An interprofessional approach to a distance learning dilemma
Teaching is not an activity that is done in isolation. It takes colleagues with diverse talents and skills to create and build effective learning tools that improve student learning outcomes. Content, pedagogy, and technical expertise are required when new learning technologies are developed.
Learning in a practice discipline, such as advanced practice nursing, can be particularly challenging. Students must assess, diagnose, and provide care for diverse populations. Their ability to be proficient at these skills could make a difference in whether a patient lives or dies. This is a high stakes profession and the education preparing practitioners is high stakes education.
Teaching nurses to become nurse practitioners is difficult under any circumstances, but when the student is part of a distance learning program the opportunity to role model professional behaviors can be elusive. The American Association of Colleges of Nursing reports that there are currently 65 distance learning nurse practitioner programs with 31 offering their programs entirely online. Almost 22% of all post-masters Nurse Practitioner programs offer distance education (AACN, 2014).
A differential diagnosis course that was previously taught in an on-campus setting needed to be restructured for students at a distance. The class, which teaches the art and science of differential diagnosis, is foundational in the nurse practitioner program. Learning the method of differential diagnosis assists experienced registered (baccalaureate) nurses in upgrading their critical thinking, information gathering, and decision-making skills to those of an advanced practitioner.
On-campus students have the opportunity to conduct a patient interview with a standardized patient (SP), an actor trained to portray a patient with a uniform set of symptoms and history. Students gather a history, perform a physical assessment, review diagnostic data, and reach a conclusion about what is going on with the patient. They determine a differential diagnosis list with a rationale based on the information gathered. While the use of standardized patients for practice of clinical examinations is common in medical schools, this experience is provided less often to nurse practitioner students. It was highly valued by our on-campus students, as reported in course evaluations.
