Innovation in Use of Avatars for Documentation

Purpose: To evaluate whether the integration of avatar software will increase student skill in writing clinical notes. Background:  Avatar software (Shadow Health) has been used by over 140 universities to help teach physical assessment skills, history taking and documentation. A major benefit is the student’s ability to review content until mastery (Kelley, 2013).  Our program has recognized the need to improve documentation skills in advanced practice nurses before starting clinical rotations. The Shadow Health system requires students to complete a weekly SOAP note for virtual visits completed with an adult avatar which has multiple medical problems. Method: Students purchase the software from Shadow Health website as a “textbook” in the course.  Students complete a focused health history interview and physical examination on the Avatar with a clinical note every week prior to going to physical assessment lab.  Upon clinical note submission, a model documentation note is provided for review within the software and a student self-reflection paragraph is prompted concerning their own documentation skill. Two major assignments include a comprehensive history and a focused SOAP note. Pre and post course surveys elicited student perceptions of the avatar learning experience.  Faculty determination of the caliber of documentation will be measured by retrospective comparison of grades on a comprehensive history and focused SOAP note assignment from a previous semester. Outcomes: Pre-test surveys demonstrated a wide range of opinions concerning learning with avatars. Many were hesitant to use technology, others welcomed the opportunity to have repetitive encounters with a “patient” in a risk-free learning environment.  Comparative thematic analysis of pre and posttest opinion will monitor for trends in acceptance and usefulness of the learning with Avatars. Documentation grades will be compared using inferential statistics during January 2015 using SPSS 20.Implication: Clinical documentation is a critical skill in advanced practice for communication, legal reasons and determination of reimbursement rates.  Traditionally, preparation for clinical documentation has been limited to only a few assignments. Increased practice is intended to improve student skill and competence in creating a complete clinical note.