Hidalgo, Therese

English

University of New Mexico

University of New Mexico
UNM Digital Repository
HSC Education Day Health Sciences Center Events
9-28-2018
Coaching for Success: A Strategy for Early
Identification & Remediation for FNP Student
"Strugglers"
Therese Hidalgo
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Recommended Citation
Hidalgo, Therese. "Coaching for Success: A Strategy for Early Identification & Remediation for FNP Student "Strugglers"." (2018).
https://digitalrepository.unm.edu/hsc_ed_day/14
Coaching for Success: 
A Strategy for Early Identification 
& Remediation for FNP Student 
“Strugglers”
UNM-HSC - EDUCATION DAY 
September 28, 2018
Therese Hidalgo, DNP, RN, FNP-BC
Objectives:
 Identify the Formative OSCE as a valid method for assessing 
clinical competency using the “FACTS” Checklist as a tool for 
the identification of FNP students who are struggling clinically.
 Apply the “FACTS” Checklist Tool as a method for evaluating 
clinical competency and targeted feedback based on the 
OSCE performance.
 Appraise the value of a small group problem-based learning 
method utilized in a 4-week coaching class for “strugglers”
OSCEs &  Clinical Practice
 What is an OSCE
 Why do we use OSCE’s?
 How do they compare with clinical site 
evaluations?
FACTS Evaluation Tool
 Communication style/patient interaction
 Focused Health history
 Focused Physical Exam
 Differential Diagnoses
 Assessment/Plan
 Overall Performance
Self-Regulation Learning Model
 Self-generated 
feedback
Also
 Effective Faculty 
Feedback
 Taught Effective 
Strategies
 Observed Practice 
(1)
Forethought 
(before)
(2) 
Performance 
Phase 
(during)
(3) Self-
Reflection 
(After) • Task Analysis
• Motivational beliefs
• Self-observation
• Self-control
• Self-judgment
• Self-reaction
Research Questions:
Coaching for Success
 Does a targeted, 4-week coaching seminar positively affect first 
year FNP students’ performance on a Summative OSCE after 
failing an earlier Formative OSCE?
 Do first year FNP students who have failed the Formative OSCE 
and have taken the coaching seminar have a higher percentage of 
improvement compared to the students who passed the Formative 
OSCE and did not take the coaching seminar?
 Does the number of coaching sessions improve the outcome of the 
Summative OSCE scores?
Research Plan
 Research Design:
 Quasi-experimental study 
▪ Pre & Post- intervention comparisons
 Sampling:
 Convenience sampling of first-year FNP students 
taking their 1st adult health clinical course 27 
students included in class cohort.
▪ 15 identified as “strugglers”
▪ 12 identified as “non-strugglers”
Coaching/Remediation:  
Clinical Skills
 Student Assessment/Evaluation
 Feedback
 Faculty
 Self-reflection
 Coaching/Remediation Strategies
 Individualized
 Small group problem-based learning
 Simulation
 Program Evaluation
 Student Survey
 Performance on Summative OSCE
Methodology
 Data Collection
 Formative and Summative OSCE performance scores (percentages) 
during 1st clinical course of the first-year FNP curriculum (Spring 2018)
▪ “FACTS” Checklist
 The difference in performance scores (percentages) between the 
Formative and the Summative OSCEs will be compared for individual 
students
 The differences in performance scores (percentages) between the 
Formative and the Summative OSCEs will be compared between the 
“Strugglers” and the “Non-Strugglers”
 The differences in averaged difference in performance scores 
(percentages) between the Formative and the Summative OSCEs for 
those attending the 4-week coaching seminar compared to the number 
of sessions attended
Results
Table 1:  
“Strugglers” individual 
percentage scores,
normalized gain <g> for 
individual scores, and number 
of attended remediation 
sessions.
“Strugglers”
ID Code Formative OSCE Summative OSCE <g>** Coaching Sessions
2 55 91 80 4
4 64 82 50 3
5 55 82 60 4
6 64 80 44 1
8 59 88 71 3
10 69 85 52 4
11 51 80 59 4
12 49 82 65 4
13 59 81 54 3
14 69 81 39 2
17 67 82 46 3
18 60 82 55 3
22 55 94 87 4
25 62 88 68 4
26 63 91 76 4
Results
Table 2:
“Non-strugglers” individual 
percentage scores, normalized 
gain <g> for individual scores, and 
number of attended
remediation sessions.
`
“Non-strugglers”
ID Code Formative OSCE* Summative OSCE* <g>** Coaching Sessions
1 79 85 29 0
3 70 85 50 0
7 75 85 40 0
9 79 76 -14 0
15 79 88 43 1
16 73 87 52 0
19 71 84 45 0
20 76 94 75 0
21 75 84 36 1
23 73 96 85 0
24 78 78 0 1
27 76 90 58 1
Results
_____________________________________________________________________________________________ 
               Inventory Score 
                                                                                                              ___________________________________ 
 
  
   Group    ɳ    M   SD 
 
“Strugglers”                   15    60.4*   13.9 
 
“Non-Strugglers”   12    41.6*   27.8 
_____________________________________________________________________________________________ 
* normalized gain = <g> as statistically significant at (t (25) = 2.30, p = 0.03; CI = 1.93-35.67) 
Table 3 
Means and Standard 
Deviations on the Measure of 
Normalized Gain of 
Percentage Score 
Differences between the 
Formative and Summative 
Percentage Scores between 
“Strugglers” and “Non-
strugglers” groups.
Survey 
Results
 75% felt more comfortable with the summative OSCE; 
25%  neither agreed/disagreed
 83% felt they were successful with the summative 
OSCE; 17% neither agreed/disagreed
 100%  agreed small group learning worked for them
 83% agreed the guide sheet examples were useful tools 
for learning; 17% weren’t sure
 92% would come to sessions such as this even if not 
required; 8% disagreed
Qualitative data analysis:
Survey of 63% of 
remediation participants 
obtained retrospectively 
about 1 month after 
summative OSCE
Discussion
 The increase in averaged normalized gain <g> scores between the 
two groups is statistically significant using the unpaired t-test: t(25) 
= 2.30; p = 0.03; CI = 1.93 = 35.67 with a large effect size;  Cohen’s 
d = 0.903. 
 The correlation between the number of mediation sessions 
attended compared to the average normalized gain <g> in scores of 
the “strugglers” using the Pearson Correlation Coefficient (r) = 0.67 
for n =15.
Discussion
 “Strugglers” with coaching compared to “Non-
strugglers” without coaching demonstrated a19% 
increase in normalized gain <g> scores
 “Non-strugglers” w/course compared to those without 
any coaching demonstrated an11% increase in 
normalized gain <g> scores.
 The students felt strongly the coaching sessions were 
helpful in preparing them for the summative OSCE
Conclusions/Future Plans
 Coaching program successful for early identification of 
“Strugglers” with the opportunity to receive targeted clinical 
coaching to better prepare “struggling” students for clinical 
experiences.
 Some more work needs to be done to continue to evaluate 
FACTS Checklist for reliability/validity
 Students appreciate small group, case-based learning
 Clinical Enrichment Topics Course (Summer of 2018) 
References
 American Association of Colleges of Nursing (AACN). (2011). The essentials of Master’s education in Nursing. Retrieved September 19, 
2018 from:  https://www.aacnnursing.org/Portals/42/Publications/ClinicalEssentials99.pdf
 Beckham, N.D. (2013). Objective structured clinical evaluation effectiveness in clinical evaluation for family nurse practitioner students. 
Clinical Simulation in Nursing, 9(10), e453-459.
 Carraccio, D., & Englander, R. (2000). The objective structured clinical examination: A step in the direction of competency-based 
evaluation.  Archives of Pediatrics and Adolescent Medicine, 154(7), 736-741.
 Cleary, T.J. (2006). The development and validation of the Self-Regulation Strategy Inventory-Self-Report. Journal of School 
Psychology, 44, 307-322.
 Durning S,Cleary T,Sandars J, Hemmer P, Kokotailo P,  Artino A. (2011).  Perspective: Viewing “Strugglers” through a different lens: 
How a self-regulated learning perspective can help medical educators with assessment and remediation. Academic Medicine, 86 (4), 
488-495. 
 Motola, M., Devine, L.A., Chung, H.S., Sullivan, J.E., & Issenberg, S.B. (2013). Simulation in healthcare education: A best evidence 
practical guide.  AMEE Guide No. 82. Medical Teacher, 35, e1511-e1530.
 National Organization of Nurse Practitioner Faculty (NONPF). (2017). Domains and core competencies of nurse practitioner practice. 
Retrieved June 8, 2018 from:  www.nonpf.org/resource/resmgr/competencies/2017_NPCoreComps_with_Curric.pdf
 Winston, K.A., Van Der Vleuten, C., & Scherpbier, A. (2012). The role of the teacher in remediating at-risk medical students. Medical 
Teacher, 34, e732-2742.
 Zimmerman, B.J. (2008). Investigating self-regulation and motivation: Historical background, methodological developments, and future 
prospects. American Educational Research Journal, 45(1), 166-183.


Coaching for Success: A Strategy for Early Identification & Remediation for FNP Student  Strugglers

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Coaching for Success: A Strategy for Early Identification & Remediation for FNP Student Strugglers

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