insight: “I’m using this as a pilot study, so I’m currently developing the cases, the scenarios and the workflow, and I’m hopeful that once that is solidified, I can open up the project to more colleges on campus as an interprofessional education initiative. This spring, we’ve had great success introducing the joint simulation to our BSN and DNP students, and within the next year, I’m going to try to invite the other colleges on the MUSC campus to participate in this interprofessional simulate telehealth activity.”

Chike-Harris’ excitement is palpable when envisioning the long-range impact of telehealth. “I love telehealth,” she enthused. “You know telehealth is my end game. I think it is critical that everybody be exposed to it, especially learners. If students become comfortable with it, then they will adopt it after graduation. My main love with telehealth is that we are reaching populations that we typically cannot reach due to a number of healthcare barriers.”

Equitable access to healthcare has always been a passion for Chike-Harris. “My mother was a first-generation immigrant to the United States, and even though my father was military and American, my mother still had language barriers, and at that time a lot of discrimination,” she said. “There was also the challenge of navigating the complex healthcare network of the United States. So, growing up with those challenges gave me a better appreciation of those underserved populations that need help.”

In addition to her work as a College of Nursing faculty member, Chike-Harris serves as a provider for South Carolina’s school-based telehealth program, which helps to deliver medical care to children in underserved areas through more than 100 school-based clinics across 23 counties. Each school participating in the program receives a specialized telehealth cart (with attached peripherals such as an electronic stethoscope, otoscope and lens) which allows the school nurse to telepresent children to remote providers, who are able to see and hear the examination results in real time. “So instead of children missing a part or a whole day of school, we can provide them with care,” said Chike-Harris. “Nine times out of 10, they are back in class within 15 to 30 minutes, increasing their seat time and education.”

Chike-Harris also uses the school-based telehealth program as a clinical precepting opportunity for her Doctor of Nursing Practice students, who can join her physical location or connect through one of the other supported school-based clinics located around the state. It is an innovative approach to both clinical training and care delivery.

“It’s called the teleprecepting model, which is something that not a lot of people are doing in the United States with pediatric or family nurse practitioner students—or at least not reporting on,” Chike-Harris explained. “I haven’t found much documentation where people say they are using nurse practitioner students in this model. We’re unique in the way we can provide a whole exam with the carts and the peripherals.”

The teleprecepting model can potentially provide more pediatric clinical opportunities for nurse practitioner students, which is currently a major challenge for many nurse practitioner programs in the United States. Several students can be placed within the school-based clinics and telepresent patients to one provider, thus increasing the traditional 1:1 student-preceptor ratio. Additionally, the teleprecepting model offers nurse practitioner students the opportunity to intimately experience the health care challenges underserved populations face and how telehealth can improve their access to quality health care.