Nursing Education

Video Assessment & Nursing Education: Raising the Bar for First-Year Nurses

A webinar featuring Patrick Luna from the University of Colorado

Patrick Luna, Senior Instructor of Clinical Teaching at the University of Colorado, shares how he improved nursing students’ competence and confidence with recorded video feedback.

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Sam Butterfield:

Thank you for joining our webinar today. My name is Sam Butterfield. I am an employee and account executive here at GoReact. And I am joined today with a dear friend of mine, Patrick Luna out of Colorado. Patrick, how you doing?

Patrick Luna:

I’m doing well. It’s a little cold here, but we’re making it through. Good to see you, Sam.

Sam Butterfield:

Good to see you too. Well, I have a prepared statement to introduce Patrick to the world. Most of you might have actually already seen him as he’s done a couple webinars with us and has just helped us here at GoReact discover new ways of using assessment and stuff within the classroom. But Patrick, do you want to go ahead and introduce yourself to the group?

Patrick Luna:

Sure. My name’s Patrick Luna. I’m a senior instructor of clinical teaching at the University of Colorado College of Nursing. My main focus and just the main thing I do as faculty there is I’m a instructor, both in the simulation lab and in the lab setting as well as didactically and my focus is first year nursing students. That foundational level that we all know is very critical, that’s my world. That’s what I live in.

Sam Butterfield:

I love it. Patrick is awesome, if you haven’t had the chance to talk with him before. I know, we had the chance to go to the IMSH conference. Was that last month? Feel like time is just-

Patrick Luna:

Yeah, it was a few weeks ago. Yeah, that was great.

Sam Butterfield:

But we talked about the number of people that just hear about GoReact and call Patrick to hear what you’re doing. And so I appreciate you joining us today, Patrick, and talking a little bit about what our topic is today, which is video assessment and raising the bar for those first year nurses’ competency. So, as we do that, I just want to dive into some, quick for all you new GoReact webinar beginners, just some quick things to know. We do have a question and answer button at the bottom of your screen. So, if you do have any questions, go ahead and pop those in. The first, probably, 15, 20 minutes we’ll just go through the presentation. You’ll hear from Patrick on what he’s doing with video assessment through his courses, through simulation, different ways that he’s been creative with video in the classroom.

Sam Butterfield:

And then we’ll also jump into what that looks like instead of GoReact as well. But the last probably 10 minutes or so we’ll be open to any questions that the group has. So feel free to click on that button, submit any questions that you have, and we’ll answer as many as we can within this 30-minute timeframe that we have. With that said, let me go ahead and share my screen and we can go ahead and get started. If you’re good, Patrick, we’ll jump in. All right. Okay. So as I mentioned, today’s webinar is talking about Video Assessment and Nursing Education: Raising the Bar for First-Year Nurses. I want to start with just asking Patrick, because this is, again, something that you’ve presented on in the past, tell me about why this topic. Why is this something that’s important to you within the nursing education field and for others that are in the same boat?

Patrick Luna:

Oh, it’s massive. This particular assessment, just using as a tool for assessment and for feedback, this is, I didn’t know too much about this, this is something that was a frontier for me in my own teaching as just a pedagogy, as something that I could use as a tool to help my students retain information and just overall just improve outcomes. So, in the hands of an experienced educator or somebody that has ideas about reaching their students, I think it’s a valuable tool that can be used in a lot of different formats within the realm of nursing education. So, I’m a huge proponent. I feel like I’m pretty new at it, but I’ve dove head first and it’s given me a lot of leeway and I’m seeing good results.

Sam Butterfield:

I love that. And I know we’ve known each other for about three years now, but is this something you’ve always used, video, or is this…? Tell me the history there of how you started using video and what that process has looked like and how it’s changed.

Patrick Luna:

So, to answer that question, Sam, I got to tell you the story of 2020. So, in education, we’ve all had to react to the changing landscapes. Our students clinicals being canceled. Our classes going from traditionally in-person to online. And I had a direct mandate from my program director to find a tool that would allow me to assess student skills while they were at home. So, this led me down a path of multiple video techniques. I went through almost all of them, every one that I could find, the ones that were available at my college already, and that I just found inadequate. It wasn’t until I found the GoReact tool that I felt like I was still maintaining the quality of my teaching with the students not even being with me, which was definitely a transition, but that’s my story in a nutshell, and how I just started using this tool.

Sam Butterfield:

That’s awesome. And I love, segueing into… So obviously 2020 was chaos and we met during that chaos, but it was the following year, and that’s something we get a lot of questions about as well, everything started returning back to face-to-face. Things started to find that new normal. And, I guess, you’ve continued to use video quite a bit within your classrooms. Is that correct?

Patrick Luna:

I would call this almost my primary tool now for both my simulation assessment, lab assessment, and for certain things in my didactic classroom. Using this tool has multiple advantages. And I know we’re going to get into a lot of them, but I’ve found a lot of advantages to using this form of not only assessment, but also just performative assessment as well, ensuring that my students are getting feedback to get better within multiple areas, so multiple competencies. Video is a very dynamic medium, something that I didn’t see utilized a lot when I first became a faculty member and started teaching students. So, it’s definitely something that I feel I use quite a bit, quite a bit, along with some traditional methods, but this one has a lot of advantages.

Sam Butterfield:

That’s awesome. Well, let’s, like you said, let’s jump into it and learn a little bit more about how you’re using it currently and the why. And I know we wanted to start with this quote that came from the scholarly article, A Crisis in Competency. This quote is a big reason as to why you’re continually use videos, so we wanted to talk about that. It says, “Only 23% of graduate nurses were able to demonstrate practice readiness by identifying and then managing a clinical scenario that required a nursing intervention.” So talk me through a little bit about that quote and how you’re seeing it inside the classroom.

Patrick Luna:

So, this is the motivation for a lot of the new regulatory standards that we’re seeing within our profession, not only in the clinical realm, but in the academic realm as well. I have the advantage or just with my current role, I straddle that academic and clinical practice areas. And this is exactly what we have been hearing for quite a long time, is that the nurses that we are graduating, how prepared are they for the rigors of practice and how prepared are we making them for the rigors of practice? We’ve seen what our regulatory agencies are doing. We’ve seen the next generation NCLEX standards, and this was one of the motivating factors for that entire change with the AACN and the new essentials that just came out this last year.

Patrick Luna:

We’re seeing a change to direct competency and what our students can exactly do, and not so much what they know. So, it’s bridging the academic practice gap and there’s a lot of reasons behind this but this is our overall just point. And our mandate is to catch up, to really start to prepare our students for what they’re going to see in practice. And we know how dynamic the practice area is. So, yeah, any tool, any way to reach them, any way to give them some feedback on what they’re exactly doing. That’s part of our mandate to be innovative as educators.

Sam Butterfield:

And that’s a big mandate. That can be a lot, especially without any direction. So, with that said, it leads to the next question of, again, your personal experience. Patrick, how does using video and feedback for nursing skill instruction translate into more competent, successful, and confident first year nurses?

Patrick Luna:

So, this is an expansion of what we were talking about earlier, Sam. The expansion is, once I found the tool, once I said that this can do what I thought it was going to do, how do I utilize it? What am I going to do with it? And I think, what I’ve noticed and the way that I ended up using it was first for this direct evaluation of skills. Students would record a video. I would give them feedback through this mechanism, which we’ll see in a bit, and what I noticed and what happened anecdotally, and this is not just me speaking, this was coming from my clinical instructors that were with my clinical students in the practice area, that they were performing better. And so what I started to look at was what exactly had I changed about my techniques?

Patrick Luna:

I have a large, my college of nursing is very large. We’re the largest nursing school in this entire state. I can have upwards of 30 people in my lab at one time. And giving them pinpoint feedback is, of course, very, very difficult. With this mechanism, what I’ve been able to do is actually watch more students perform their skills. And so once I can give them, not just me but my colleagues, can give them direct feedback, that is the one thing that’s improved about my program. And when COVID came to an end and we were, it’s definitely not as ended yet, but when things started to loosen up and I could get back in-person, I couldn’t get rid of this method. This method still worked for me. I just had more leeway. They didn’t have to record at home. They could record in my lab. And so, it just became a tool for longevity.

Patrick Luna:

I spoke earlier a little bit about the knowledge-to-practice aspect of this. So this is something that comes from my didactic teaching as well is I can sit down and we can sit in class and I can explain all of these different things to you. I teach mainly clinical courses in the didactic realm, and it’s really, really interesting. And it was something that I felt very early. It’s like, “How am I standing in front of all these people and they are all sitting down and I am trying to teach them how to be a nurse?” I’ve been a nurse. I know what it’s like and what it takes to succeed in that realm, and sitting in a chair isn’t always the way.

Patrick Luna:

And so I want to see what you’re doing with the knowledge that I’m giving you. I want you to demonstrate the main points and I want to see if this is working. It’s an assessment not only for the student, it’s an assessment for me, because if this isn’t working and if I’m not achieving my clinical competencies with my students, then I need to change something about the way that I’m working. So, this is a knowledge-to-practice thing. I create my assignments within GoReact to assess their ability to apply didactic knowledge. So, this is a very direct thing I want to see them do. And so that’s what I’m watching and that’s, I think, where I think I’ve utilized the tool the best. I have my students do more than I have them write. I’d rather have them explain something than put it down on paper, because we do that more in the clinical setting, especially now with the changes in the electronic health records.

Patrick Luna:

Another thing I’ve noticed is the confidence that this type of feedback instills in my students is when they are given feedback just to improve. I have a recent assignment that I put together about, it’s literally a spoken care plan. And what I want to see them do is talk their way through a plan of care and I want to give them feedback to make that process, just to improve their process going forward. That’s something they’re never are going to stop doing. They’re going to care plan throughout our program. So, I’m just the beginning, but I want to give them feedback so that they are prepared not only for the rest of their career, but for the rest of their nursing student careers. So, this is incremental steps that, through a medium like this, I can really pinpoint and see that they feel better about this. They feel more comfortable with care planning. They feel more comfortable with communication and it’s just because of that opportunity I have to provide feedback.

Sam Butterfield:

That’s awesome. Well, let’s look at it real quick and we can, just to show everybody that’s here what that looks like. So, I’ll pull up an example video. This is the GoReact platform. Patrick, if you want to just walk us through what we’re seeing and how, again, based on what you just said, talk us through what you’re actually doing inside the platform to work with those individuals.

Patrick Luna:

So, this is an example of a student or a demo for sterile technique. So, what I can do throughout this process, and you can see what Sam’s done within this interface, is I watch this video and I give feedback based on pinpointed areas within the video. So I might, at this point, type in, “Did a good job cleaning your surface area.” And then they would see that at that direct time period. So, this is reinforcing good behavior or good sterile technique as well as giving feedback on what they can improve. And the student has access to this in a very simple, the providing feedback is just as easy as receiving it. They just go through, they can click on their feedback and go to that specific area of their video to see what they’ve done well and what they need improvement with.

Patrick Luna:

And this is just one example of many. I have students perform assessments, perform [esbars 00:16:49], just about everything that I can put into this interface. Due to the ease of use, it’s pretty quick to do this, and I’ve taught multiple faculty members how to engage with the interface to provide feedback.

Sam Butterfield:

Awesome. And I know we’ve talked about some of the repetitive feedback that you give across the board. Are you utilizing what we call these markers, these colorful boxes. Is that part of your style when you’re doing it?

Patrick Luna:

I love markers, especially, and it took me a little bit, a little while Sam. Once I had some experience with creating these assignments and then realizing that a lot of my feedback was similar, I could build these into the assignment and then I just click on those colored markers and it makes this process even quicker.

Sam Butterfield:

I love it. That’s awesome. One other thing, again, for most of you, if you’ve seen GoReact, these are old news, but if this is brand new, we want to make sure that people have seen it. Patrick, I know we’ve talked about rubrics as well. Is that something that you use a lot within your courses?

Patrick Luna:

I have a library of rubrics Sam that is used throughout my university. I love this aspect. So, as you’re watching these videos, you can load your rubric into GoReact and grade your assignment as you go through. So, I use rubrics quite a bit. My particular LMS is Canvas. GoReact builds into canvas. Once the rubric is populated through GoReact, it directly populates within my grade book. I don’t have to input that manually. That was a huge selling point for me. I mean, that’s ease of use.

Sam Butterfield:

Awesome. I love it. Thanks, Patrick. And that leads us into a question that I get a lot with working with video is, “Hey, isn’t it take longer? Doesn’t it increase the amount of work that I have to do if I’m working with video?” And so I know a big question that we wanted to ask and have you talk about is workload. So, through all this process, how does using video feedback reduce workload for you?

Patrick Luna:

All right. So there were some hard stops for me when I first started using this tool, technology. Were my students going to be able to navigate this? And how difficult or how easy was the uploading process? And I can say, I have, like I said, over 300 students use this for the past going on three years. I’ve never had a student tell me that they couldn’t upload a video. Sometimes they need to wait a little bit, depending on their internet connection. The other one was, “How easy was this for me to teach other faculty to use?” I knew how to use it, but I wanted to see if this could translate to basically anybody. And so the majority of the feedback that I got from all of the other faculty was that they saved time using this tool.

Patrick Luna:

So, this is a huge term. This is a huge thing that we discuss as faculty is workload. And how does this particular tool keep our workload minimized? So, creating assignment, very, very easy. Once I’ve created my assignments, I can copy them to my next course. No problem. It’s easy. And I’ve actually taught other people how to do that. And so it, like I said, it integrates with my LMS, so I don’t have to spend time actually inputting grades. So, it goes directly to my grade book. I can create the assignment within my LMS and copy over a rubric and settings from a previous course and have everything ready to go from day one in the course, unless I want to make some minor changes just based on my own feedback.

Patrick Luna:

It’s allowed me more time. That’s why I’ve used it so much is the ease of use and how I can do everything in real time. Once I start typing a feedback, the video stops, so I can finish my thought, do what I need to do there and then the video will start once I enter that feedback. What you can see at the bottom there is multiple methods for you to give your students feedback. I can write a note, that’s that in note. I like to use the video button, so at the end of their video or whatever they’ve submitted their assignment about, I give them a video so they can see me. That was really important during COVID when we were all at home. I got to interact with them through that method.

Patrick Luna:

And when it came time to go back to class, and my director had given me a specific instruction that we were going to get rid of GoReact when we were back in class, I had integrated it into so many different things and was using it so much and had so many faculty that were using it in their courses that there was no way that we could get rid of it. We still use it to this day. Other courses, it’s not just me. Graduate faculty are using it. It’s just a really good method and it wouldn’t be as popular if it wasn’t convenient, if it had technological issues. But from the massive amounts that I’ve used it, that would have been a deal breaker if there were problems with any of that. But it saves people time, and that’s what I’m hearing from my fellow faculty.

Sam Butterfield:

Absolutely. I think that’s true across the board. With how busy life is in general, especially instructing a teaching, if it’s not saving you time, if it’s not making your life easier, it’s probably not something that’s going to last for very long. We just don’t have time for it. That’s great. That leads me into our last question. We do have a couple questions that are popping in here as well. So, just a reminder, if you have any questions for Patrick, please feel free to enter them into the Q&A. We will get to them at the end of our session, so, again, feel free to jump in. But Patrick, one more thing before we jump into our closing remarks, talk to me a little bit about how using video feedback enriches debriefing outcomes because that’s something that you’ve recently doven into with the GoReact video and utilizing that with your debriefing sessions as well.

Patrick Luna:

So, this is the missing link. And, like I said, I’ve been using GoReact in different mediums. And for debriefing, it was really interesting just to think about how I could utilize it. And where I see the most benefit with it is actually after the students get their feedback. We know that debriefing has a specific definition within the simulation realm, but this can also have didactic implications and definitions as well. Once the students read their feedback, whether it be from a simulation or from a role play or from a case study prompt, once they read their feedback, the questions that they have for me, the level of conversation that I’m having with them is not, “Hey, you broke sterile field here.” It’s, “Oh, why did that occur? How can I get better?”

Patrick Luna:

So we’re having deeper conversations because all of the basic things are handled within the tool. So, the specifics about just improving on a certain thing are, that’s taken usually very literally and they can improve that next time. But what we end up talking about is about the overall just takeaway, because they have this group of feedback that they’re allowed to process independent. So, once they look at all of that, it’s more like, “How do I get better? What was my takeaway from this assignment?” And those are the conversations we have when we’re discussing these assignments in class. They’re a lot deeper. And I was shocked by it at first, but I think it’s a frontier for using a method like this to provide feedback is it’s very deliberate. And so those conversations that I have with my students are a lot deeper now.

Sam Butterfield:

That’s awesome. And I mean, I would have to argue that plays a huge role into the whole overarching topic, which is competency and working with these nurses and making sure that they’re prepared. Being able to dive into not the basic points that they need to fix, but the meanings behind it and the deeper conversations has got to help substantially in that improvement.

Patrick Luna:

Hey Sam, do you want to head into the Q&A?

Sam Butterfield:

Yeah. Let’s do it.

Patrick Luna:

We got a couple of questions.

Sam Butterfield:

Absolutely. So, just as a reminder, as we did get a question about just the recording, so this webinar has been recorded and it will be sent out after the fact. If you don’t, for any reason, receive it, just reach out to our team here at GoReact and we’ll be sure to get you that. If you don’t have any contact information, there’s a link on our website or you can always reach out to sales@gorereact.com and that will get you in touch with one of our account executives who can get you the copy, but it will be sent out afterwards. We did have a question from Ellen Rose. So Ellen asked, “Patrick, how do you use this in a health assessment course and is it used in addition to in-person skill labs or in place of those?”

Patrick Luna:

So, this is really interesting and this is something that I recently did. I’m the lead simulation faculty and lab faculty for my health assessment course. Like I said, 300 students a year come through that course and I’m almost the first person they see in the entire program, because it’s one of the first courses they have or along with the first course that they have in my program. So the way that I’ve used this now is completely redesigned the way that I teach health assessment. So, because this is literally imparting specific skills is I actually have recordings of myself demoing the specific assessments. So, I put those within GoReact, they can make notes, they can do whatever they need to do to interact with this video. But when they come to class or to the lab section, they already have seen me demo and they’ve interacted with this video, and it’s part of their pre-work.

Patrick Luna:

So, when they come to lab, we are simply just practicing that. So, we’re practicing for their high stakes test, which is a complete head-to-toe physical assessment. So, they record that within the lab and then we evaluate that along with my faculty team. So, I flipped the classroom literally from doing a lot of instruction when I had that limited amount of time with them, especially when lab time was being cut during COVID. So, I ended up putting a lot on video so that they could come ready to engage with these assessments and then I could give them focused feedback. They also have record a video within GoReact every week based on one of the assessments. So, that’s something that I’ve started to do, but I’ve gotten good feedback from students and it’s really improved their performance.

Sam Butterfield:

Awesome. Thank you, Patrick. We got another question from Amy asking about the hardware side of things. So she asked, “Did you use or did you have to purchase video cameras to record students doing their skills or simulations or did they just use their phones?”

Patrick Luna:

That’s a really good question and that was one of my questions when I first started using this. We all know how expensive video recording equipment can be. My students use their phones. The only thing that I did for when they record in-lab is I actually went out and purchased some of those phone tripods that I put in some of my simulation rooms so that they can record in there. So, quality of video, I’ve never had an issue with that. Using all these different devices or various devices that students have, that hasn’t been an issue. So, we use their own devices and it’s worked great.

Sam Butterfield:

Awesome. So, Scott had a question. I know we’ve talked about this Patrick when we last met about how it works inside of Canvas. So, just to preface it, so GoReact does have an LTI integration that works with all major LMS systems. However, do you want to just talk briefly, Patrick, on your experience with the LTI integration, specifically with Canvas, if that’s what you’re using?

Patrick Luna:

Yeah. So Canvas actually acts as an external tool and this might get into the nuances of Canvas, but it’s an external tool that when you create an assignment and you connect GoReact to your course, you can integrate it or choose it as an evaluation method or a method of submission. So, it could be, along with if you want a file submission or something like that, it’s just listed under there. So, once you connect GoReact to an assignment, you can set the settings on whether you want it to be for grade and if you want it to populate to the grade book and all of those things as you would a normal assignment. It’s been a huge time saver for me. It integrates just wonderfully within Canvas. I can’t speak enough to it. I love that I can just plug it into my LMS.

Sam Butterfield:

Awesome. Thank you. And thank you for those questions as well. We do have one more. Again, feel free, if you have any lingering questions, feel free to jump in. Theresa had one more that asked about the payment side of things and was curious if you charged your students to access GoReact or was there some sort of financial aid that was used to purchase the license for your program?

Patrick Luna:

For my particular use case, that was a huge discussion. And so I had to navigate that through my director as to how we were going to do that. And because we were so literally desperate for a tool during COVID, we didn’t have it as an extra expense to our students. We purchased it for them and we’re continuing to do that to this day. There are different payment structures and Sam was the first guy I ever met over there and he helped me to work through those. So, possibly, Sam could tell you about some other things or other methods.

Sam Butterfield:

Yeah. Thank you for that, Patrick. There’s a lot of different options in terms of accessing GoReact. So, we have a team of aid account executives that work across United States and globally. So, if there’s interest in exploring options of GoReact within the program, but you don’t know financially how it’s going to work, reach out. We’re happy to talk through and find the best option for you. Our price is posted on our website as well, our starting price, which is $60 per user but there are a ton of discounts available. There’s a lot of different things that are available to you outside of just that publicized price. So, please reach out if you have any questions with pricing or how that works, and we can get you taken care of that way and explain all the options.

Patrick Luna:

I have one thing to add about that, Sam. So, the pricing, and this was interesting, includes usage license per student for an entire year and I was only purchasing it initially for one course. So, because it was available for a whole year and it was attached to a student, that’s why I started using it so much. And I also started to promote it to other faculty who were teaching those students within that first year. So now we’re getting a ton of value out of that one per student price, because now it’s being integrated throughout their first year. So, that’s just something that was a huge advantage to us.

Sam Butterfield:

Absolutely. And yes, there was a question there. So, that’s $60 to what Patrick just said, that is for an annual license. And so that covers storage, that covers access. They can record as much as they want. There’s no limit in terms of comments or courses or assignments that they can do, so that covers all that. And that’s not including, as I mentioned, any of the discounts based on volume or based on higher ed that are available to you as well. So, please reach out to us and we can talk through all the specifics and, again, get you on the right pathway that makes the most sense for your program. So, Patrick, I think that’s all the questions that we have today. I know we covered our time plus a little bit. So, if there aren’t any other questions, I don’t see any in the Q&A. I’m not seeing any in the chat, so forgive me if we are missing anything.

Sam Butterfield:

I know we have our GoReact team that’s monitoring both sides. But with our time, I think we’ll call it for today. If you do have any questions, if you want to talk to a member of our team, or if you have anything else for Patrick, again, please feel free to reach out and we’ll connect you with the right person. And, again, Patrick is such, I can’t say enough, one of the coolest guys I’ve ever met. And so if you do have any questions or if you want to chat with him, I’m volunteering his time now.

Patrick Luna:

Thanks Sam. I appreciate it. Sam’s going to give everybody my cellphone number.

Sam Butterfield:

That’s right. I’m going to post your Facebook page or whatever, but no, please reach out. We’re happy to, Patrick, again, is awesome. He’s been super helpful for a number of people who have had questions that I personally work with. So, we’re happy to help you. We’re happy to get you connected with the right people. We appreciate you taking time to join us today for this webinar. Again, it has been recorded. We will be sending it out, so feel free to share that out with your friends, your family, your teams, whoever you’d like to. And, again, thank you for joining today. Thanks Patrick.

Patrick Luna:

Oh, no problem Sam.

Sam Butterfield:

Goodbye, everybody.

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