For nursing students, getting a complete health history from a patient is a critical skill that is necessary as a foundation for successful patient care.
But leaders at NorQuest College, a publicly funded community college in Edmonton, Alberta, Canada, realized that their instruction plan was limiting how students could integrate their learning.
One of the assignments in coursework was for students to find a family member, relative, or friend and do a health assessment on them.
Karyn Nickerson, Program Chair Year 1 of the Practical Nurse Program at NorQuest, explains: “The problem was that we were asking them to do a very detailed assessment. And it was something that they haven’t really been taught. So we were almost essentially setting them up to fail, because they had to use or utilize all of these subjective questions that we hadn’t really taught them yet.”
Adding to this challenge was the fact that the nursing students would only get one chance to do this health history during the course. In fact, most students wouldn’t get to try again for one year, until they had patient interactions in the clinical setting. There was no opportunity for students to work with their instructor, do the assignment again and then resubmit for a higher mark.
And finally, grading for the instructors was onerous, taking approximately 45 minutes to assess each of the 100 students’ work. Not surprisingly, many students struggled to do well, with some getting scores 20 and 30 out of 100 on the assignment.
Shadow Heath changes everything
Implementing Shadow Health was a profound change for NorQuest’s nursing program. Immediately, students could do their health history assignment using Shadow Health’s Digital Standardized PatientTM, Tina Jones.
Nickerson said: “We replaced our old assignment with this one and allowed them to redo it as many times as they wanted to until the deadline and they were happy with their grade.”
Many students did the assignment two or three times. The repetition, paired with immediate, personalized feedback was key in getting a better feel for the intake interactions and were able to apply knowledge from not just Health Assessment but from Nursing Communications and Nursing Foundations.
Elaine Monteith, Instructor Practical Nurse Program, pointed out that many students struggle with follow-up questions. “A student would say: ‘Oh, do you have a cough?’ And the patient might say yes. But previously, they didn’t get the interaction to follow up and say: ‘Well, is it a productive cough? What time of day? What triggers the cough?’
“With Tina Jones, the ability to actually practice follow up questions was really important and allowed the students to dig deeper into what those concerns or issues could be.”
Elaine was also impressed with Shadow Heath’s ability to improve empathy skills for students. “Empathy is something that some people naturally have and some people have to work at it,” she said. “One of the things I liked about it is they were learning about empathy and education right at the get go. I think those components of Shadow health are really beneficial.”
Both instructors liked how Shadow Health gives them increased transparency into exactly where students were struggling. They can go into Shadow Health and see how they did the intake and then meet with them to talk about specific skills to develop.
Grades up, scoring time down
The team at NorQuest quickly saw an improvement in the grasp of the taking of health histories by the nursing students, which was then reflected by their higher grades.
Karyn said: “The health history assignment is worth 20% of their mark. So if they do very poorly, it could mean the difference between them passing and failing our course. Taking the assessment until they got 100% really took the pressure off of them for the rest of the course on their midterms or finals.”
And as scores were going up, grading time was going down. How much? “It went from 45 minutes to 3.2 seconds to grade,” Karyn laughs.
Expanding Shadow Health
As NorQuest sees the notable improvements for Health Assessment, the college has brought more Shadow Health Digital Clinical ExperiencesTM (DCEs) to its nursing students and added the Pharmacology and Leadership DCEs to expand the impact from simulation-based learning.
The school hopes to continue to garner positive feedback from students, as it has from those who have used Health Assessment, who praised it by saying “It made me think more than I normally would,” and “It provided real-life scenarios students will encounter in the real world.”
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