Transforming graduate nursing education during an era of social distancing: Tools from the field

Online education isn't the best choice: evidence-based medical education in the post-epidemic era-a cross-sectional study

BACKGROUND

The COVID-19 pandemic led many educational institutions to shift to online courses, making blended education a significant trend in teaching. We examined the effectiveness of blended learning in an evidence-based medicine course.

METHODS

We compared the examination scores of a blended learning group, an online only group, and a traditional offline group and conducted a questionnaire survey on students' preferences for different learning modes and the reasons for their preferences. A total of 2100 undergraduate students in clinical medicine were included in this cross-sectional study. Examination results were collected, and questionnaires were administered to the study participants. We compared the mean scores and exam pass rates of the three teaching groups using ANOVA and c2test for multiple comparisons.

RESULTS

The blended group's exam scores and pass rate were significantly higher than those of the offline and online groups. Furthermore, 71.6% preferred the blended teaching mode. In the survey on " learning effectiveness", the majority of the students believed that blended education could better enhance the initiative of learning, the interest of the course, the pertinence of the learning content, the comprehension of evidence-based medical thinking, and the basic skills of evidence-based practice. Subsequently, in a questionnaire administered to a blended group of students, their foremost reason for liking online instruction was 'flexible in time and space' (99%), followed by 'can be viewed repeatedly, facilitating a better understanding of knowledge points' (98%). Their foremost reason for liking offline teaching was 'helps to create a good learning atmosphere' (97%), followed by 'teachers can control students' learning status in real time' (89%).

CONCLUSIONS

This study explored the effectiveness of learning in evidence-based medicine courses by comparing the learning outcomes and personal perceptions of three different teaching modes. This is the first cross-sectional study in which three different teaching models are compared and discussed in an evidence-based medicine course. We also elaborate on the specific instructional protocols for each model. This study shows that using a blended education approach in evidence-based medicine courses can improve students' learning motivation, autonomy, and satisfaction. It also enhances instructional efficiency, thereby improving students' understanding of the course content.

Virtual Practical Examination for Student Nurse Educators in Health Sciences Education during the COVID-19 Pandemic: A Narrative Review

(1) Background: There is a gap in the literature that explores challenges and opportunities relating to virtual or e-assessment health science education with particular relevance to the Health Sciences Education practical examination for student nurse educators. Therefore, this review aimed to address this gap and provide recommendations for enhancing identified opportunities and for overcoming identified challenges.; (2) Methods: The review was conducted across Google Scholar, PubMed/MEDLINE, Science Direct, Directory of Open Access Journals, Complementary Index, SCOPUS, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) with the intention of identifying opportunities and challenges presented by e-assessment in the HSE practical examination for student nurse educators during the COVID-19 pandemic.; (3) Results: The following aspects are discussed: (1) opportunities, including benefits, for both student nurse educators and facilitators and opportunities for Nursing Education; and (2) challenges, including issues with accessibility and connectivity as well as the attitudes of both students and facilitators.; (4) Conclusions: Despite challenges which included connectivity issues that led to frustration and stress, the unpreparedness and attitudes of students and facilitators, there are some opportunities that have emerged from e-assessment that can be beneficial to both the students and the facilitators, as well as the institutions. These include a reduced administrative burden, improved teaching and learning, and immediate feedback from facilitators to students and from students to facilitators.

Predictors of undergraduate occupational therapy students' academic performance during the Covid-19 pandemic: A hierarchical regression analysis

BACKGROUND

The rapid switch to online learning in response to the Covid-19 pandemic affected occupational therapy students' education delivery. It is, therefore, important to investigate these impacts.

AIMS/OBJECTIVES

This study investigated the potential predictors of academic performance in undergraduate occupational therapy students after moving to online or blended learning post-Covid-19.

MATERIAL AND METHODS

A total of 208 students from three Australian universities completed a demographic questionnaire and the Distance Education Learning Environment Scale (DELES). Hierarchical linear regression analyses were completed to identify significant students' academic performance predictors.

RESULTS

Hierarchical regression explained a cumulative total variance of 24.6% of students' academic performance. The following independent variables were significant predictors: DELES student autonomy (p = 0.033), number of hours per semester week dedicated to indirect online study (p = 0.003), number of hours per semester week dedicated to indirect offline study time (p = 0.034), gender (p = 0.005) and English as a first language (p = 0.045).

CONCLUSIONS

The findings add to the knowledge base on the range of factors that have impacted occupational therapy students' academic performance during the Covid-19 pandemic.

SIGNIFICANCE

The outcomes will assist faculty in developing supportive and pedagogically sound learning modes across online, hybrid and traditional forms of instruction within occupational therapy curricula.

The Theory-Practice Gap in Nursing Education During the Pandemic Period from the Perspective of Stakeholders: A Qualitative Study

Objective: The purpose of this study was to understand the experience of theoretical and practical nursing education carried out by distance education during the COVID-19 pandemic and the theory-practice gap in nursing education in Turkey. Methods: This qualitative study used a descriptive qualitative study. This research was conducted with nursing lecturers and students from two universities in two different geographical regions. Lecturers and undergraduate students participated in the research. The data for the research were collected using the online Zoom program during four focus-group discussions. Results: Three main themes emerged for the categories of theoretical and practical education emerged during the study: strong structural conditions (technological integration and accessibility) both strong and weak structural conditions (asynchronous participation and changing comfort levels/routines) and weak structural conditions (cold contact and inequality of opportunity). Conclusion: This study revealed the strengths and weaknesses in the experience of distance nursing education and will guide future planning of nursing education programs and clinical fields.

'Learning in and out of lockdown': A comparison of two groups of undergraduate occupational therapy students' engagement in online-only and blended education approaches during the COVID-19 pandemic

Introduction

In many countries, the COVID‐19 pandemic resulted in sudden changes to the delivery of health professions education in response to local and national lockdowns. Within occupational therapy, university education programs traditionally delivered in face‐to‐face classroom, and clinical settings, the transition to online learning presented unique issues and challenges for faculty and students. This study compared the experiences and perceptions of learning in two groups of occupational therapy students during the pandemic: one group converted to online learning only and the other had a blended approach that combined face‐to‐face on‐campus learning with some online lecture content delivery.

Methods

Two hundred and eight (n = 208) undergraduate occupational therapy students from three Australian universities completed an online self‐report demographic questionnaire and two standardised instruments: the Student Engagement in the e‐Learning Environment Scale and the Distance Education Learning Environment Scale. An independent‐samples t test with bootstrapping was completed to examine differences in students' scores.

Results

Statistically significant differences were observed between the online and blended learning groups across a range of the SELES and DELES subscales. The strongest findings related to psychological motivation (p = 0.001), personal relevance (p = 0.001), interactions with instructors (p = 0.002), instructor support (p = 0.001), student interaction & collaboration (p = 0.001), and cognitive problem solving (p = 0.001).

Conclusion

Occupational therapy students who transitioned to online‐only learning experienced higher levels of motivation, interactions with instructors and peers, and self‐directed learning than students who experienced a blended education delivery approach of face‐to‐face and online learning. The findings extend educators' understanding of the matrix of factors that have impacted students' education during COVID‐19 and support the development of contemporary and pedagogically sound online and traditional modes of occupational therapy instruction. The results provide evidence of the importance of well‐structured programs that facilitate active and flexible learning, provide meaningful and positive experiences, and promote initiatives safeguarding social and personal well‐being. Further research in this area is recommended.

Exploring the Effect of COVID-19 on Graduate Nursing Education

Graduate nursing students are both nurses and adult learners. During the COVID-19 pandemic, many found themselves working on the frontlines while maintaining their studies and confronting challenges in their professional, educational, and personal lives. Changes in work environments, including redeployments, increased hours, and furloughs, challenged their work-study balance. The rapid pivot to virtual instruction allowed graduate nursing students to continue their coursework, but asynchronous delivery of course content increased their isolation and stress. Academic institutions supported graduate nursing students through innovations such as regular town hall meetings and flexible attendance policies, while the widespread closure of clinical learning sites became one of their biggest challenges. A minimum of 500 hours of supervised direct patient care is required to prepare a student to practice as a nurse practitioner, but there is no formal, financed clinical placement system for nurse practitioner students-leaving this clinical learning requirement particularly vulnerable to disruption during the pandemic. Some of the clinical learning alternatives employed included occupational health work, tele-precepting, and simulation. Since telehealth will be a part of the future of health care delivery, tele-precepting practices should be further developed, but simulation was underused and not an acceptable replacement for supervised direct patient care. A postpandemic future needs to limit gaps in the development of safe, competent health care providers by viewing graduate nursing students as essential workers and ensuring their access to the robust didactic and clinical learning opportunities that will best position them as leaders in health care.

Nursing education in the pandemic: A cross-sectional international study

BACKGROUND

The COVID-19 pandemic has raised the need for distance learning in nursing education. The necessary precautions have been taken in nursing schools involving the application of various restrictions, including the suspension of face-to-face classes and the closure of educational institutions, and this has had a profound effect on nursing educators and nursing students alike.

OBJECTIVES

The study seeks to answer the following questions: DESIGN: descriptive, cross-sectional, multicentered and international study.

SETTINGS

An online survey was completed by 30 nursing educators working in establishments listed among the top 60 highest-ranked nursing schools in the world.

PARTICIPANTS

nursing educators in undergraduate nursing programs.

METHOD

An internet-based survey comprising open-ended and multiple choices questions was disseminated to 60 nursing schools on the 2020 QS World University Ranking list.

RESULTS

Survey responses were received from 30 nursing schools in 30 countries. Since the announcement of the pandemic, the structure of distance education in nursing has taken different forms from one country to another, and nursing educators and students alike have encountered a diversity of problems during this process. The findings of the present study reveal that 65% of the nursing educators thought that they had been caught unprepared for the COVID-19 outbreak, 44% thought that the nursing program outcomes had been achieved through distance education, and 48% encountered Internet-related problems.

CONCLUSION

We believe that the present study will (i) aid in the decisions of nursing educators considering a transition to distance education, provide suggestions to those that have already made such a transition or inspire those seeking to improve the effectiveness of practice in obligatory cases, (ii) serve as a guide for educational institutions, and (iii) contribute to the taking of precautions to counter potential problems.

Student Interviews Exploring the Influence of the Coronavirus Pandemic on Graduate Nursing Education

Introduction

Advanced practice nurses are needed to fill the primary healthcare gap in the United States. Advanced practice/graduate nursing students were profoundly affected by the coronavirus pandemic in ways that may impact their educational experience.

Objective

The objective of this study was to explore the influence of the coronavirus pandemic on the educational experience of graduate nursing students.

Methods

An exploratory descriptive qualitative study using semistructured video conferencing interviews of 11 graduate nursing students at one university in the United States was conducted during July 2020. Data were explored using theme analysis.

Results

Four themes expressing the pandemic's impact on graduate student experience were identified: Alteration in human connections; Agility in action; Collaborative construction of change; and Metamorphosis emerging from disruption. The pandemic brought an alteration in how students connected with faculty, other students, and family. Many faculty and students responded with agility to the new mandates for social distancing. The students and faculty worked together to construct changes needed to provide the students with the required components of graduate education. These factors together created a metamorphosis in the functioning of the institution, breaking through hierarchical barriers in academia.

Conclusion

The disruption in graduate nursing education due to the pandemic led to opportunities, including swift faculty innovation, a collaborative spirit between faculty and students, and new appreciation for connections with faculty and fellow students. Continuing intentional implementation of these opportunities would benefit students' experiences moving forward.

The Impact of the COVID-19 Global Pandemic on Undergraduate Nursing Students' Study of Anatomy and Physiology

The COVID-19 global pandemic caused major disruptions to the delivery of human Anatomy and Physiology courses to nursing students worldwide. The aim of the current study is to evaluate nursing students' experiences and perceptions of transitioning from a blended to a purely online study mode for first year Anatomy and Physiology courses during the global pandemic. Qualitative and quantitative methodologies were used with a sample of undergraduate nursing students enrolled at a regional Australian university across its three campuses. Descriptive statistical analysis was used to describe the study population. Content analysis was used to evaluate the participants' use of resources, experiences, and preferences in studying anatomy and physiology. There were 101 participants recruited in the study. Results indicated that face-to-face study mode (41.86%) was the preferred method of delivery during the global pandemic and participants were having a renewed appreciation for the blended study mode (38.37%). Online study mode was the least preferred (19.77%), with the participants' opinions of this mode of study not altered by the global pandemic. Although the COVID-19 global pandemic shifted the traditional teaching of anatomy and physiology in nursing programs to an online environment, the long-term impacts of this disruption have yet to be ascertained.

Impact of COVID-19 on public health nursing student learning outcomes

BACKGROUND

The COVID-19 pandemic has highlighted the importance of a strong, effective public health nursing workforce while also requiring public health nursing faculty to adapt teaching strategies as courses transitioned online. It is essential to understand how the pandemic-enforced transition from face-to-face to remote learning impacts student outcomes. The purpose of this paper is to compare student learning outcomes in a pre-licensure public health nursing course before, during, and after the transition to remote learning.

METHODS

Descriptive statistics were computed for assignments, exams, and final course grades for three terms (Fall 2019, Spring 2020 and Fall 2020).

RESULTS

Analysis showed statistically significant differences between terms for assignments and exams but not the final course grade. However, these differences were driven by small standard deviations rather than differences between mean scores demonstrating that there was actual little difference in student learning outcomes across terms.

CONCLUSIONS

Authors suggest strategies to support consistent academic outcomes and future research needed understand student learning outcomes during the pandemic; ultimately building the public health nursing workforce necessary to address the current and future public health crises.

Impact of emergency remote teaching on nursing students' engagement, social presence, and satisfaction during the COVID-19 pandemic

Background

The COVID‐19 pandemic interrupted face‐to‐face education and forced universities into an emergency remote teaching curriculum. Studies show that students’ engagement, social presence, and satisfaction are critical factors for optimal online teaching.

Purpose

Therefore, in this study, we sought to understand how the sudden transition to emergency remote teaching impacted nursing students’ engagement and social presence, as well as how it affected their satisfaction with online courses in a middle‐eastern public university.

Methods

A cross‐sectional descriptive correlative research design was adopted in this study. Data were collected through three questionnaires measuring students’ engagement, social presence, and satisfaction with emergency remote teaching compared to the traditional approach from a sample of 177 nursing students.

Results

Results indicate that students had a high level of engagement but low social presence and low satisfaction level with emergency remote teaching. Additionally, both engagement and social presence were positively associated with satisfaction.

Conclusion

Our findings support the importance of engaging students and integrating social presence strategies into online courses to enhance nursing students’ satisfaction.

Spanish nursing and medical students' knowledge, confidence and willingness about COVID-19: A cross-sectional study

BACKGROUND

COVID-19 challenges world governments. In Spain, measures to contain the pandemic are novel, and include the possibility of contracting Nursing and Medical students who might not be ready or willing to treat infected cases.

OBJECTIVES

To study Spanish Nursing and Medical students' knowledge about COVID-19 community transmission prevention measures, treating infected patients, and their confidence and willingness to treat cases. To learn their views about the first public health policy measures adopted by the Spain government to contain the pandemic.

DESIGN

Cross-sectional study.

SETTINGS AND PARTICIPANTS

237 Spanish Nursing and Medical students.

METHODS

An online questionnaire was designed on the knowledge, confidence and willingness to treat, and the suitability of the public health policy measures adopted in Spain. The data were collected through social networks. The results were compared according to their university degree.

RESULTS

Knowledge about community prevention was suitable, unlike knowledge about treating infected patients. Students had little confidence in treating cases, but their willingness and moral responsibility were high. Very few significant differences were found in their university degrees. Medical students evaluated the measures taken in Spain more favorably.

CONCLUSIONS

Students' knowledge about COVID-19 community prevention measures was adequate, but not about preventive measures when treating patients with COVID-19. They felt little confidence despite being willing to treat infected patients. The sample agreed with the public health measures adopted in Spain.

COVID-19: Knowledge, anxiety, academic concerns and preventative behaviours among Australian and Indian undergraduate nursing students: A cross-sectional study

AIMS AND OBJECTIVES

To compare knowledge, anxiety, academic concerns and preventative behaviours between undergraduate nursing students in Australia and India during the COVID-19 pandemic.

BACKGROUND

Based on the World Health Organization's direction for containment of the novel coronavirus (COVID-19), countries implemented varying levels of restrictions including closure of university campuses and providing on line undergraduate education.

METHODS

Students in NSW, Australia and Kerala, India completed an online survey assessing their (a) knowledge and source of information about COVID-19; (b) anxiety; and coping strategies; (c) academic concerns; and (d) preventative behaviours. Descriptive and inferential statistics were used to summarise the data.

RESULTS

Data from 99 Australian and 113 Indian undergraduate nurses were analysed. Greater number of Indian students indicated having sufficient knowledge of COVID-19 (OR 0.22; 95% CI 0.08, 0.63), getting information about COVID-19 from social media (OR 0.03; 95% CI 0.01, 0.07) and being concerned about 'attending clinical placement' (MD-1.08; 95% CI -1.94, -0.23). Australian students reported significantly higher levels of anxiety (MD 1.99 95% CI 1.21, 2.78), difficulty sleeping (OR 18.00; 95% CI 6.76, 47.96), concentrating (OR 33.22; 95% CI 13.85, 79.67) and eating (OR 14.05; 95% CI 3.19, 61.84). Greater number of Australian students indicated that they would go to the University if they needed to meet with other students (OR 9.21; 95% CI 3.08, 27.55), had to access the library (OR 7.20; 95% CI 3.26, 15.90) or had a group assignment (OR 2.93; 95% CI 1.26, 6.77).

CONCLUSIONS

Wide variations were present in knowledge, anxiety, academic concerns and preventative behaviours among undergraduate nursing students in two countries.

RELEVANCE TO CLINICAL PRACTICE

Undergraduate students may benefit from additional support from the University and staff in the clinical setting with online learning and resources in order to adjust to the 'new normal' and enable them to achieve academic success.

Implementing the National Incident Management System at schools of nursing in response to COVID-19

Unprecedented financial and logistical barriers in educating nurses during COVID-19 have threatened nursing education. The purpose of this article is to provide a template to facilitate the maintenance and stability of teaching and learning in a pandemic environment for nursing school administration and faculty leaders. The National Incident Management System (NIMS), previously used in training nurses for emergency preparation and response, has been applied as a guiding framework. The framework consists of five elements: Preparedness, Communication/Information Management, Resource Management, Command and Ongoing Management/Maintenance. This paper addresses how schools of nursing may apply each of these elements to address both the needs of the institution and community. The Comprehensive Vulnerability Management paradigm is further offered as a lens for professional development. Free preparedness education is showcased from leading nursing and healthcare professional and government organizations. Finally, the Quality and Safety Education for Nurses competencies are used for integrating NIMS and social dimensions of disaster. Such tools may equip academic leaders at schools of nursing to surmount challenges posed by the pandemic, and to ensure educational readiness to respond to global health crisis through use of the NIMS framework.

Experiences and needs of nursing students during pandemic outbreaks: A systematic overview of the literature

Background

Recent epidemics have placed overwhelming demands on health systems, leading at times to the deployment of nursing students during the crisis. Little is known about the impact this experience has on students. Although studies have explored nursing students' knowledge about infection control, there are no specific recommendations regarding how these issues should be addressed in nurse education.

Purpose

To conduct a comprehensive systematic overview of the literature concerning nursing students in the context of emerging infectious disease epidemics or pandemics caused by zoonotic viruses.

Methods

Systematic overview.

Results

Forty-eight articles were included. Five themes were identified: education; knowledge, concern about risk and preventive behaviour; willingness to work during a pandemic outbreak; experiences and emotional impact; and ethical dilemmas.

Conclusions

There is a need to enhance nurse education to ensure that students have adequate education in infection prevention and control and the opportunity to develop the skills and attitudes required to provide care to infected patients during a pandemic. The outcomes of these education programmes would need to be evaluated using valid and reliable instruments so as to enable comparisons to be made to prepare future nurses to deal with new pandemics in an increasingly globalized world.

Transitioning from direct care to virtual clinical experiences during the COVID-19 pandemic

When the COVID-19 pandemic forced university campuses and healthcare agencies to temporarily suspend both undergraduate and graduate direct care educational experiences, nursing programs had to formulate alternative plans to facilitate clinical learning. Texas Woman's University used this opportunity to assemble a faculty group tasked with creating a set of college-wide guidelines for virtual simulation use as a substitution for traditional face-to-face clinical. The process included completing a needs assessment of both undergraduate and graduate level programs across three campuses and identifying regulatory requirements and limitations for clinical experiences. The task force utilized the information gathered to develop evidence-based recommendations for simulation hour equivalence ratios and compiled a list of virtual activities and products faculty could use to complete clinical experiences. Undergraduate and graduate student surveys were conducted to determine the effectiveness of the transition to virtual clinical experiences. Overall, the majority of survey results were positive regarding virtual simulation experiences providing students with valuable opportunities to enhance their learning. Negative comments regarding the impact of COVID-19 on a personal level included issues involving internet access and web conferencing logistics, lack of motivation to study, family difficulties, and faculty inexperience teaching in an online environment. Undergraduate pre-licensure students were provided with opportunities to successfully complete all remaining required clinical hours virtually, while graduate students were allowed to complete non-direct care hours as applicable using virtual clinical experiences.

Academic caring pedagogy, presence, and Communitas in nursing education during the COVID-19 pandemic

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Strong faculty academic human caring presence is paramount during the exponential use of asynchronous, remote learning during the COVID-19 pandemic.

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Caring pedagogy, presence, and Communitas support the holistic learning and teaching needs of nursing higher education in times of global crisis.

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A theory-guided, holistic caring pedagogical approach is offered to augment remote learning pedagogy and to further humanize remote learning.

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Suggested caring and narrative pedagogical approaches aim to support student success during such times of immense stress and crisis.

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Creation of Caring Spaces and other modalities to transcend physical distancing of faculty and students are offered to humanize remote or online teaching and learning and to nurture togetherness, or Communitas, within the virtual classroom.

Background

Strong faculty academic human caring presence is paramount during the exponential use of asynchronous, remote learning during the COVID-19 pandemic.

Purpose

The purpose of this article is to provide a holistic, theoretical foundation for evidence informed-caring pedagogical practices.

Methods

Watson's (2008; 2018) Unitary Caring Science theoretical approach offers one pedagogical caring framework for advancing teaching-learning in the digital age.

Discussion

Examples to humanize the virtual classroom and remote or online teaching include narrative, theory-guided pedagogical approaches, such as creation of caring spaces and other modalities to transcend physical distancing and nurture Communitas (caring community) among of faculty and students.

Conclusion

A theory-guided, holistic caring pedagogical approach supports the needs of both faculty and nursing students.