Top Nursing Program Tackles Shortage of Nurses with New Technology

“This was the perfect app that I needed right at the perfect time. Everything came into alignment when I found GoReact.” —Dr. Michael D. Bumbach, Assistant Clinical Professor

For sixteen years running, nursing has ranked as the top most trusted and most ethical profession in Gallup polls. Americans trust their nurses—and it’s really no wonder why.

In the medical profession, nurses are the professional gatekeepers of life and death. They’re the ones in the trenches caring for babies, staffing hospitals, and keeping the elderly comfortable at the end of their lives. And nursing skills have proven to be a significant factor of patient survival.

The Stakes of Nursing

A large body of research has linked the quality nursing education with patient outcomes in hospitals.

Basically nurses with higher education levels—and specifically with bachelor’s degrees—have lower patient mortality rates and lower rates of failure to rescue. In fact, 10 percent more nurses with bachelor’s degrees on a staff can decrease deaths and failures by roughly 4 percent, regardless of environment quality.

No one is more aware of these trend than the instructors in charge of training our future nurses. One of these faculty members is Dr. Michael D. Bumbach.

Dr. Bumbach is a trained nurse who worked in urgent care for over 15 years. Now he is a nurse practitioner at the Archer Community Health Center and an assistant clinical professor in the University of Florida’s College of Nursing.

Bumbach explains, “Research shows that nurses with strong skills have better patient outcomes. If patients aren’t having good outcomes, usually they die in the hospital. So the educational background of the nurse really matters.”

Nursing faculty like Dr. Bumbach are dedicated to helping students learn, grow, and become board-certified as critical preparation for saving lives out in the field. The trouble is that the number of new nurses entering the field is shrinking.

The National Nursing Shortage in the U.S.

Statistically speaking, the United States will need more nurses than ever in a few short years—and our nursing pool is drying up.

According to the American Nurses Association, the U.S. will require an additional 1.13 million nurses by 2022.

Why? Because our medical landscape is changing at alarming speed.

Our general population is aging. Beyond that, our nurses are aging too. Nearly 40 percent of registered nurses will be 50 years or older within the next 10 years, and the number of new nurses under 30 is decreasing rapidly.

Nursing education programs are aware of this national shortage and fighting to meet the rising demand for quality nursing professionals. Institutions around the country are working hard to recruit more nurses, train them properly, and truly prepare them for successful nursing careers.

One such program is the College of Nursing at the University of Florida (UF).

Nursing in the Sunshine State

Located in Gainesville, the University of Florida has been educating nurses since 1956. UF is one of six colleges that make up the UF Health Science Center (HSC), and the UF College of Nursing consistently ranks in the top ten percent of nursing schools in the nation.

Perhaps the biggest reason UF excels is thanks to its experienced and dedicated faculty. In his position, Dr. Bumbach has an up-close and personal view of UF’s nursing program.

“The College of Nursing’s main goal is to produce qualified, intelligent, and strong nurses,” said Dr. Bumbach. “We want our nurses to be extremely competent when they leave our program. We want them to be able to enter any field of nursing that they want to go into.”

Every aspect of the college aims for this goal, but that doesn’t mean UF doesn’t face obstacles.

Challenges at the University of Florida

For students to become licensed registered nurses, they must pass the NCLEX exam. Students are allowed to take the exam after they complete their Bachelor of Science in Nursing (BSN), so UF’s nursing faculty evaluate their students progressively through the program. The goal is to teach strong nursing skills and correct practices so students are ready when the NCLEX rolls around.

The foundation of all nursing skills is assessing the health of a patient. “Nurses have to know how to do the physical examination because everything else comes off of that,” said Dr. Bumbach. “You can’t assess your patient if you don’t know what’s going on. It’s like putting a puzzle together. First you do the borders, and that’s what I would call health assessment.”

But to teach students how to conduct a health assessment, faculty members must give each student hands-on experience. To get that experience they need patients to work on.

Dr. Bumbach is the first to admit this isn’t an easy task: “Our biggest challenge is giving the nursing student enough experience in the nursing program. We want to slowly build them up so they can get comfortable in the clinical atmosphere. We felt we had to facilitate that by increasing clinical hours and simulation experiences in the lab. But in my course I have 120 students. There’s no way I could find 120 individual patients, but they do have each other.”

Dr. Bumbach decided to train his students to perform health assessments on each other. The first 60 students do an evaluation of their cohort, and the other 60 do vice versa so everyone has a patient. But even this solution for patient access wasn’t enough.

To truly develop their skills, each nursing student needs individual feedback from their professor. The peer evaluations helped get students started, but it didn’t give Bumbach any more time to observe his students and share detailed critique of their work.

The Power of Feedback

With such large classes, professors like Dr. Bumbach struggle to find the time and energy to make sure every single student is on track.

Bumbach was concerned that his students weren’t getting the face-to-face interactions and individual feedback they needed: “We’ve seen a big trend of people moving nursing instruction online to train more students, but then you miss out on the face to face. It’s hard to read body language over Skype, over phone, or whatever.”

Early on Bumbach wondered if video projects were the answer. Could students film themselves doing health assessments so he could observe and give feedback that way? It was worth a try.

As an experiment, Bumbach created a video assignment for his class and had them use UF’s educational platform, Canvas, to submit the videos. But Canvas video sharing proved to be both clunky and frustrating. There wasn’t a great way of evaluating the videos, and the files were far too large for Canvas to handle 120 videos from an entire class.

Still he refused to give up. Bumbach had a hunch that video was the answer to helping his many students prepare for certification. It was the secret to giving new nurses personalized feedback, which just might be the way to reverse our national nursing shortage over time. So instead of throwing in the towel, Bumbach started hunting for the perfect technology solution.

 Looking for a Canvas-Compatible Tool

In his search for the best video tool, Dr. Bumbach teamed up with James Kocher, the instructional designer for the College of Nursing.

What’s the role of an instructional designer? As Kocher explains it, “Mostly I prepare courses for each semester, and part of that is finding new technologies that improve classroom experiences. When Professor Bumbach came to me last year, he was having an issue with videos being too big to upload into Canvas. I went to EduAppCenter and saw the video product GoReact. Its upload sizes were bigger and there was built-in time-stamping, comments, and all the cool things we needed.”

Best of all, GoReact was already at UF. The Business School had had success with the platform, so transferring it to the College of Nursing wasn’t difficult.

“I was the guinea pig trying it out for our college,” said Dr. Bumbach. “It’s proven to be exactly what we needed.”

Making Video Assessment a Reality

So the pilot began. Dr. Bumbach introduced GoReact to his students and had them conduct a health assessment on camera. They submitted the videos directly to him for critique.

Almost immediately he recognized the time-saving difference the product made. “In our undergraduate health assessment course, each student would record a 15- to 30-minute complete physical examination. And they upload that file. The video assessments are really useful for me to see how they’re doing and what needs to change. And I don’t have to schedule everybody in the lab. That would be physically impossible with a class of 120 students. That’s 60 hours of person power.”

Instead of scheduling 60 hours in the lab, Bumbach had the ability to view all the assessments anywhere and at any time. “Assessing the students in a place that wasn’t necessarily the lab was a perfect modality for me. I could do it at midnight outside of working hours. Or I can stay home in my pajamas and just do it whenever.”

Kocher has also noticed what a big difference GoReact makes for professors, not just in nursing but in many different disciplines. “Before GoReact, students had to upload videos to YouTube, and it’s a lot messier that way. Now they can record themselves doing their skill, and the instructor doesn’t have to be there right away. They can, on their own time, go grade and give better feedback. Students can also control what the professor sees because they can record a segment over and over until it’s right. It gives them a chance to practice more. It really is the best product.”

Here’s just a sampling of the ways GoReact has helped the UF College of Nursing:

LMS Integration—The software integrates seamlessly with most university LMS systems. University of Florida is an enthusiastic Canvas user. Understandably, professors want to function in the environment they’re used to, and GoReact allows that.

Video File Sizes—Large files were the biggest obstacle for using video in the nursing program. Now that issue has been virtually eliminated. Students film themselves, save their videos, and submit them all within GoReact. Every video submission is compressed automatically and goes directly to their professor.

Simple Equipment—Instead of expensive, complicated camcorders, nursing students can film themselves with their own smartphones and laptops. UF almost never has technical difficulties with GoReact, and students can easily pause, clip, or re-film an entire segment.

Better and More Frequent Practice—Best of all, the nursing students are getting more practice and better instructor feedback than ever. This has helped Dr. Bumbach train his students faster and with greater precision.

Saving time for faculty—In Dr. Bumbach’s words, “Because we have a faculty shortage, GoReact has really allowed me to maximize my time. If I’m on the bus for 20 minutes, I can do my work then. It saves me literally days of time.”

Proven Improvement

For Bumbach, discovering GoReact and using it in innovative ways has changed the entire structure of his class.

The time-coded comments he makes on videos are more or less the same ones he would make in real life. The difference is that these notes are at the exact point in the video he’s referencing. It requires less work for students to understand his comments and less time for him to give them.

Dr. Bumbach already knew GoReact was making his life easier; now the question was if it was making a statistical difference in his program. The software felt like a good solution, but did the data back up Bumbach’s gut feeling?

“I like GoReact a lot,” he confessed. “So I surveyed our students, and I looked at how prepared they were after the health assessment video. My survey results all came back pretty strong. The process itself helps students learn and was very good hands-on practice.”

Bumbach has been surprised multiple times at just how much his students liked GoReact too. In fact, they went out of their way to tell him even after the semester was over.

“So you know when the semester is done, basically students owe you nothing? But people actually came to my office, saw me sitting there, and said, ‘Listen man, I just want to tell you how good that final project was.’ So I had some really good anecdotal evidence.”

Researching GoReact

The favorable results from the survey and his students have prompted Dr. Bumbach to explore the reach and results of video feedback in the nursing field. Although his research is still coming together, so far everything he’s found has come back positive.

Currently Bumbach is researching the product and gathering official data to prove how well GoReact works in the classroom and beyond. Although his findings are still preliminary, Bumbach is already enthusiastic to share what he’s finding:

“I was able to take my data to my administration and say, ‘Hey guys, what do you think about this? It looks pretty solid.’ It impressed them also. I’ve talked to several colleagues that I think will start implementing it, even at other universities. If it works and it creates good nurses, that shouldn’t be a chain secret.”

Bumbach looks forward to publishing and presenting his research at conferences since he knows he’s found a ground-breaking tool for nursing education. As he puts it, “We’ve got an innovative method that may really help strengthen nursing faculty because of the nursing faculty shortage. The constraints that we have associated with patients and patient care, I think that this has a lot of potential to turn that around in nursing education and make online nursing education better.”

GoReact Nursing

Looking to the Future

As Dr. Bumbach has grown more enthusiastic about GoReact, he’s now opening his mind to the many types of activities this tool could support in his course.

“I can see there’s many different ways of using it in the undergrad and graduate program,” said Bumbach. “So far, I just started with the big health assessment project. How about having somebody record their office visits with patients? Or how about with the nursing student learning the body systems? GoReact has a lot of opportunity in nursing.”

Kocher is also eager to introduce GoReact to more departments so more faculty in more subjects can start using video feedback at UF:

“I shared GoReact with pharmacy because they have labs as well. It’s already used for business and sign language courses, and I mentioned it to our public health and health professions because they have an audiology program and speech therapy. There’s definitely uses all over campus.”

Whether it’s greater reach at the University of Florida or deeper penetration in the College of Nursing, both Bumbach and Kocher plan to share GoReact again and again without reservation. When asked to sum up his overall feelings about GoReact, Bumbach expressed, “This is such a good product. The data is so strong that you guys have something great.”

For more information on the University of Florida, check out their official website. And to read about other schools trying GoReact, you’ll love our case study on the teacher education program at University of West Alabama.



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