How Online Education Helps the US Meet Growing Demand for Better Healthcare

Healthcare in America is at a crossroads:An aging population and an influx of Americans now receiving coverage throughthe Affordable Care Act (ACA) are demanding more from the healthcare system.The more than 75 million baby boomers will need more medical attention as theyage, and more than 12 million Americans are newly insured through theACA.

But while the need for healthcare isgrowing, physicians likely won’t be able to fulfill demand. More doctors aredrifting away from primary care, and medical schools simply can’t produce thevolume of doctors needed.

Enter nurse practitioners (NPs) andphysician assistants (PAs), who are rising to the challenge and adapting to thechanging healthcare environment. Both NPs and PAs have been filling in thegaps left by a void of primary care physicians in underserved areas of thecountry. In fact, the number of NPs doubled in the past decade, rising to more than 205,000 bythe end of 2014.

The growth in NPs—and the addedresponsibilities placed upon them—has some schools expanding their graduatenursing programs to online education, either to augment the campus experienceor to help fill shortages by providing more convenient education opportunities.These schools are asking themselves an important question: How can we create anonline curriculum that teaches the right skills and knowledge while identifyingand correcting any gaps in learning?

Theexpanded role of nurse practitioners

In the past, NPs played the role ofwellness coordinators, and treated common recurring and chronic, but stable,illnesses. Now, the job is growing more complex: in some areas of the US,doctors are leaving primary care behind because of low reimbursement rates,high administrative costs, and the resulting need to see too many patients fortoo little time to make the economics work. They are being replaced by clinicsstaffed by NPs. In this role, NPs treat patients with both acute and chronicailments, many of which are treated with a blend of medications. NPs might seebetween 20 and 30 patients per day at a clinic, challenging their ability todeliver positive outcomes and proper healthcare treatments to all.

Today, it’s hard to differentiate therole of physicians, physician assistants, and NPs, according to Linda Steele,program director for MSN Nurse Practitioner Specializations at WaldenUniversity’s School of Nursing. As such, schools must expand training for NPsto address increasingly complicated questions from patients and employ thecritical thinking skills necessary for accurate diagnoses. To ensure NPs areready for their added responsibilities, and to accommodate the growing graduatenursing classes, schools are using online programs and simulations that trainNPs in the detective work of medical diagnosis.

Aflexible option for the next generation of NPs

Throughout the country, higher learninginstitutions are integrating online programs to complement theirbricks-and-mortar classroom experience to meet demand from growing numbers ofstudents, many of them non-traditional. In some cases, these programs existprimarily online without a physical classroom environment, bringing students tocampus only once or twice a year.

“Theroot cause of the rise in online education programs for NP degrees isnecessity,” said Steele. “Typically, nurses enrolled in these programs workirregular schedules and outside of the typical 9-to-5 workday. So as a result,asynchronous, online learning offers tremendous flexibility for these students,and allows them to work 12-hour shifts while earning their degree.”

That dichotomy has pushed educators tofind new ways to develop student competencies and measure their achievement andunderstanding. How can they hone and refine the critical thinking skills thatallow medical professionals to accurately diagnose patients? And just asimportant, how do educators in online programs gauge the critical thinking andclinical encounter skills of students on the other side of a computer screen?

Usingonline simulations to teach diagnostic skills

Simulation is a staple of nursingeducation at all levels. To date, much of it has been mannequin-based learning,a format focused on teaching psychomotor skills and team-based response toemergencies. Another type of simulation uses actors—known as standardizedpatients—who portray symptoms and undergo live examinations to teachcommunications and interpersonal skills. Both mannequins and standardizedpatients only touch upon developing critical diagnostic competencies. On-campus,and especially online students who only visit campus once or twice a year, needconsistent practice in asking questions, reviewing a patient history, investigatingsymptoms, interpreting tests and physical exams, and identifying afflictions.

To fill this need, nurse practitionerschools such as Walden University’s School of Nursing are using cloud-based trainingplatforms that feature virtual simulation, allowing students to build criticalthinking skills and provide them with the understanding of how to react in areal-world environment. These programs, which offer a complete virtual activelearning experience, use dynamic patient simulations and provide continuousfeedback. They are being adopted in more NP programs throughout the nation,especially as online programs continue growing.

Brick-and-mortar schools too are usingvirtual patient simulation both in the classroom and online. “These platformssimulate a wide range of health issues and illnesses, and replicate the medicalhistory interview, physical exam, and diagnostic process while providingeducators the opportunity to observe students’ learning and assess theirdecision-making and clinical judgment,” Steele said.

These types of programs help graduatenursing students attain the same experiential competencies online as they wouldon campus but with the flexibility to accommodate their schedules. There’s noneed to pencil in time with a high-fidelity mannequin or a standardizedpatient. While online simulations complement both these learning tools with developmentin critical cognitive competencies, virtual platforms are unique in that theyallow students to hone their diagnostic skills and clinical competencies fromanywhere at any time, reporting results to instructors, who can then trackstudent progress.The end result is a mastery of the critical thinking skills that can improvetreatments and decrease the misdiagnoses that affect one in 20 US adultoutpatients.

With a growing number of insuredpatients overwhelming the health care providers in many areas, the ranks of NPscontinue to expand to meet the need. But to accommodate this ensuing surge ingraduate nursing students, we need online programs to offer working nurses theability to advance their careers and shoulder more responsibility for patientwell-being.

As these online programs grow and mirrorthe current demand in the healthcare market, it will be increasingly importantfor NP and PA students to develop critical thinking and decision-making skillswhile receiving constant feedback and assessment to ensure they’re trained andcapable of improving patient outcomes. The increased adoption of these virtualtraining tools will foster a more well-rounded education for such studentsthroughout the US.