Dissertations, Theses, and Capstone Projects

Date of Degree


Document Type


Degree Name





William Samuels

Committee Members

Juan Battle

Patti Simino-Boyce

Eileen Gigliotti (Initial committee)

Subject Categories

Curriculum and Instruction | Educational Methods | Health and Physical Education | Nursing | Other Medicine and Health Sciences | Public Health | Telemedicine


Health literacy, associate degree nursing students, telesimulation, experiential learning, confidence, application, nursing curricula


Background: Assessing and addressing health literacy (HL) in patients is an essential role of the nurse and a critical component of nursing student education. Yet, large gaps exist within nursing school curricula with regard to the development of HL knowledge and skills, and the confidence to implement practices that target HL. Furthermore, effective training modalities that examine the transformation of nursing students’ knowledge into practice through the development of confidence during experiential learning have not been well explored.

Purpose: Evaluate the effectiveness of a HL information and a HL telesimulation intervention on the HL Knowledge, Application and Confidence of first-semester nursing students using Kolb’s Experiential Learning Theory (ELT) as the theoretical framework.

Method: Using a repeated measures design, in Fall 2021, three CUNY AAS nursing programs were randomly assigned to the intervention and control arms: no-treatment group (City Tech, Group 1, n = 52); HL information only intervention group (BMCC, Group 2, n = 72); and a HL information plus telesimulation intervention group (QCC, Group 3, n = 54). The HL-Knowledge, Application and Confidence Scale (HL-KACS) measured the outcome variables. Groups 2 (BMCC) and 3 (QCC) received a 1- hour online HL education intervention and each participant in Group 3 (QCC) engaged in a 30-minute HL telesimulation intervention with a standardized patient. All students completed the HL-KACS at pretest: prior to planned interventions and at posttest: three weeks after the HL telesimulation intervention.

Results: The results of the HL-KACS pre- and posttest analyses showed that HL Knowledge scores in both the information-only and information + telesimulation groups improved and were significantly higher than the no-treatment group’s scores. The information + telesimulation group’s HL Knowledge and Confidence scores were also higher than the no-treatment and information-only groups but the results were not significant. Additionally, the information + telesimulation group’s HL Application scores were significantly higher than the no-treatment and information-only groups.

Conclusions/Implications: New knowledge generated from this study expands upon prior research in HL Knowledge, and builds a new knowledge base for HL Confidence, HL Application, and telesimulation. The results of this study suggest that participating in a knowledge-based HL information intervention and an experiential-based telesimulation intervention together can be an effective technique to improve HL knowledge, confidence and application in nursing students. Moreover, using first semester nursing students with no prior nursing experience as the study sample coupled with the study’s interventions embedded within Kolb’s ELT provides a feasible modality for training healthcare workers in various settings across the world.

This work is embargoed and will be available for download on Saturday, September 30, 2023

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