Date Presented 04/22/2023
Telehealth is rapidly expanding in OT practice; therefore, advanced technologies must also be incorporated into OT education. A telepresence robot was used for a remote faculty presence and to stimulate critical thinking skills during an OTD Level I fieldwork experience. Student satisfaction scores were significantly higher when the robot was incorporated into the learning than when it was not, and students reportedthat learning was enhanced with this technology.
Primary Author and Speaker: Kirsten Davin
Additional Authors and Speakers: Barbara M. Mollere Doucet
PURPOSE: Telehealth has become a viable option for occupational therapy service delivery and the incorporation of advanced technology into practice has followed. Many occupational therapy educational programs are therefore challenged to include technology into the classroom for student learning. Telepresence robotics are rapidly appearing a valuable tool in health care settings within both clinical practice and clinical education (Shaw et al., 2018). The purpose of this study was to determine if the use of a telepresence robot was an effective design element and enhanced entry-level OTD students’ learning of clinical skills.
DESIGN: Students from two entry-level OTD cohorts (N=85) were invited but not required to participate. The study used a quasi-experimental, one-group design where participants experienced educational instruction within a Fieldwork IA (FWIA) course without the telepresence robot and within a second Fieldwork IB (FWIB) course two months later with the robot.
METHOD: The Fieldwork experiences consisted of small student groups that rotated between eight varied patient simulation scenarios where students were required to perform an initial evaluation, select assessment tools, and construct treatment plans. The telepresence robot entered the simulation areas of each student group randomly. The robot consisted of an ipad mounted on a remotely controlled base controlled by faculty instructors who were located remotely. Faculty could observe student interactions from this remote location and assess behavior within the setting unobtrusively. Instructors were also able to simulate the roles of physician, social worker, and family member through the use of the robot, spontaneously questioning the students on behaviors observed, practice methods used and discharge options selected. Faculty navigated the robot to different student groups throughout the experience. Students completed the Simulation Design Scale [SDS] and Student Satisfaction & Self-Confidence in Learning tools [SSSL] (National League for Nursing, 2005) after both FWIA and FWIB experiences. Data analysis included compilation of average scores on the SDS and the SSSL with comparison between FWIA (without robot) and FWIB (with robot) responses. Paired t-tests were used for the comparisons and non-parametric tests were used when indicated.
RESULTS: A total of 85 SDS and 79 SSSL forms were matched and analyzed. Average total scores (max 100) on the SDS were 82.87 ± 12.43 for FWIA, 92.73 ± 6.52 for FWIB; p<0.001. For the SSSL, satisfaction domain scores (max 25) yielded 21.63 ± 2.92 FWIA, 23.82 ± 1.87 FWIB, p<0.001; self-confidence domain (max 40) yielded 33.34 ± 4.62 FWIA, 36.32 ± 3.69, p<0.001, total score (max 65) 54.97 ± 6.80 FWIA and 60.14 ± 4.99 FWIB, p<0.001.
CONCLUSION: Entry-level OTD students reported a high satisfaction with the use of a telepresence robot within a Fieldwork experience; overall scores on the SDL and SSSL instruments were significantly higher when the robot was incorporated into the learning experience. Students reported that there was a stronger learning effect than when not used, and that the robot was effective for learning skills for patient simulations. Generalizability is limited due to results reflecting homogeneity/single institution data; however, outcomes can inform instructional techniques for other educational programs and provide an option for remote instruction or patient care.
IMPACT STATEMENT: Students perceived the use of telepresence technology within OT education to enhance learning. This training tool can expose students to advanced technology within the clinic and prepare them to explore future options for remote service delivery.
National League for Nursing (2005). Simulation Design Scale (Student Version) [Measurement Instrument]. Retrieved from: http://www.nln.org/docs/default-source/professional-development-programs/nln-instrument_simulation-design-scale.pdf?sfvrsn=0
National League for Nursing (2005). Student self-confidence & satisfaction in learning scale. (Student Version) [Measurement Instrument]. Retrieved from:http://www.nln.org/docs/default-source/default-document-library/instrument-2_satisfaction-and-self-confidence-in-learning.pdf?sfvrsn=0
Shaw, R. et al. (2018). Telepresence Robots for Pediatric Clinical Simulations: Feasibility and Acceptability. Pediatric Nursing, 39–43.