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  1. Telehealth technologies play a vital role in delivering quality healthcare to patients regardless of geographic location and health status. Use of telehealth peripherals allow providers a more accurate method of collecting health assessment data from the patient and delivering a more confident and accurate diagnosis, saving not only time and money but creating positive patient outcomes. Advanced Practice Nursing (APN) students should be confident in their ability to diagnose and treat patients through a virtual environment. This pilot simulation was completed to help examine how APN students interacted in a simulation-based education (SBE) experience with and without peripherals, funded by the National Science Foundation’s Future of Work at the Human-Technology Frontier (FW-HTF) program. The SBE experience was created and deployed using the INACSL Healthcare Simulation Standards of Best PracticesTM and vetted by a simulation expert. APN students (N = 24), in their first assessment course, were randomly selected to be either a patient (n = 12) or provider (n = 12) in a telehealth simulation. Student dyads (patient/provider) were randomly placed to complete a scenario with (n = 6 dyads) or without (n = 6 dyads) the use of a peripheral. Students (providers and patients) who completed the SBE experience had an increased confidence level both with and without the use of peripherals. Students evaluated the simulation via the Simulation Effectiveness Tool-Modified (SET-M), and scored their perception of the simulation on a 1 to 5 point Likert Scale. The highest scoring areas were perceived support of learning by the faculty (M=4.6), feeling challenged in decision-making skills (M=4.4), and a better understanding of didactic material (M=4.3). The lowest scoring area was feeling more confident in decision making (M=3.9). We also recorded students’ facial expressions during the task to determine a probability score (0- 100) for expressed basic emotions, and results revealed that students had the highest scores for joy (M = 8.47) and surprise (M = 4.34), followed by disgust (M = 1.43), fear (M = .76), and contempt (M = .64); and had the lowest scores of anger (M = .44) and sadness (M = .36). Students were also asked to complete a reflection assignment as part of the SBE experience. Students reported feeling nervous at the beginning of the SBE experience, but acknowledged feeling better as the SBE experience unfolded. Based on findings from this pilot study, implications point towards the effectiveness of including simulations for nurse practitioner students to increase their confidence in performing telehealth visits and engaging in decision making. For the students, understanding that patients may be just as nervous during telehealth visits was one of the main takeaways from the experience, as well as remembering to reassure the patient and how to ask the patient to work the telehealth equipment. Therefore, providing students opportunities to practice these skills will help increase their confidence, boost their self- and emotion regulation, and improve their decision-making skills in telehealth scenarios. 
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