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. 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. 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.