Abstract
Context: Teleconsultations are now essential in the clinical practice of nurse practitioners (NPs). At the Faculté des sciences infirmières (FSI) of the University of Montreal, teleconsultation, and ethical implications of telemedicine, were little addressed in the curriculum of future NPs. Eight telesimulations have been developed for NP students in mental health, primary care, and adult care. Telesimulation is an innovative simulation modality perfectly suited to the learning outcomes of this activity.
Objective: NP students had to intervene in a professional, safe, and respectful manner during a simulated teleconsultation. Each scenario focused on a clinical situation specific to each of the NP specialties, and included an ethical challenge related to the remote interaction, which had to be properly managed during the teleconsultation.
Description: Eight telesimulation scenarios on ethical issues in teleconsultation were created for the three NP programs. The telesimulations were carried out with online embedded participants representing a patient or a family member or other. NP students had to assess the person's health condition and formulate recommendations adapted to the clinical situation, while managing an ethical issue, such as a risk of breach of confidentiality, a validation of consent or a technological problem compromising the security of personal data. Those telesimulations were offered as a formative activity to all NP students of the three clinical specialties, at the end of year 1 and 2 of the programs (n=115 students). They took place entirely online, via Zoom, over a period of eight days.
Impact: The design and implementation of those telesimulations required complex logistics and raised pedagogical and organizational challenges. However, the students recognized that they were better equipped to carry out this type of professional consultation. They also mentioned the need to include more simulations across the curriculum. In addition to meeting a learning need for future NPs, the development of these telesimulations has also enabled content experts and facilitators new to simulation to experiment this pedagogy with the coaching of nurse educators expert in simulation.
