"Finding My Own Way": The lived experience of undergraduate nursing students learning psychomotor skills during COVID-19

Improving the psychomotor performance of student nurses using remote clinical skills practice: a mixed-methods study

INTRODUCTION

Innovative approaches are essential in nursing education to ensure the continuity of skill acquisition, particularly in situations where traditional face-to-face teaching methods are not feasible.

OBJECTIVE

This study aimed to evaluate the effectiveness of remote learning in enabling student nurses to acquire psychomotor skills, with a focus on 'blood pressure measurement'-a noninvasive procedure that can be practiced safely at home.

METHODS

Using an experimental design with group randomization and a mixed-method approach, 44 first-year nursing students participated, with 22 in the experimental group and 22 in the control group. After a theoretical course on blood pressure measurement, the control group followed a licensed video program, while the experimental group practiced with a simulated patient under an educator's guidance in an remote environment. The research was conducted between March 2021 and October 2021, encompassing all phases of the study. These phases included preliminary information, remote training, and feedback sessions in March 2021, the first assessment in April 2021, and the second assessment in October 2021. The 'Descriptive Characteristics Form,' 'Blood Pressure Measurement Skill Checklist,' and 'We Practice Remote Clinical Skills Together Online Comments Form' were used for data collection. Descriptive statistics (means, standard deviations, frequencies, percentages) and the Mann-Whitney U test were applied for quantitative data analysis, while qualitative data were analyzed inductively based on student opinions from both groups.

RESULTS

The first performance assessment showed no significant difference between the control and experimental groups' mean scores (p = 0.440). However, the second assessment revealed a significant difference favoring the experimental group (p = 0.001). The qualitative data were categorised into three main themes: emotions, learning and confidence, with a total of 34 codes. Emotions accounted for 50% of the codes, including happiness, stress, comfort and anxiety. Learning accounted for 41% and included awareness, interaction-communication, skill acquisition and information retention. Finally, self-confidence, represented by skill practice in the laboratory, accounted for 9% of the codes.

CONCLUSION

This study demonstrates that educator-guided remote skill training can positively impact students' psychomotor skill acquisition. It highlights the potential for effectively teaching specific nursing skills in remote environments when guided by an educator.

Simulated Practice Learning Experience in a Virtual Environment: An Innovative Pedagogical Approach to Practice Learning for Nursing Students

Background/Objectives: The use of simulated learning as a teaching approach has been used and embedded in nursing theoretical curriculum for many years. There is a wealth of evidence to support the positive impact simulated learning or simulated-based education can have on the student experience, developing skill competency and enhancing patient outcomes. However, the evidence on the use of simulation as a replacement for clinical practice learning in undergraduate nursing education is limited. In response to the challenges posed by the COVID-19 pandemic, the authors introduced virtual simulated practice learning experiences (SPLE) for a cohort of year one pre-registration adult and mental health nursing students. The SPLE project aimed to assess the effectiveness of simulated practice learning as a viable alternative to traditional clinical practice learning and to explore student satisfaction with the new practice learning experience approach. Methods: All year one student nurses attending the four simulated practice learning experience (SPLE) weeks were invited to participate and complete a generated questionnaire within the virtual practice environment on their final day of each SPLE week. The questionnaire employed a mix of both quantitative and qualitative questions across key areas to evaluate the effectiveness of the SPLE and explore student satisfaction with their overall practice learning experience. Results: A total of 216 students participated in the simulated practice learning weeks across the spring semester in 2023 with a response rate of 98-100% across all four SPLE weeks. Students reported an overall satisfaction score of 88%, highlighting their preparedness and positive feedback on the organisation, delivery, and content of the SPLE. Qualitative analysis revealed key themes, including the development of transferable skills and personal growth, the value of peer learning, the benefits of a virtual environment, and appreciation of service user and healthcare professional input. Students reported significant personal growth, improved communication skills, and a deeper understanding of holistic care through interactive and collaborative learning experiences. Conclusions: This evaluation underscores the innovative potential of simulated practice learning to enhance nursing practice education, emphasising the importance of integrating emerging technologies and diverse pedagogical approaches. The findings suggest that SPLEs can effectively prepare nursing students for the complexities of clinical practice while addressing the evolving demands of healthcare. Future research should focus on longitudinal studies to assess the sustained impact of simulated learning on clinical experiences and professional development.

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.

Nursing students' experiences of teaching and learning during the COVID-19 pandemic: a systematic review and meta-synthesis of qualitative studies

INTRODUCTION

During the COVID-19 pandemic, the sudden transition to virtual learning led to several challenges for nursing students. This study aimed to synthesis nursing students' experiences of teaching and learning during the COVID-19 pandemic.

CONTENT

A meta-synthesis of qualitative articles were conducted. Three online databases were searched from December 2019 to December 2022. Qualitative studies and qualitative sections of mixed method studies were included.

SUMMARY

Twenty-four qualitative studies and seven mixed-method studies were included in the review. The findings consisted of one main theme "educational transformation", and three categories "challenging face-to-face clinical training", "transition from face-to-face to virtual education", and "support continua". The evidence indicated that during this health-related crisis, most of the training was provided as distance learning in various forms. According to the findings, distance education alone cannot replace face-to-face education and is suggested to be considered as a supplementary learning method.

OUTLOOK

This study provides a comprehensive understanding of nursing students' experiences during the COVID-19 pandemic, offering practical implications for educators and institutions globally. The lessons learned can inform strategic decisions, policies, and practices to enhance the resilience and adaptability of nursing education in the face of unforeseen challenges.

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.

New Graduate Nurses Navigating Entry to Practice in the Covid-19 Pandemic

BACKGROUND

The Covid-19 pandemic has significantly impacted organizational life for nurses, with known physical and psychological impacts. New graduate nurses are a subset of nurses with unique needs and challenges as they transition into their registered nurse roles. However, this subset of nurses has yet to be explored in the context of the Covid-19 pandemic.

PURPOSE

To explore the experiences of new graduate nurses entering the profession in Ontario, Canada, during the Covid-19 pandemic approximately one year after entering the profession.

METHODS

Thorne's interpretive description method was utilized.

FINDINGS

All participants identified as completing second entry nursing programs, offering a unique perspective on new graduate nurse transition. Four themes emerged in the data: 'Virtual Didn't Cut It,' 'Go Where You Know,' 'Picking Up the Pieces,' and 'Learning When to Say No and Let Go.' Participants felt ill prepared to enter the profession and were cognizant of the various challenges facing the nursing profession, and how these pre-existing challenges were exacerbated by the pandemic. They acknowledged the need to protect themselves against burnout and poor mental health, and as such, made calculated early career decisions - demonstrating strong socio-political knowing. Half of the participants had already left their first nursing job; citing unmet orientation, mental health, and wellbeing needs. However, all participants were steadfast in remaining in the nursing profession.

CONCLUSIONS

Second entry new graduate nurses remain a unique subset of nurses that require more scholarly attention as their transition experiences may differ from the traditional trajectory of new graduate nurses.

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.