Nursing students' and faculty members' experiences of online education during COVID-19 across Southeast Asia: A Photovoice study

Lifestyles and Academic Stress in University Students of Health Sciences: A Mixed-Methodology Study

The global health emergency generated by the COVID-19 pandemic (caused by the SARS-CoV-2 virus) led to the implementation of extraordinary measures such as confinement and isolation in many countries to mitigate the spread of the virus. (1) This study analyzes the lifestyles and academic and perceived stresses of university students of health sciences during the period of online learning due to the COVID-19 pandemic. The relationship between lifestyles and academic stress was examined. (2) A parallel mixed-method convergent study was conducted, with a correlational non-experimental design. Quantitative and qualitative data were collected and analyzed in parallel, with parametric and nonparametric testing for quantitative data and Miles and Huberman's approach to qualitative analysis. The qualitative findings complemented the quantitative results. The number of students who participated in this study was 2734, from six programs in health, nursing, medicine, clinical laboratory, physiotherapy, dentistry, and clinical psychology at the University of Chimborazo, Ecuador. (3) Overall, the health science students had "Unhealthy or health-compromising lifestyles", medical students being the ones who have healthier lifestyles. However, more than 80% experienced and perceived stress during the period of online learning and social isolation due to the pandemic, women being the ones who experienced it at a higher level. (4) The online learning modality during the COVID-19 pandemic modified lifestyles and generated stress in health science students, due to changes in daily routines, sedentary lifestyle, and stress, as a result of social isolation. Therefore, the students prefer face-to-face teaching, perceived as enabling more enriching interactions with their teachers and peers and the opportunity to develop essential practical skills in their health practice.

Student nurses' experiences of remote learning during Covid-19 pandemic: A qualitative evidence synthesis

AIM

To systematically synthesize undergraduate student nurses' experience of online, blended or distance learning during Covid-19 pandemic.

DESIGN

A qualitative evidence synthesis (QES).

REVIEW METHODS

A QES. Themes were organized using the 'best fit' framework approach. Methodological limitations and confidence in the review findings were informed by GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research).

DATA SOURCES

Qualitative literature from five databases including CINAHL, PubMed, Medline, Education Full Text (H.W. Wilson) and ERIC were searched from March 2020 to November 2021.

RESULTS

Nine qualitative and two mixed method studies were included in this 'best fit' framework using Chickering and Gamson's Seven Principles for Good Practice in Undergraduate Education. Importance of the social presence of the teacher through effective communication and interpersonal relationships is highlighted. Clinical placement and in-person practical skills training are needed for effective nursing education.

CONCLUSIONS

This review highlighted that online content can be developed into efficient and high-quality learner-centred education within blended undergraduate nursing programmes incorporating essential face-to-face and practical components. Various supporting measures are required for both students and faculty. We suggest an adaptation of a 'Blending with Purpose: The Multimodal Model' with key considerations for undergraduate nursing programmes where pedagogical objectives and activities drive the approaches to achieve intended learning outcomes and student satisfaction.

IMPLICATIONS FOR THE PROFESSION

Well-designed online programmes using digital tools that support interaction and teamwork are required for undergraduate nursing education.

IMPACT

Blended learning approaches offer more flexibility than online learning alone which leads to improved student engagement. Clinical placement and in-person practical skills training are needed for effective nursing education. REPORTING METHOD: 'Enhancing transparency in reporting the synthesis of qualitative research' (ENTREQ) for QES.

NO PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Insights from a multi-country study: Lessons for future nursing education from community clinical practice amid the COVID-19 pandemic

Background

The COVID-19 pandemic prompted adjustments in education, raising concerns about students' competency achievement. Despite these changes, aspects like student engagement (SE), basic needs fulfillment (BNF), and stress levels (SL) in nursing students during community-based clinical practice remain understudied.

Objectives

This study aims to examine the relationships between students' competencies achievement (SCA), student engagement, basic needs fulfillment, and stress levels among nursing students engaging in community-based clinical practice during the COVID-19 pandemic.

Design

and Methods: A cross-sectional online survey was conducted with 451 nursing students from Indonesia, Malaysia, and India. Online questionnaires assessing SCA, SE, BNF, and SL were administered between November and December 2021.

Results

The study involved 131 participants from Indonesia, 138 from Malaysia, and 182 from India, with an average age of 22.52. Multivariate analysis, employing linear regression revealed that across the three countries, online student engagement demonstrated the strongest association with SCA (B: 0.701; p-value: 0.0001). However, specific factors-stress levels, learning methods, and study year-showed greater relevance in Indonesia, India, and Malaysia, respectively.

Conclusions

The COVID-19 pandemic significantly impacted nursing students' teaching and learning experiences during clinical practice. Enhancing online engagement between academic lecturers and students is imperative for attaining clinical competencies.

Expectations, experiences and challenges of nursing students using the virtual learning medium during the COVID-19 pandemic: A descriptive phenomenological study

BACKGROUND

The COVID-19 pandemic caused several higher educational institutions to switch from traditional face-to-face to virtual learning medium. This abrupt shift came with new expectations, experiences and challenges to nursing/ midwifery students, particularly new users, and even more so when preparation, orientation, and support were lacking or ineffective. The present study therefore aimed at exploring the expectations, experiences and challenges of nursing students using the virtual learning medium during the COVID-19 pandemic.

METHODS

This was a descriptive phenomenological design using 12 purposively sampled nursing and midwifery students from a public university in Ghana. With the aid of a semi-structured guide, individual face-to-face interviews were audiotaped, transcribed verbatim at a later time and deductively analyzed into themes using the customer experience execution model.

RESULTS

Participants were aged 22-36 years and involved equal number of males and females (n = 6), with majority being Christians (n = 11). Six themes were generated from the study: (1) "Initial thoughts and emotions" described participants initial reactions to the virtual educational medium during the pandemic; (2) "Expectations with the virtual medium" referred to the participants' anticipations regarding the convenience offered by the virtual medium; (3) "Experiences with the virtual medium" depicted the participants' recognition of both positive and negative encounters while using the virtual learning platform; (4) "Evaluation and recommendation" described participants' reports of meeting expectations and recommendations they made to enhance virtual learning; (5) "Challenges and limitations of the virtual medium" typically represented the obstacles encountered by nursing/ midwifery students when they embraced the virtual medium; (6) "Prospects of the virtual medium" referred to participants' views on the future of the virtual medium.

CONCLUSION

The study has brought to light that the virtual education environment comes with its own expectations, experiences and challenges to students. Provision of adequate support such as orientation and simulation laboratories by higher education institutions to satisfy students' needs is necessary to enhance nursing education.

Alternative Clinical Practice Experiences of Korean Nursing Students during the COVID-19 Pandemic

Background: Routine clinical practice (RCP) experiences provide nursing students with the opportunity to gain confidence in their professional roles. The purpose of this study was to explore the alternative clinical practice (ACP) experiences of nursing students during the COVID-19 pandemic using the Q methodology. Methods: Fifty-two nursing students located in four cities across South Korea participated. The participants sorted the order of and ranked 41 Q statements about their experiences with ACP into a Q sort table; the data were analyzed using the PQ method. Results: The following three distinct viewpoints were extracted: (1) ACP helps with balancing learning and life (favorable view of ACP); (2) ACP does not help with balancing theory and clinical field practice (critical view of ACP); and (3) RCP cannot be replaced by ACP (negative view of ACP). Conclusions: The findings of this study indicate that developing a curriculum for clinical practice that can enhance the strengths of ACP while compensating for its weaknesses will help promote learning among nursing students.

Repercussions of the COVID-19 pandemic on Nursing training: A Scoping Review

to map the knowledge produced about the repercussions imposed by the COVID-19 pandemic on Nursing training. this is a Scoping Review, guided by the recommendations set forth in the Joanna Briggs Institute Reviewer's Manual and carried out in 15 electronic databases and theses and dissertations repositories. The protocol was registered at the Open Science Framework. The data were analyzed and synthesized into two pre-established analysis categories: positive and negative repercussions; and descriptive statistics. 33 publications identified, the most cited positive aspects were the development of new teaching strategies adapted to the virtual environment and the training of future professionals in clinical practice in the context of a health crisis. The negative repercussions are related to psychological issues such as increase in the cases of anxiety, stress and loneliness among the students. the diverse evidence suggests that remote teaching was a timely emergency way out for the continuity of academic training; however, this educational modality presented positive and negative aspects that need to be rethought for a better systematization of teaching-learning in other contexts that resemble the COVID-19 pandemic.

Nursing lecturers' perception toward E-learning approaches used in nursing colleges: Scoping review

BACKGROUND

Nursing colleges have traditionally taught students in hospitals and laboratories. COVID-19 compelled most nursing colleges to embrace e-learning without prior experience or preparation after 2020, which may influence nursing educators' views and attitudes toward its use.

OBJECTIVE

This scoping review explores the nursing educators' perception of the e-learning approaches used in nursing colleges.

DESIGN

A comprehensive review of five databases, Cochrane, Ebsco (Medline), PubMed, Science Direct, and Scopus, was conducted, adhering to the Joanna Brings Institute (JBI) standards full theme, utilizing preset eligibility criteria and adhering to the PRISMA Extension for Scoping review (PRISMA-ScR) recommendations.

METHODS

This scoping review examined studies published in English from January 1st, 2017-2022. Three reviewers evaluated the eligibility of the literature and retrieved data to address the research question from prior literature. A content analysis was done.

RESULTS

Thirteen articles with various hypotheses and models were reviewed. The review reveals that nursing educators are novices at using e-learning approaches in their classes due to their novelty in most nursing colleges. Nursing educators have a modest positive perception, with an optimistic perspective on e-learning effectiveness in theoretical course teaching, emphasizing that it is inappropriate in teaching clinical courses. The review demonstrates that e-learning faces numerous challenges that negatively impact educators' perceptions.

CONCLUSION

Institutional preparedness in terms of personnel through educator training, provision of necessary infrastructure, administrative support, and incentives are critical to improving the perception of the e-learning method and increasing its adoption in nursing colleges.

Generation Z nursing students’ online learning experiences during COVID-19 epidemic: A qualitative study

In early 2022, the coronavirus disease 2019 (COVID-19) continued to spread quickly globally and broke out in some metropolitan areas. To stop the spread of infection, all colleges and universities were shifted to a closed model, and higher education was transformed into online learning (OL). These transitions posed numerous challenges for Generation Z students, especially those in the nursing profession that featured face-to-face practice courses. This study aimed to explore and understand the experiences of OL among Generation Z nursing students during COVID-19 epidemic. This qualitative phenomenological research design applied a purposive sampling approach to enroll 14 Generation Z nursing students from a college. Data were collected and analyzed using in-depth, semi-structured interviews and Colaizzi seven-step method. The analysis demonstrated four themes and eleven subthemes: challenges encountered during OL, advantages perceived during OL, experience of loneliness and stress, and developing resilience during OL. This study concluded that the sudden shift in learning styles presents challenges to Generation Z nursing students. Despite the adversity, the students showed tremendous resilience and endurance. During the pandemic, educators should provide support measures based on the characteristics of Generation Z to improve the effectiveness of OL and respond positively to stress.

Communication and cooperation challenges in the online classroom in the COVID-19 era: a qualitative study

BACKGROUND

The increasing prevalence of COVID-19 affected all aspects of life, including education. Communication and interaction are vital in any form of education. This study explained health profession educators' and students' experiences regarding the challenges of communication and cooperation in exclusively online classrooms during the COVID-19 era.

METHODS

The present descriptive explanatory qualitative study examined health profession educators' and students' experiences with exclusively online classrooms during the COVID-19 era. They were included in the study by purposive sampling. In-depth and semi-structured telephone interviews were conducted to collect data. The content analysis presented by Graneheim and Lundman was used to analyze the data. The present study employed four strength criteria: credibility, confirmability, transferability, and dependability.

RESULTS

The results of the present study included communication and cooperation challenges in exclusively online classrooms related to the COVID-19 pandemic. Two themes emerged from 400 open codes: lack of students' socialization and communication-related concerns, which each had subcategories.

CONCLUSIONS

Lack of students' socialization and communication problems were identified as the participants' main experiences. Defects in teacher training due to the sudden transition to virtual education, acquiring a professional identity that is possible in in-person education was also flawed. The participants experienced challenges in their class activities, leading to a decrease in trust, a lack of motivation to learn from students, and teachers' teaching. Policymakers and authorities should adopt new tools and techniques to improve exclusively virtual education outcomes.

An Exploration of Psychological Resilience among Undergraduate Nursing Students Undertaking an Adult Nursing Virtual Practicum during the Coronavirus Pandemic in Taiwan: A Qualitative Study

This qualitative study aimed to explore the psychological resilience of undergraduate nursing students partaking in a virtual practicum during the coronavirus pandemic (COVID-19) in Taiwan. The virtual practicum, a form of online learning, creates challenges compared to the traditional teaching-learning experience of an actual clinical placement. Exploring how students overcome learning difficulties and build resilience is necessary for a new learning environment or for future online learning. Constructivist grounded theory and the Standards for Reporting Qualitative Research checklist were followed. Purposive and theoretical sampling were used to recruit 18 student nurses for data saturation. Semi-structured, face-to-face interviews were conducted individually to collect data. Initial, focused, and theoretical coding and constant comparative data analysis were performed. Credibility, originality, resonance, and usefulness guided the assessment of the study's quality. The core category of psychological resilience in the virtual practicum was constructed to reflect Taiwanese nursing students' progress and experiences of learning during the virtual practicum. This core category consisted of three subcategories: (i) learning difficulties within one's inner self; (ii) staying positive and confident; and (iii) knowing what is possible. The findings identified psychological resilience as an important factor for students to adjust to the adverse experiences of a rapidly changing learning environment, such as the virtual practicum. The substantive theory of psychological resilience provided a frame of reference for coping with possible future difficulties. Correspondingly, psychological resilience reflected individuals' potential characteristics and may help students to enter and remain in the nursing profession.

Navigating nursing curriculum change during COVID-19 pandemic: A systematic review and meta-synthesis

AIM

To consolidate the evidence around the experiences of nursing undergraduates and faculty members navigating through remote and online education during the COVID-19 pandemic.

BACKGROUND

The Coronavirus disease 2019 caused by the SARS-CoV-2 Virus (COVID-19) has placed massive pressure on healthcare, economic and education systems globally. Restrictive social distancing policies and public health measures necessitated educational institutions to switch from face-to-face to remote and online education to sustain the learning process. These changes have created an uncertain path and undue stress for healthcare learners and faculty, especially for professional roles that traditionally require more hands-on and access to clinical practice particularly pre-licensure nursing students. As such, there is an urgent need to consolidate evidence on the experiences of nursing undergraduates and faculty members as they navigate the rapid transition from face-to-face to remote and online education to ensure continuity of learning in achieving optimal learning outcomes and to support them during current and future public health crises.

DESIGN

A systematic review and meta-synthesis of the qualitative literature was undertaken using Sandelowski and Barroso's approach.

METHODS

Six electronic databases, CINAHL, Embase, ERIC, PsycINFO, PubMed and Scopus, were searched systematically using the eligibility criteria from December 2019 to September 2022. The Critical Appraisal Skills Program checklist for qualitative studies was used to conduct the critical appraisal of the selected articles.

RESULTS

Forty-seven studies were included in this review, which encapsulates the experiences of 3052 undergraduates and 241 faculty members. An overarching meta-theme 'Remote and online education: a rollercoaster ride', emerged along with three main meta-themes: (1) Transition to remote and online education: A turbulent road, (2) Acceptance of the untravelled road, (3) Hopes and recommendations for the road ahead.

CONCLUSION

To improve nursing undergraduates' and faculty member's navigation of remote and online education, more institutions should move towards establishing hybrid education as the new 'normal' and exercise prudence in the organisation and delivery of curriculum, teaching, well-being and clinical attachment contingencies of their healthcare courses.

A Meta-synthesis on Technology-Based Learning Among Healthcare Students in Southeast Asia

Healthcare education providers are eager to apply technologies in teaching and learning activities; however, students are the consumers in higher education, and their opinion and experience should be considered. We performed a meta-synthesis of qualitative studies to help inform our understanding of Southeast Asian healthcare students' perceptions and experience of technology-based teaching and learning in their education. Our search strategy located 1599 articles from a dozen electronic research databases. Articles were analyzed for quality using the Hawker's Evidence Appraisal Tool, and 23 qualitative studies were included in the final meta-synthesis. Technologies investigated largely involved online or blended learning, with fewer exploring virtual reality, simulations, telehealth, game-based learning, and videos. Three overarching themes were synthesized: (i) culture does matter in the implementation of technology-based learning; (ii) the values and limitations of technology used for learning; and (iii) technology is part of daily life and creates new challenges in education. Technology is an asset to enhance the learning experience, but educators must be aware of its limitations. Pre-coronavirus disease 2019 (COVID-19) studies were more focused on technology and product, and were optimistically reported, whereas COVID-19-spanning studies focused on life experience and paid more attention to reporting on the inherent challenges. The educational approaches, theories, cultural aspects, and availability of facilities all play a vital role in steering successful technology use in learning.