Hands-on really cements the skills in the students brain. How 'bout a homework assignment if you can't get to a skills lab during class time. Not easy at the upper levels ( my husband just wont let me do a needle decompression on him, go figure), but as far as taking vitals, let them practice on friends and family and get documentation ( with signatures from "patients) ) to prove they have done the skill...something like 10 complete sets of vitals a week. Or improvise at home with splinting materials and have them take a picture of what they did. Get creative...the students will moan about it a lot at first, but they will GET IT by the time it comes to do it for real.
just a thought,
cranberry