What cannot be told: The impact of visual narratives on observational assessment skills

Recent trends have created a healthcare climate whereby the profession of nursing is expected to care for an increasing number of patients with various co-morbidities and complex healthcare needs. These trends have led to a reliance on technology and an imbalance between tasks and observation. Coupled with a shortage of professional nurses, this climate lends itself to potential delays in patient care delivery and unfavorable patient outcomes. Leading organizations have challenged nursing education to identify and implement strategies that will minimize unfavorable outcomes. Astute observational assessment skills are crucial to timely interventions, and therefore, have the potential to minimize unfavorable outcomes. Utilizing a pre- and post-test design, this experimental study examined one educational strategy that focused on a systematic analysis of visual narratives and the subsequent impact on observational assessment skills of undergraduate nursing students. Eighty-three undergraduate nursing students, drawn from accredited schools of nursing in the Midwest, were enrolled in the study. Study participants randomized to the experimental group engaged in five weeks of bi-weekly hour long sessions that focused on the skill of observation through a systematic analysis of visual narratives. An independent samples t-test revealed a statistically significant difference in the mean post-test scores between the control and experimental groups ( t (81) = t 9.539, p = .000). A paired samples t-test demonstrated an increase of 3.814 (95% CI, 3.415 to 4.213) on the post-test compared to the pre-test for the experimental group. The data supports the use of visual narratives as an educational strategy to strengthen and refine observational assessment skills. Strong observational assessment skills have the potential to enhance patient care delivery and minimize untoward patient outcomes. Implications for practice are numerous and include the integration of visual narratives into nursing education and various health care settings. Recommendations for future research include replication of the current study with a larger sample size to confirm the findings. Additionally, the current study could be replicated to strengthen other skill sets critical to the profession, or conducted utilizing a qualitative design to gain a broader understanding of how a systematic analysis of visual narratives impacts observational assessment skills.