Sharpening Technical Nursing Skills With Student Videos

Hillary Gamblin: Hello. Thank you for joining today’s workshop on how to sharpen technical nursing skills with student videos. My name’s Hillary Gamblin. I’m a GoReact employee, the company that is sponsoring this workshop. I’ll be your emcee, host, whatever you want to call me. Today I’ll be interviewing Dr. Victoria Davis and Dr. Shelli Gibbs. I’d love for the two of them to introduce themselves, so Victoria, do you want to start us off?

Dr. Victoria Davis: Yeah. I’d be happy to. Thank you guys so much for having us today. We are so honored to be here. I’m Victoria Davis. I am an assistant professor at the University of South Carolina College of Nursing. I’ve been with the college since 2015, and I teach in the undergraduate and graduate programs. I also practice as a pediatric nurse practitioner. My scholarship focus is on integrating social determinants of health and experiential learning in nursing education, and also developing community health programs that focus on helping vulnerable pediatric populations.

Dr. Shelli Gibbs: Hi. I am Shelli Gibbs and thank you for inviting me to do this presentation. I am also an assistant professor at University of South Carolina and I’ve been here in the College of Nursing for eight years now. I teach in the undergraduate and graduate courses. I also practice as a family nurse practitioner and my scholarship area focuses in simulation and obesity in the primary care setting.

Hillary Gamblin: Thank you. Welcome, you two.

Hillary Gamblin: Now for those of you that are new to our GoReact workshops, I’ll outline kind of how this virtual event is structured. So, for the first thirty minutes or so, I’m going to discuss with Victoria and Shelli their experiences using videos to help students develop important nursing psycho-motor skills. After the interview, we’ll then do a Q&A for about fifteen minutes. If you’d like to submit a question for the Q&A, there is a tab just below the video feed and if you see a question that you’re like, “I want that answered, too,” there’s actually a really cool upvote feature so you can upvote it.

Hillary Gamblin: Then also don’t forget to use the chat feature which is located on the right side of the video feed. A lot of activity happens in there. People are sharing resources, giving each other their information so they can connect after the workshop, so don’t miss out on that.

Hillary Gamblin: Then right next to the Ask a Question, there actually is a polling feature and so we actually would like to start today off to get to know everybody that’s here a little bit better so if you click on that, the question is, “Do you currently record your nursing student’s clinical hours for coaching and feedback? Yes or no.” And as you’re answering that, I’ll give a little context.

Hillary Gamblin: I know today we’re focusing on using video for skill development but we recently were talking to a nursing educator that’s been using GoReact primarily to record live clinical hours. We thought that was so interesting so we’re curious to see how many nursing educators out there are using video assessment that way. So let’s see what the results are.

Hillary Gamblin: 50/50. Huh. Okay, that’s actually higher than I thought. Maybe that would be a good workshop for the future. What do you guys think?

Dr. Victoria Davis: Yeah, definitely.

Hillary Gamblin: So for a while, there have been nursing educators, that we’ve been talking about, that are recording students performing their skills check-offs and that of course has gone up incrementally because of the pandemic. So we’re hoping that by the end of the workshop that everybody here will have at least one tip or strategy to more effectively leverage video as they’re using it to teach and assess nursing schools.

Hillary Gamblin: We’ve covered all the technical details, we’ve learned a little bit more about the audience and outlined the goals, so let’s get started.

Hillary Gamblin: Shelli, two years ago you and Victoria began teaching an online advanced assessment course to nursing graduate students and you used videos to demonstrate gold standard example, but early on you found that these types of videos just wasn’t enough. Can you describe the difficulty you were running into as you began teaching this online course?

Dr. Shelli Gibbs: Yes, so Victoria and I started this, as you mentioned, two years ago teaching this online advanced assessment course and we originally started out by having students document their skills practice on a document. They learned their skills by listening to videos through their text as well as listening to many lecturettes that are being offered and also by asking questions for us to provide on our discussion and were able to provide feedback on that.

Dr. Shelli Gibbs: What we found out was when we did … we do what we call mid-term and end of the year evaluations when they’re talking about their skills. One thing that we found out was that they wanted feedback, they wanted to know if they were doing these skills correctly. Prior to [inaudible 00:05:14], we had a three day immersion here on campus. So when we did an end of year evaluation, they said that this would be something good for them, something for us to give them feedback prior to coming to get checked off on that three day skills immersion.

Dr. Shelli Gibbs: So I’m going to explain a little bit about the three day skills immersion. Day one, they come in and it’s nothing practicing the skills and us trying to help fine tune those skills for them. Then day two, they would check off on those skills and then day three, we would have some program-specific skills for them to do.

Dr. Shelli Gibbs: What we were looking at, Dr. Davis and I were looking at was trying to figure out a way, what can we do after reading those evaluations and those mid-term evaluations, what can we do to help these students so that they feel more prepared and feel like they are performing the skills correctly prior to coming to campus? So we looked at several different platforms and we chose GoReact, and one of the reasons why we chose GoReact is because we’re able to give that feedback to the students synchronously, give it back to them synchronously while they’re watching the video.

Hillary Gamblin: Now I’ve heard of nursing educators use video to record and complete summative assessments for skills check offs, but it’s not as common to use video for formative assessments which is kind of what you’re doing here. How do you specifically use student videos as scaffolding to teach technical nursing skills?

Dr. Victoria Davis: Yeah, so Shelli and I started using GoReact, what she was saying, after we did some researching and we found GoReact and we really liked how the platform was set up because it really was a way for us to bridge that gap that the students were reporting to us, building their confidence, building their skill level throughout the semester before they came into that on-campus immersion, which we knew in the past we had not done that, had not used that platform and students were really not liking just coming in one time at the end of the semester and not really feeling confident in knowing whether they did their skills correct or not, learning those skills correct or not throughout the entire semester.

Dr. Victoria Davis: So we kind of developed a scaffold approach to help them build their confidence and their knowledge throughout the semester and we started in kind of a three part series for them that kind of spanned the entirety of the semester. This three part series started with some systems and it kind of built on this systems on the head to toe assessment and by the end of the three part series, they were performing a full head to toe assessment and then that’s the same assessment that they actually perform for a summative assessment during the on-campus immersion experience, so it really was a great way, the way that we set it up, to kind of build confidence, build skills, and then at the very end before they came in, let them practice that head to toe and get real time feedback from other practicing nurse practitioners.

Dr. Victoria Davis: We kind of started this scaffold in spring of 2020 not knowing what was going to be coming our way with COVID. We’re like, “Okay, we’re ready.” We were prepping in fall of 2019 and then we implemented in Spring 2020 and then COVID hit, so it actually was really, really beneficial for us that we had used GoReact and we had it already integrated in our course because of all of the trials and tribulations that COVID and the pandemic has caused everybody. It’s just been really beneficial and so far we feel like the students are really enjoying the assignments and feel better prepared for the immersions.

Dr. Victoria Davis: To kind of break down the three assignments, the first assignment starts with a health history, a skin assessment, respiratory, cardiac and HENT assessments and then the second assignment is an abdomen, MSK, and neuro exam, and then the third assignment is the practice head to toe. Now, one of the things that we wanted to make sure that we did with the three assignments that students recorded throughout the semester was with each part to make sure we were capturing all of the advanced assessment skills they were learning. There’s a lot, and a lot of times we don’t necessarily see these skills being done on the daily in practice, especially in a primary care setting. So we wanted to make sure that they had practice and knowledge about these kind of skills that weren’t so normal, so common and so they could those skills and then at the third assessment when they were doing the head to toe it was built like we would normally see a head to toe done in a primary care setting. So it didn’t include all of the MSK skills, it didn’t include every single abdominal advanced assessment skill, to help prepare them for what they’re actually going to see in practice.

Hillary Gamblin: So for people that are maybe interested in doing a similar strategy with student videos, how did you structure the student video assignments? Was it pass/fail? Was it just participation? Did you give feedback synchronously? Asynchronously? Did you do peer feedback? Can you tell us a little about how you structured those?

Dr. Shelli Gibbs: Yes. So originally we started out providing a pass/fail grade to the assignment so it was a new assignment being initiated in the course. If student scored less than an 80 on the assignment, they needed to complete it again to receive a pass. We did have some students that had to repeat their videos multiple times in order to receive a pass, which obviously was difficult for them and difficult for us to enforce. After reviewing the end of the year evaluations, students wanted a grade to be assigned to it because they felt like it required a good bit of their time and a lot of their hard work.

Dr. Shelli Gibbs: So now for the last two semesters, students receive a grade based on the rubric that we provide to them and we have that embedded into the GoReact so they can see that as well. We have a Word document and it’s embedded into the GoReact so that they know what they’re getting points off on. The grades are received as a part of a percentage towards their final course grade.

Hillary Gamblin: Now in our workshops we try to give as many tangible examples as possible, so could you share how you created these video assignments in GoReact? What it looks like?

Dr. Victoria Davis: Yeah, so we actually have permission from a recent student in one of our semesters where we started using GoReact as part of a grade, and we’ve kind of clipped the videos here and there to kind of show you different aspects of the different assignments. So once we watched a video, we will also show you the feedback, so the rubrics and the comments the instructor made and I think that’s important for everyone to see because you can see how the feedback is being given in real time and the student is able to respond back to the instructor and is able to see what the instructor is seeing, able to see where they may need to improve, maybe help the instructor see something they missed. So it really, really advantageous for the student and for the instructor and it kind of builds that rapport and it builds that relationship that really is missing in a lot of asynchronous online learning.

Dr. Victoria Davis: We’re going to start with our first video and this is part of our Assessment Check-In One. So this is the skin, hair, nails, respiratory, HEENT, cardiac, and respiratory video. You will see her starting out with her health history, so I’ll let you guys watch the video now.

Kelly: Hi. My name is Kelly. I’m the nurse practitioner who’s taking care of you today. How are you doing?

Holden Clark: Good. How are you?

Kelly: Good. Before we get started, can you tell me your name and date of birth?

Holden Clark: Holden Clark. August 10, 1995.

Kelly:And what brought you in today?

Holden Clark: Just a checkup.

Kelly: Okay. And is that a checkup of your head and neck, chest, lungs, heart, and skin?

Holden Clark: Uh, yeah.

Kelly: Okay. And as far as your past medical history, do you have any history of any chronic conditions?

Holden Clark: No.

Kelly: Any surgeries?

Holden Clark: No.

Kelly: Any hospitalizations?

Holden Clark: No.

Kelly: Okay. Are your vaccines up to date?

Holden Clark: Uh, yeah.

Kelly: Okay. And do you take any medicine on a regular basis?

Holden Clark: I do not.

Kelly: Are you allergic to any medication?

Holden Clark: Not that I’m aware of.

Kelly: Okay. And then as far as family history, do you have a family history of any chronic conditions?

Holden Clark: No.

Kelly: Okay. Does anyone have any skin problems? Cancer, eczema, anything like that?

Holden Clark:Not that I’m aware of.

Kelly: Okay. What about any head, ears, eyes, nose, throat problems?

Holden Clark: No.

Kelly: Okay. So no hearing loss, headaches run in the family?

Holden Clark: No.

Kelly: Okay. And then what about any lung problems, like COPD, asthma?

Holden Clark: Not that I’m aware of.

Kelly: And what about any heart problems? Anyone have any of those?

Holden Clark: No.

Kelly: Okay. What about high blood pressure.

Holden Clark: My father, he’s been diagnosed with high blood pressure.

Kelly: Okay. So your father is the only one who has high blood pressure?

Holden Clark: Yes.

Kelly: Okay. And then as far as social history for you, where do you work?

Holden Clark:Dominion Energy.

Kelly: And what do you do there?

Holden Clark: I’m a lineman.

Kelly: So is it safe to say that you work outside a lot?

Holden Clark: Yes.

Kelly: All right. And what is your current relationship status?

Holden Clark:Married.

Kelly: Okay. And do you smoke?

Holden Clark: No.

Kelly: Do you drink alcohol?

Holden Clark:No.

Kelly: Okay. And what about do you do any kind of drugs?

Holden Clark:No.

Kelly: Okay. All right. And then in general, how would you describe your overall health?

Holden Clark: Good.

Kelly: Have you recently had a fever?

Holden Clark: No.

Kelly: Been around anyone sick?

Holden Clark: Not that I’m aware of.

Kelly: Been extremely tired lately?

Holden Clark: No.

Kelly: Okay. And skin. Do you have any skin problems?

Holden Clark: No.

Kelly: Any abnormal rash, itching?

Holden Clark: No.

Kelly: Have you noticed any changes in your moles or freckles recently?

Holden Clark: I have not.

Kelly: Okay. What about head? Have you had any head injuries?

Holden Clark: None.

Kelly: Any headaches?

Holden Clark: No.

Kelly:Do you wear glasses or contacts?

Holden Clark: I do not.

Kelly: Okay. Any eye problems? Vision loss lately?

Holden Clark: No.

Kelly: What about any hearing problems?

Holden Clark: No.

Kelly: Okay. And do you wear any hearing aid?

Holden Clark: I do not.

Kelly: Okay.

Dr. Victoria Davis: All right. So you can see that this student did a really nice job completing her interview. This is her first semester kind of in the clinical role as an advanced practice nurse, so this is her first time doing a health history interview, so I think she did a pretty good job for her first time. This is also her first video recording so you can kind of tell she’s a little nervous and it’s a little awkward but overall she did a really great job demonstrating what we were asking her to do based on the information and the rubric that we provided her.

Dr. Victoria Davis: We’re going to go to our next video and this video is a clip of this same kind of session in our Assessment Check-In One and you’re going to see this student demonstrating an HEENT assessment. You’re going to be able to see her assessment techniques pretty well.

Kelly: I’m going to look in your ears, okay?

Holden Clark: All right.

Kelly: Good.

Kelly: Great.

Kelly: So what I’m going to do is I’m going to be standing behind you and I’m going to have you cover this ear and what I’ll do is I’ll repeat some letters and numbers and once I’m finished you just repeat it back to me, okay?

Holden Clark: Okay.

Kelly: So, I just need you to cover-

Dr. Victoria Davis: So she did a really great job here. We were able to see her examine that outer ear, so doing a nice skin assessment, checking that tragus, the auricle and she holds the otoscope really, really nicely. I think that the camera angle here is really great because the instructor can give her feedback on maybe how to hold the otoscope a little differently or how to adjust her hand grip and we have a really great view. So it’s a really nice way to kind of elevate that best practice scenario for our students before they get into the clinical setting.

Dr. Victoria Davis: So the next part we’re going to show you a rubric and this is more of like comments that the instructor has given to the student. In this screenshot you’ll see these real time comments. You’ll see it timestamped based on the video and what the student was doing at that time. These are actual comments that the student received from an instructor and you can see how the instructor is, you know, saying, “Good job,” or, “Try this, try that,” or, “You missed this.” A nice way to kind of map it out for the student.

Dr. Victoria Davis: Then I think we have another screenshot to show you. It’s a rubric that’s more specific and it’s the part of the rubric that Shelli and I created and we kind of embed it into GoReact and GoReact kind of creates its own little platform for the rubric and the instructor can go in and it can be a grade, it could be comments, it’s could be, “Poor, fair, excellent, average,” however you want it to be. You can make it your own the way that they have it set up in the platform.

Dr. Victoria Davis: All right. So our next video is going to be part of our Assessment Check-In Two, so this is the student conducting an abdomen, MSK, and neuro exam and we’re just going to take a look at the abdominal section and you’ll understand why in a little bit. This is the next piece of the scaffold, so again it’s kind of segmented. They’re just doing those three systems, not a full head to toe and let’s watch the video and then I’ll talk about it after.

Kelly: Go ahead and listen to your stomach.

Kelly: (silence)

Dr. Victoria Davis: Pull up the rubric comments from this video, and you’re going to be able to see that the instructor here had a really difficult time seeing the appropriate techniques that that student was conducting on the abdomen exam. So you see the student and the instructor kind of talking back and forth on the chat and this is not synchronous. They’re not chatting back and forth right this second together. The instructor might have made a comment at 12 o’clock and the student may have seen it at 1 o’clock so the student’s typing back so it doesn’t have to occur minute by minute. Both can see the part that the instructor’s referring to about where the student … the camera angle was struggling with.

Dr. Victoria Davis: This is such a great tool to not only be able to see comments about how the student did well or did not do well, but also to be able to communicate back and forth about concerns, areas for improvement, kind of chatting and also kind of improving the videography because obviously we’re learning how to be a nurse practitioner, we’re not learning how to be video specialists, so it’s a really good way to kind of communicate and kind of be on the same level.

Dr. Victoria Davis: So now is one of our last videos and it’s a video of the Assessment Check-In number Three and this is the full head to toe that is tailored to what we would see in a primary care setting so this would include all those extra advanced assessment skills that students learn throughout the semester. This is the last piece of our scaffold and this is the video that students complete prior to coming in to the three day immersion on campus. So let’s go ahead and watch that.

Kelly: Hi. My name’s Kelly. I’ll be the nurse practitioner taking care of you. How are you today?

Holden Clark: I’m good.

Kelly: Good. And what brings you in today?

Holden Clark:Just a routine [inaudible 00:22:18].

Kelly: Good.

Dr. Victoria Davis: All right. So it was a quick little snippet here but I just wanted to show you guys how this student has transformed. Think back to the first video where we saw her start her health history and then now you’re watching her do her health history again, and she just seems so much more bubbly, so much more confident, and I really think that is one, she’s taken a full semester now of the course. She’s been able to interact with the instructors. She’s been able to interact with faculty, ask questions on the discussion board, attend sessions that me and Shelli host, like impromptu Q&A sessions. Also, I think it’s because she’s had the chance to do other assignments similar. She knows the expectations, she knows what we want, she knows what she needs to do, and you can see that kind of exuding from her confidence in the video.

Dr. Victoria Davis: Then our last video … oh actually, I think that was our last video, right? I think so. Yeah, that’s right. That’s right. There’s an abdomen video. That’s right. Yeah. So this is our last video, I promise, and the abdominal video is part of the Assessment Check-In Three from the head to toe and what’s really great about this is why I wanted to show you the abdomen video earlier is you can see how the student has improved, taking that constructive feedback and has made the improvement that she needs to do for the videography piece to demonstrate her abdomen skills in this next video.

Kelly: A little bit, okay?

Holden Clark: All right.

Holden Clark:(silence)

Kelly: And so now I just have to push a little bit harder, okay, and you let me know if you have any pain.

Holden Clark: Okay.

Kelly Can you take a deep breath?

Kelly: Okay. And then can take a deep breath for me?

Kelly: And then another deep breath.

Kelly: All right. And then a deep breath for me.

Kelly: And another deep breath, and another deep breath. Good. And then I’ll have you turn on your right side.

Dr. Victoria Davis: All right. So in that last video, obviously there’s still some camera angle concerns because we can’t see that right side of the patient, which we really want to see so we can see exactly where the student is putting her fingers when she’s doing things like measuring the liver span or checking the different organs, but there’s always going to be a limitation to technology but the student did improve her camera angle from the initial abdomen video where the instructor kind of gave her some ways to improve.

Dr. Victoria Davis: So there’s limitations in lots of different things. There’s limitations to telehealth even, so that’s kind of another purpose of our on-campus immersion, that day one that Shelli was talking about, is we still take that day one to hone the skills, talk to the students, make them feel confident, make sure their fingers are exactly in the right place before they have to do that summative physical exam in the day two immersion.

Hillary Gamblin: Thank you for sharing all of those. Now to kind of bring us back. So the whole reason that you did this was in hopes that your students could find out sooner if they were doing a technique wrong. Did that end up being the case and were there other benefits that you noticed from this formative assessment approach to technical nursing skills?

Dr. Shelli Gibbs: Yeah, so it helped the students to get the skills early and getting them right early when they’re performing them throughout the semester, so they’re not performing the technique incorrectly throughout the semester so they were able to get that feedback quickly. GoReact was great for practicing the skills for the buildup to the immersion assessment head to toe which we found that out throughout our evaluations that we did and throughout us checking off the students.

Dr. Shelli Gibbs: It also helps the students feel so much more confident when they come to immersions to get checked off. The real time feedback from licensed nurse practitioners seemed to be helpful for the students because they were receiving feedback at specific points in time on the video so they could see exactly where they needed to adjust. So it was very … it was synchronous, is what we were calling it. Synchronous feedback.

Dr. Shelli Gibbs: Also receiving feedback from other practitioners, I think adds to the student’s understanding of the technique and differences that are still appropriate and add to the robust feedback for the course. It improved the interaction between instructor and student because they were able to interact more with the instructors on this online platform.

Dr. Shelli Gibbs: It increased peer to peer engagement. GoReact fosters a friendly, relaxed student/faculty relationship of how they do this, you might try it too. Here are the pearls I’ve learned, you might want to try this too. In the past there was no time for peer to faculty, so it fosters a positive relationship for that student. “I know this skill now, and I have a solid foundation. What can I refine even more?” So good feedback from the students and the faculty.

Hillary Gamblin: And when you go beyond the gold standard of you show yourself, video tape yourself doing an example, and you start asking students to record themselves, technology, expectations, privacy all become issues. So I was hoping that you could share with some of us your best video practices as I’m sure most of the people that are attending this, they’re using video. So let’s share.

Dr. Shelli Gibbs: Yeah, so I think that we have a PowerPoint slide showing, so I’m just going to review this and kind of talk about this. Some things that we have added along the way to this because we learn from our experiences, from doing the video. The student nurse practitioner should wear business casual attire with a lab coat. We have them do this whenever they come to campus, too, so it’s actually practicing as if they were going to come to campus and practicing as if they were out there in that clinical setting and that primary care setting, right?

Dr. Shelli Gibbs: The client should wear appropriate attire based on the examination being conducted. Attire sure a t-shirt and shorts is appropriate so various anatomical landmarks can be visualized easily. When videoing, please do not expose any intimate areas. So we had the client, that’s their patient that we’re calling the client on the video, so that way we know that they’re wearing the appropriate clothing so that the faculty members can make sure that they’re performing those skills appropriately.

Dr. Shelli Gibbs: We do have a prescribed length on the video and that is built in to the rubric. With each rubric there’s a different time so they know that in advance so they can practice before they actually post their GoReact video to make sure they’re getting that timed correctly.

Dr. Shelli Gibbs: Then when videoing, they need to consider their surroundings. Make sure they let their family members know that they are recording so they don’t have any background noises. Ensure that the lighting is appropriate so that you’re able to see appropriately with the camera. We want to make sure that they have all that in place prior to recording.

Dr. Shelli Gibbs: Then when completing the GoReact assignments, videos should not be clipped or altered in any way. This is something that we found out along the way. We want to see them from start to finish. We want to see the flow, so we ask them not to clip or alter that video in any way.

Hillary Gamblin: What additional helpful guidelines and practices do you have your students do prior to submitting a video?

Dr. Victoria Davis: As part of our preparation for students to being recording their three GoReact assignments, we do use our individual training from the Institute of Simulation Educators through the NLN, National League for Nursing, to help promote a safe container prior to that first assignment starting. Setting that safe container for students is really vital so that they understand that the assignments are built for them to aid their knowledge, promote their confidence, the critical thinking and prepare them for this summative experience they’re going to have on campus.

Hillary Gamblin: Now you’ve been teaching this as an online course and as we know, a lot of educators are using video more and more for skills check-offs during the pandemic, but do you think video assessment is a tool that can be equally helpful in a face to face, in-class environment?

Dr. Shelli Gibbs: I would say it depends on the course delivery method of your course. If it’s hybrid or if it’s a split classroom, this type of delivery might benefit from the platform to assess critical thinking and skills being learned. Also, it depends on the class being taught and what the objectives are for that course. So it does not have to be a recording on skills. It can be a recording with students presenting a health history or students presenting information to a provider or students doing an SBAR. So those are some examples.

Hillary Gamblin: So there is a lot of variety that you can do. I think that’s a good point.

Hillary Gamblin: Well thank you for answering all of my questions. I’m sure all of your answers, your examples have sparked some ideas and questions from those that are participating in the workshop, so let’s take the next ten to fifteen minutes to answer those. Again, if you’d like to submit, there is still time. Just take the tab right below the video feed. My colleagues have been monitoring your questions and have selected a few.

Hillary Gamblin: The first one is what kind of setting do you assign for the formative and summative feedback? Currently I could not set up live review because I would lose my ability to give comments or markers on videos as I was observing my student demonstration.

Dr. Victoria Davis: So that’s a really good question. I would probably have to go into the platform to be able to tell you exactly, but we’re going to provide our email information after this session so you could definitely email us that question. I know that when we set it up, the way that we set it up it’s … I’m not sure the terminology for it, but we set up with the rubric and the students submit their video and then later the instructor comes in and actually reviews it and provides the feedback and grades on the rubric.

Dr. Victoria Davis:I do want to be clear, formative and summative. We have a rubric that is part of a grade, so it’s still graded but it’s leading up to this bigger grade and bigger kind of check-in that we do on campus. We still use a rubric because we were finding before when we first started it we weren’t using a rubric with points and so it was really, really difficult to hold the students accountable. It was just a pass/fail, and so what is a pass/fail? We had to give it some kind of objective measure so that students really understood, and we understood, and that way we could be fair across all students to know all right, this student did this and this student did that. Does that equal a P? Does that equal a pass? So we made objective measures.

Dr. Victoria Davis:You might have to still, if you’re trying to do formative, you might still have to create some type of objective measure to equal what that pass/fail is.

Hillary Gamblin: Okay. Second question, it says, “Our students will have their own iPads in the spring.” Congrats, students. “We will also have access to GoReact already but currently rely on a taping system that goes to a local server for our many of our core skills. Those tapes are being reviewed on a basis and the rubric is on paper. How would we transition to using an iPad for the student to film their own skills or perhaps have another student film their skills?”

Dr. Shelli Gibbs: So transition would be quite easy. I know some of our students use an iPad to record their assessment. I think it just really depends. I always tell our students to practice with either a computer or the iPad. Record one, make sure that we can see all the surroundings before they actually submit it, so yes, we have plenty of students that use their iPads to record their videos.

Dr. Victoria Davis: Yeah, and I would just add for the rubric that’s on paper, either your or another faculty or a GA, all they have to do is just manually enter that rubric once into GoReact and then I believe it saves it so you don’t have to reenter it every single time. That would be the most taxing part, which is really not that bad. I mean, it’s pretty easy.

Hillary Gamblin: Yeah, and I would also like to add, too, that with GoReact you can actually use multiple cameras, too. So if your student can have their iPad and their phone so they can get two different angles at the same time and we can do up to nine so I don’t know if anyone has nine phones with them, in their house, but that is a possibility, too.

Hillary Gamblin: The third question is, “Curious to see how many students are enrolled in the course. Currently in our program we have 140 students in the sophomore course where students learn assessments and skills. What were the length per video?”

Dr. Shelli Gibbs: So our class size for our advanced assessment for our graduate students, they kind of vary. We go from a hundred to seventy to fifty, so we do have an influx of students. Sometimes we have a lot, sometimes we have few. We’re able to handle that because we have multiple faculty that help assist us with the grading. So that does help us when we’re doing that.

Dr. Shelli Gibbs: The length of our varies. Our first, we call them Assessment Check-Ins, so Assessment Check-In One, Assessment Check-In Two I think is twenty minutes and then that final one, the head to toe, is thirty minutes. It depends on what skill you’re having them to do and how long you think that they need to how long you would set that on their rubric.

Dr. Victoria Davis: And also because you’re talking about sophomores, thinking that you are referring to undergraduate students, you might want to think about some different ways of capturing those assessment and skills, because we had actually talked with the undergraduate assessment faculty member about potentially using GoReact if we weren’t going to be coming back to campus and they thought it sounded like a good idea. Usually undergrad is going to be a higher number of students in the cohort so just making sure you have the faculty to kind of help you or you break it up. Maybe you do it in clinical groups, so this clinical group will submit one video and in that one video you’ll have them all demonstrate a cardiac exam. That way you’re only grading fourteen videos instead of 140 videos. That’s just something to think about.

Hillary Gamblin: Always thinking about ways to make so you don’t have to grade as many videos, right?

Dr. Victoria Davis: Yeah, exactly. We are always thinking about it that way.

Hillary Gamblin: The next question is, “Are all the assignments limited to a single attempt?”

Dr. Shelli Gibbs: As I mentioned earlier when we used to do the pass/fail, we used to have students submit multiple times so yes, they can submit more than once for that assignment.

Hillary Gamblin: Okay. Last question. It is, “Can you share a little more about your immersion time on campus? Is it one block of time?”

Dr. Victoria Davis: Yes. So our immersion is three days. It’s eight hours for three days straight. I would call it more of an intensive than an immersion, but we like to use the word immersion. Students are pretty tired at the end of it and we’re pretty tired at the end of it. That’s one of the reasons why we have a lot of adjunct faculty in the course who are licensed nurse practitioners because they help us grade, get to know the students, and then they help us in the immersion experience on campus. We have three days. Day one, like Shelli was talking about, is really a practice day. It’s not a day for them to relearn skills. It’s not a day for us to teach them skills. This is a day for them to ask questions, like, “Am I really placing my finger in the right spot? Am I really pressing down hard enough?” It’s also a great day for us to kind of give more tips and tricks on how to do certain assessments. They really, really struggle with the fundoscopic exam, so we kind of talk about how we do a fundoscopic exam or how we measure the liver span or how we percuss the abdomen or whatever. Then I’ll let Shelli take day two and day three.

Dr. Shelli Gibbs: On day two, day two is typically we do our check offs. It’s designed a little bit different this semester. That’s the good thing about it. You can kind of design it a little different. But this semester we have where they’re actually going to practice in head to toe with the faculty and do a focus exam with the faculty. Then in the afternoon they break up into their program specifics. Then on day three we actually are doing our head to toe check offs where they’re going to be checking off with a standardized patient that we have and they’re going to be prepared because day one, like Victoria said, they’re practicing and then day two they’re actually putting it all together. On day one, they had individual stations so the first station might be CV, respiratory. The second station might be MSK, abdomen.

Dr. Shelli Gibbs: Then on day two when they come back to campus, they’re putting it all together for the head to toe station and then we focus on a focused exam as well because in the course we have what we call patient simulations and it’s kind of bringing that patient simulation to life when they come to campus so they can see that as well. Then they’re going to break up into their program specifics. We have acute care, we have psych, and we have family nurse practitioner students in this one course. So they break up into their program specific stations in the afternoon, and then day three they come in and they are checked off, doing their head to toe assessment as well as they received feedback from our standardized patient and feedback from our faculty members on the head to toe assessment and they are poured off to the provider which is something that we teach in the class as well.

Hillary Gamblin: I hope they get to take a nap at the end of that. That sounds like a really intense three days.

Dr. Victoria Davis:It really is, but I think that they are … this is something that the college started probably like what? Three years ago, Shelli? So far I think that the students really enjoy it. I think the biggest challenge is a lot of nursing education and higher education in general is moving to online and not just online but online asynchronous so there’s just not a lot of time for students to interact with faculty in the first place and then when you have something like nursing where it’s really, truly hands on it’s just a struggle, and so I think students really enjoy the immersions because it gets them face time with faculty, it gets them hands on experience before they really go into a clinical setting. That’s, again, one of the great things about the GoReact platform is it really helped elevate our relationship with the students, kind of being able to connect at least three times in the semester before they come to campus to meet us in person.

Hillary Gamblin: So you weren’t strangers.

Dr. Victoria Davis: We were not strangers, this time.

Hillary Gamblin: So actually that was our last question. We weren’t able to answer all the questions today, but we appreciate everybody that took the time to submit one. Your questions are what make these workshops living, breathing and valuable resources. So if we didn’t get to your question this time, don’t lose heart. Join us for our next webinar and we’ll try to get to your question next time.

Hillary Gamblin: Before we end, I’d like to ask our guests to share with us three takeaways. So if you could embed three things from today’s workshop to those that are watching, what would it be?

Dr. Shelli Gibbs: I would say number one, make sure that your video assignment aligns with your course objectives. Just don’t put a video in there for them to record. Make sure that it aligns with those course objectives. Really value your end of year evaluations because that’s how we built our GoReact videos is really use those student evaluations. Then also remember to be flexible. At first there were some challenges, but if you’re flexible you’ll eventually get that strong platform for the students.

Hillary Gamblin:I feel like the pandemic is making us all a little more flexible. Forcing us to be a little more flexible.

Dr. Victoria Davis: It’s making us flexible, resilient, all of those things.

Hillary Gamblin: Shelli and Victoria, thank you so much for sharing your techniques, your experiences with us today. You did this workshop voluntarily, so we appreciate you taking your personal time to share your strategies and what you found with your fellow nursing educators.

Hillary Gamblin: We know that this workshop will be really valuable for our participants so we’re going to make a recording of this available as soon as possible and then we’ll send an email with a link to the recording along with a captioned version, so watch for that in your inbox.

Hillary Gamblin: But that is it for today. Thank you to those who participated, thank you to those working behind the scenes, and of course our guests, Doctor Victoria Davis and Doctor Shelli Gibbs. We will see you next time.