Date of Award

Spring 5-5-2022

Document Type


Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Dr. Sallie Coke, Ph.D., APRN, PNP-C, FNP-C, PMH

Second Advisor

Dr. Krystal Canady, DNP, APRN, FNP-C

Third Advisor

Dr. Carolyn Rutledge, Ph.D., FNP-BC



Background: During the COVID 19 pandemic, access to healthcare was impacted tremendously. The utilization of electronic information and communications in healthcare is known as telehealth. Telehealth is a technology to deliver care when patients and practitioners are not at the same site. Although telehealth has been suggested as a solution to the access to care concern, a major limitation was the lack of education on delivering successful telehealth visits. Quality of care can be negatively affected if proper etiquette is not utilized to ensure an effective telehealth visit.

Objective: This DNP project aimed to increase the practitioners’ comfort and competence in telehealth etiquette, by delivering an educational intervention on telehealth etiquette and allowing the practitioners the opportunity to practice the skill.

Method: A total of 13 individuals (NPs and PAs) were recruited and agreed to participate. Pre-intervention, participants completed a self-rating on telehealth etiquette comfort and competence and completed a virtual simulated telehealth visit with a trained standardized patient. Following that, the participants were delivered a virtual educational intervention focused on telehealth etiquette. Post-intervention, the participants were able to complete another simulated telehealth patient visit and re-rate themselves on telehealth etiquette comfort and competence using a Likert Scale of 1 to 10, with 1 = not comfortable/competent and 10 = very comfortable/competent.

Findings: The average reported rating by each participant before the intervention was 7.46 (SD 2.18) for telehealth comfort and 7.23 (SD 1.92) for telehealth competence. Post-intervention, the average reported rating by each participant was 9.1 (SD .64) for telehealth comfort and 9.4 (SD .77) for telehealth etiquette competence. A dependent t-test showed a statistically significant increase in participants’ self-rating in telehealth comfort (M 1.61, SD 1.89) t (12) = 3.1, p< .001. There was also a statistically significant increase of competence in the participants’ self-rating in telehealth etiquette (M 2.15, SD 1.77) t (12) = 4.4, p = .001.

Conclusion: Telehealth is here to stay and is a viable avenue to improve access to healthcare. Practitioners must be adequately trained in telehealth etiquette to maintain the quality of care delivered through telehealth. The DNP project was a success in that the finings indicated a statistically significant increase in the pre-and post-intervention ratings. The telehealth etiquette education significantly increased the ratings of the practitioners' comfort in delivering patient care through telehealth and their competence in telehealth etiquette. The results of this research may be used to make informed practice recommendations and replicated, or similar studies aimed at improving the practitioner-patient telehealth experience

Keywords: “telehealth, telemedicine, telemonitoring, telehealth etiquette, COVID-19, video conferencing”

Included in

Nursing Commons