Shadow Health DCE™ Implemented in a BS-MS Online Physical Assessment Course

Graduate nursing students are expected to have advanced knowledge in the 3 Ps: physical assessment, pharmacology, and physiology according to the American Association of Colleges of Nursing (AACN) requirements. A high-fidelity virtual patient online simulation program (Shadow Health Digital Clinical Environment (DCE™) [Gainesville, FL]) designed to teach advanced physical assessment and interview skills to BS-MS nursing students was implemented at the University of Utah College of Nursing in Spring 2016. The Shadow Health DCE™ was used previously in a physical assessment course for RN-BS students at the University of Utah with satisfactory results, according to faculty. The effectiveness of using a high-fidelity online simulation program to teach physical assessment and interview skills to graduate nursing students remained unclear, particularly regarding improvements in confidence, focused assessment skills, and components of program acceptability. The previous BS-MS online physical assessment course was lecture and reading only, with no laboratory component. According to course faculty, the previous BS-MS course was not meeting AACN requirements. The purpose of this study was to implement the Shadow Health DCE™ in the BS-MS physical assessment course using student survey feedback and instructor experience from an RNBS online physical assessment course. The objectives included: 1) Assist in developing a new approach to the BS-MS physical assessment course utilizing the Shadow Health DCE™; 2) Adapt three Shadow Health DCE™ modules in detail and implement in the BS-MS physical assessment course; 3) Deliver and evaluate the effectiveness of the three Shadow Health DCE™ modules; and 4) Make recommendations to the NURS 6025 faculty for best practices in utilizing the Shadow Health DCE™. A pre-post implementation survey was administered to RN-BS students to determine the effectiveness of Shadow Health DCE™. These results were reviewed and used to help implement Shadow Health DCE™ in the BS-MS physical assessment course. The course objectives for the BS-MS physical assessment course were also used to guide the implementation of Shadow Health DCE™ in the course. Prior to implementation, a pre-survey was administered to the BS-MS students to determine confidence and physical assessment skills. An interim survey was also administered to compare confidence and physical assessment skills post-implementation. These survey results were used to make recommendations for improvement in the BS-MS physical assessment course for future use. Student confidence leads to compassionate, timely appropriate patient care and improved patient outcomes. While Shadow Health DCETM increased student confidence and physical assessment skills among RN-BS students, this was not found in the BS-MS cohort. Further quality improvement and research is recommended to evaluate this finding.