Development of the Teaching Interpersonal Skills for Telehealth Checklist.

While interpersonal skills in telehealth may positively impact clinical practice, patient engagement and outcomes, assessment strategies are lacking. We conducted a multi-stage iterative approach to develop and test validity and reliability of the Teaching Interpersonal Skills in Telehealth checklist (TIPS-TC). First, we identified observable communication behaviors from the literature. Second, we surveyed telehealth managers and researchers (N = 11) to rate appropriateness of potential checklist items. Level of agreement (35%-91%) and Kappa statistic (0.18-0.89) confirmed items to be retained and identified items to modify. Based on response patterns and comments, we reduced 44 items to 12 critical checklist behaviors. Third, student clinicians used the checklist with video telehealth consultations and provided feedback. Fourth, we conducted reliability testing with practitioners and administrators (N = 68) who completed the TIPS-TC for two versions of a telehealth scenario. Strong interrater reliability intraclass correlation coefficient (ICC) and test-retest reliability ICC (both p < .001), along with non-significant findings of order effects supported the checklist as an acceptable instrument to differentiate high skill from low skill telehealth sessions. The TIPS-TC offers an evidence-based approach to assessing interpersonal skills in telehealth to help evaluate clinician competence and tailor learning activities across disciplinary roles.

Clinician behaviors in telehealth care delivery: a systematic review.

Literature on telehealth care delivery often addresses clinical, cost, technological, system, and organizational impacts. Less is known about interpersonal behaviors such as communication patterns and therapeutic relationship-building, which may have workforce development considerations. The purpose of this study was to conduct a systematic literature review to identify interpersonal health care provider (HCP) behaviors and attributes related to provider-patient interaction during care in telehealth delivery. Electronic searches were conducted using five indexes/databases: CINAHL, ERIC, PsychInfo, ProQuest Dissertations, PubMed; with hand-searching of the immediate past 10 years of five journals. Search concepts included: communication, telehealth, education, and health care delivery. Of 5261 unique article abstracts initially identified, 338 full-text articles remained after exclusion criteria were applied and these were reviewed for eligibility. Finally, data were extracted from 45 articles. Through qualitative synthesis of the 45 articles, we noted that papers encompassed many disciplines and targeted care to people in many settings including: home care, primary and specialist care, mental health/counseling, and multi-site teams. Interpersonal behaviors were observed though not manipulated through study designs. Six themes were identified: HCP-based support for telehealth delivery; provider-patient interactions during the telehealth event; environmental attributes; and guidelines for education interventions or evaluation of HCP behaviors. Although unable to identify current best practices, important considerations for practice and education did emerge. These include: perceptions of the utility of telehealth; differences in communication patterns such as pace and type of discourse, reliance on visual cues by both provider and patient especially in communicating empathy and building rapport; and confidentiality and privacy in telehealth care delivery.

Teaching/learning strategies for the essentials of baccalaureate nursing education for entry-level community/public health nursing.

The purpose of this article is to describe teaching/learning strategies for each of the 15 Essentials of Baccalaureate Nursing Education for Entry-Level Community/Public Health Nursing (ACHNE, 2009). Carper's ways of knowing serve as foundations for creating classroom and clinical experiences that focus on clinical action with community as client. Each community/public health essential is defined with relevance to community/public health nursing practice. Five teaching/learning strategies have been delineated for each essential with suggestions of teaching resources and/or target population application. Teaching/learning strategies that focus on community as client, population health, and the essential knowledge and competencies of C/PH nursing will help ensure preparation of baccalaureate prepared nurses with knowledge and skills to improve the health of populations.

Public health nursing competency instrument: scale reduction and reliability of factors.

OBJECTIVES: To reduce the number of items of the Public Health Nursing Competency Instrument (PHNCI) and to report the psychometric properties of the abbreviated instrument. DESIGN AND SAMPLE: The 193-item PHNCI was administered via an online survey tool. A national sample of 2,269 public health nurses was recruited from 25 states. MEASURES: All items of the PHNCI scale were positively stated and participants were asked to rate their skill level via a 4-point Likert scale. RESULTS: A principal component exploratory factor analysis with oblique rotation and examination of scree plot resulted in a final abbreviated scale which included 81 items and six factors: (1) Evaluation Competencies, (2) Individual/Family/Community Competencies, (3) Systems' Competencies, (4) Partnership/Collaboration Competencies, (5) Planning Competencies, and (6) Assessment Competencies. The six factors in the resulting PHNCI Abbreviated (PHNCIa ) demonstrated acceptable internal consistency, ranging from 0.92 to 0.98. CONCLUSION: The six factors of the PHNCIa integrate important concepts of both the nursing process and the intervention wheel. The instrument can be used by educators, administrators, managers, and staff members to assess strengths and challenge areas, guide discussions on performance and expectations, and enhance professional development efforts. Next steps for future research are presented.

Political participation of registered nurses.

Level of political participation and factors contributing to participation were measured among Midwest RNs (n = 468) via an online survey (Cronbach's α = .95). Respondents reported engaging in primarily "low cost" activities (e.g., voting, discussing politics, and contacting elected officials), with fewer reporting speaking at public gatherings, participating in demonstrations, and membership in nursing organizations. Psychological engagement was most predictive (p < .001) of political participation with the dimensions of political interest, political efficacy, and political information/knowledge highly significant (p < .001). Resources (time/money/civic skills) significantly contributed to political participation (p < .001). Less than half (40%) felt they could impact local decisions, and fewer (32%) felt they could impact state or national government decisions. Most respondents (80%) indicated their nursing courses lacked political content and did not prepare them for political participation. Findings showed that nurse educators and leaders of professional nursing organizations need to model and cultivate greater psychological engagement among students and nurses.

Using distance technology to learn across borders: a virtual travel course in nursing.

A 6-week online course was developed and delivered to nursing students and instructors at universities in two countries. The course exposed students and faculty to nursing and health concerns in both countries. All course communications were conducted in both English and Spanish, with support from online translation software as needed. Course content covered professional nursing, global health issues, and nursing interventions used with clinical problems. Although students were initially intimidated by the course language requirements, students valued the opportunity to learn about cultural and health issues. Faculty experienced a learning curve as well and enjoyed this international experience.

Development of the public health nursing competency instrument.

This paper describes the development and initial testing of an instrument to measure population-based public health nursing competencies. Although multiple lists of public health competencies exist, literature review did not elicit a valid instrument that could measure changes in public health nursing competency over time. The public health nursing competency instrument, consisting of 195 measurable activities organized in the framework of the nursing process, was developed. Competency scores of practicing public health nurses significantly increased after a continuing education series, and the instrument was confirmed by experts to be a valid reflection of public health nursing practice. The time required for instrument development exceeded expectations because of the multiple stages of delineating competencies and validating data with national experts.

The road to population health: using Healthy People 2010 in nursing education.

Healthy People 2010: Understanding and Improving Health and corresponding state health improvement plans provide roadmaps for planning, monitoring, and evaluating population health improvement in the United States. These documents offer relevant guidance for nursing education because they address health workforce education specifically, use a population perspective, and include evidence-based action priorities. However, information about how these documents are used in nursing education is limited. This article discusses the relevance of national and state health planning documents for nursing education. Nurse educators are encouraged to reflect on the alignment of current nursing education efforts with national and state health planning agendas. Suggestions for future use of national and state population health improvement planning documents in guiding strategic, curricular, and course planning are offered.

A case study of a distance-based public health nursing/community health nursing practicum.

Facilitating a distance-based public health/community health nursing practicum for RN to BSN students posed challenges and opportunities. Challenges included time involved in arranging the practicum, relationship building with agencies and staff, communicating with students, and the need for flexible practicum scheduling. Exposure to practice models from across the nation allowed students to compare and contrast these public health nursing models. Programs planning to offer this type of course should consider faculty workload particularly during the semester prior to teaching the practicum.