Systematic reviews and meta-analyses are very important means for evaluating evidence. This can assist in serving to reform health policy, provide a basis for clinical practice guidelines, and help translate research outcomes into policies for educational practice. As nursing care moves beyond the bedside, the education required to prepare nurses to meet clients’ needs regardless of their location is indicated. The purpose of this presentation is to use integration of telehealth within nursing education as an exemplar for the systematic review process. Telehealth research completed between January 2006 and January 2017 was examined, with the purpose of exploring nursing education research on telehealth and synthesizing best practices for telehealth in nursing education that would guide and improve programmatic implementation.
Methods:
By using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to guide the review and report process, the development of a systematic review was simplified, making the process less daunting, even for novice researchers. Use of the PRISMA checklist provided a step by step formula for researchers to follow and allowed all levels of faculty, whether new or seasoned faculty and regardless of educational level, to understand the process and participate. The team conducting the exemplar review consisted of two PhD prepared and two DNP prepared faculty.
Results:
After reviewing over 1,000 articles for inclusion criteria and following PRISMA guidelines, a total of thirteen articles were included in the exemplar review. The criteria for inclusion was nursing education original research related to telehealth in an academic setting. The population was nursing students at any level of education to include pre-licensure, baccalaureate, and graduate degree programs. The education program could be either national or international nursing. The search was limited to English-language articles from January 2006-January 2017. Those thirteen articles were then extracted for the following data; design, purpose, sample, intervention, control, measurements, outcomes, limitations, bias types, and notes. The most significant evidence identified by this review was van Houwelingen et al., who used a Delphi study with 51 experts to validate 14 nursing telehealth entrustable professional activities (EPAs) with 52 corresponding competencies. The authors recommended further integration, validation, and application studies focusing on EPAs and competencies. There was a great variability of data reported which prevented identification of telehealth best practices. There was a lack of identified, valid, and reliable instruments; and the absence of reported measurable outcomes. A narrative summary was then completed due to the inability to complete a meta-analysis.
Conclusion:
Further integration, validation, and application studies are recommended, focusing on the entrustable professional activities and competencies to advance the science of telehealth nursing education. These may be used to guide curricular integration, measure outcomes, and build a program of telehealth nursing education research. The process of doing a systematic review can be a rewarding learning experience. The outcomes may be identification of further improvements, research, or policy development. Through the use of the PRISMA guidelines and collaboration the work is achievable.