The COVID-19 pandemic has increased the need for telehealth services for both health care providers and patients, and researchers at the Frances Payne Bolton School of Nursing at Case Western Reserve University have developed a four-part course to reinforce nurses’ core competencies in telehealth.

More than 400 prelicensure nursing students and several faculty members at the school of nursing have completed the telehealth modules, part of a grant received by faculty member Mary Dolansky from the Health Resources and Services Administration for integrating more primary care competencies into baccalaureate nursing education.

“Nurses and nurse practitioners are moving more into primary care to support higher numbers of patients that need care,” said Barb Tassell, a research associate at the school of nursing and an education consultant who is project manager for the telehealth course. “One growing element of primary care is telehealth. There’s a whole set of competencies that are needed for telehealth, but the traditional curriculum does not typically include this topic.”

Tassell said the pandemic expedited the research and development of telehealth education across the health sciences.

“Telehealth is growing because of the changes in primary care and because of societal changes. We have so many means of communication,” she said.

While the course was designed to support student learning, it has now also been made available to practicing nurses to further their knowledge on this topic.

Released as one course, the four different modules all focus on telehealth.

“The first, telepresence, centers around how you work with a patient via video chat or on the phone. How do you protect patient privacy?” Tassell said. “The second is skills on how to do a remote assessment. What resources do you have available to help identify your patient’s problem and direct the necessary care.”

The third module is on COVID-19 specific disease information, acting mostly as a refresher course on signs and symptoms, treatments and the difference between quarantine and isolation.

“The last module is on quality and safety in health care, and how we can maintain the expected quality and safety through telehealth,” Tassell said.

Second-year nursing student Melissa Martinez said the telehealth course helped focus her assessment skills to include more observational details.

“With video, you need to pay attention to what you see on the whole screen. While you’re assessing what the patient is saying, you can see their living space, and see how they’re living” she said. “On the phone, you need to evaluate how the patient is sounding, what their environment sounds like, and hope they’re telling you everything.”

Internet access was another point that stuck with Martinez. Prioritizing adequate access to technology to use telehealth services was another feature of the modules.

“One example in the module was a pregnant patient who was trying to see their primary care provider, but it was too far and too difficult to see them,” she said. “The provider worked with a clinic that was closer to the patient, and hosted a video conference with her primary care provider there.”

The modules were developed by Carol Savrin, a nursing school faculty member, Kathleen Szymanski, a nursing school DNP student, and Tassell.

To further support development of telehealth competency, some BSN, MN and MSN students also participated in telehealth simulations, working with remote monitoring technology, such as pulse oximeters and blood pressure equipment. Four difference simulations have been created to help teach telehealth using different modalities and reaching different levels of learners.

The expert simulation development team included faculty members Carol Kelley and Elizabeth Zimmermann. Supporting the project was alumna and consultant Kari Gali. Faculty members Amy Lower and Jessica Hoskin performed the roles of standardized patients and student evaluations. Technology support was provided by staff members Allen Selker and Messias Soares.