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Cognitive load theory, isolation of skills, readiness for practice



  1. Sheikh, Kathleen R. PhD, NP-C, CNE (Assistant Professor, Assistant Dean)


ABSTRACT: Telehealth is a way for clinicians to deliver care and for patients to access care via the internet. This method of health care delivery has become an expectation of nurse practitioner practice. Rapid-cycle deliberate practice (RCDP) is a technique grounded in cognitive load theory used to teach a sequence of predetermined skills to learners through purposeful skill augmentation and strategic repetition. Throughout the process, students receive feedback based on well-defined objectives. Material is processed from working memory into long-term memory in small portions with the intent to prevent working memory overload. Advanced practice physical assessment in-person simulation laboratory sessions were framed and focused using the RCDP model. In-person sessions were followed by telehealth simulations for the skill area. Both the in-person laboratory and online telehealth visits followed a similar framework: isolate the skill, baseline knowledge, measurable objectives, practice expectations, and evaluation. Leveled telehealth competencies and domain descriptors were used as a guide for the telehealth sessions. Using the RCDP model to facilitate student translation of physical assessment skills from an in-person venue to the telehealth care environment yielded encouraging potential to isolate and evaluate specific skills, address measurable objectives, and identify behaviors that encompass multiple competencies, developmental milestones, and levels of proficiency. The RCDP telehealth simulations showed promise in the education of nurse practitioner students to accomplish key telehealth health assessment behaviors and progression toward readiness for practice.