Date of Award

Spring 5-2-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Sallie Coke

Second Advisor

Krystal Canady

Third Advisor

Kari Mau


Background: Increasing numbers of nurse practitioner (NP) educational programs are being offered online, with little or no face-to-face contact among students and instructors. Students express lack of confidence in their physical examination skills and want live instructor demonstrations, observed practice, and real-time feedback from their clinical instructors.

Significance: NP students need to acquire physical examination skills to increase competency in assessing patients for enhanced clinical judgment and improved patient outcomes.

Purpose/Aims: to improve and measure the competency and confidence in the performance of advanced physical assessment skills of NP students in an advanced health assessment (AHA) clinical course with an innovative learning strategy called Tele-Sim.

Methods for Educational Initiative: Sample was voluntarily recruited from an AHA course for NP students. After completing an IRB approved consent, participants attended four two-hour online synchronous classes using simulated patients in a tele-conferencing format.

Results, Analysis & Implications: Participants demonstrated statistically significant increases in overall student performance & self-efficacy when performing physical exam skills post interactive Tele-Sim.

There was a statistically significant improvement in the Tele Sim Students reported a high level of satisfaction with the ease of use and effectiveness for learning physical exam skills using Tele-Sim and 100% of the participants highly recommended that Tele-Sim be offered in future courses. The Tele-Sim study supplemented current research with statistically significant results, providing evidence to support the future use of telehealth and simulation with HSPs to enhance the clinical education of nurse practitioner students.

Keywords: nurse practitioner, clinical education, simulation, telehealth, online education, physical assessment, learner self-efficacy

Included in

Nursing Commons