Problem: Online distance education has become the wave of the future in higher education. Students in the face-to-face classroom environment were able to use voice, body language, and facial expressions of the instructor to add to the feedback experience as part of their learning. The online experience was usually conducted in a text only environment and lacked those cues. Although software programs existed for audio and visual interaction from the instructor to the student, these programs were costly, required orientation for use, and entailed increased time to implement within a course. However, use of audio-visual technology would be an important application to explore for individualized feedback in the online environment. Purpose/Scope: The purpose of this capstone project was to investigate student satisfaction with instructor-student interaction with the addition of audio-visual instructor feedback in a graduate online nursing practicum course. Goal: The goal of the project was to successfully implement an audio-visual feedback intervention in response to submitted Practicum Journal entries and to measure online student satisfaction with this additional intervention. Objectives: Project objectives included to describe aggregate demographic characteristics of practicum graduate nursing students, to describe pre-intervention student satisfaction with instructor-student interaction, and to describe post-intervention student satisfaction with instructor-student interaction. Plan: Phase One: Conducted a literature review/needs assessment using a published evidence-based critique template. Phase Two: Secured an instrument for measuring student satisfaction with interaction in online courses. Phase Three: Obtained IRB approvals from Rocky Mountain University of Health Professions and the university. Implemented project and collected data. Phase Four: Evalutated student satisfaction with interaction in online course utilizing the Sherry, Fulford, and Zhang Interaction Instrument and an anchor question in Likert scale format. Outcomes and Results: A total of 28 students completed both the pre-intervention and post-intervention online surveys. Statistically significant mean scores were not discovered between the pre-intervention survey and the post-intervention survey for the 14 Interaction Instrument question responses. However, the anchor question that identified the students’ current level of satisfaction with interaction in online graduate nursing courses revealed a statistically significant difference in means from the pre-intervention survey to the post-intervention survey responses. Furthermore, unsolicited email and course evaluation positive responses to the addition of audio-visual feedback received by the course faculty indicated appreciation of inclusion of the audio-visual feedback in the course.