Baccalaureate nursing students' experiences of how the COVID-19 pandemic influenced learning - a mixed method study

Perceived competences by graduated nurses before and during COVID-19 restrictions: A repeated cross-sectional study from 2019 to 2022

AIMS

To explore the differences, if any, in the competences perceived by newly graduated nurses who attended their education before and during the COrona VIrus Disease 19 (COVID-19) restrictions.

BACKGROUND

Nursing education has undergone significant changes because of the COVID-19 restrictions. However, to date the perceived competences at the point of graduation have not been investigated over the restrictions years compared with the pre-restrictions era.

DESIGN

A repeated cross-sectional study followed by a pseudo-panel analysis. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. Data on individual, nursing programme and perceived competences with Nurse Competence Scale (NCS) were collected and analysed by also using a pseudo-panel approach.

METHODS

Two universities were involved. Those eligible were nursing students who graduated: (1) in 2020 (=323) as the first post-COVID-19 group, who were studying in the 3rd year at the onset of the restrictions; (2) in 2021 (=250) as the second post-COVID-19 graduated group, who were in the 2nd year at the restrictions onset; and (3) in 2022 (=247) as the third post-COVID-19 group, attending the 1st year of nursing education at the onset of the restrictions. Data were compared with those who graduated in 2019 (=336, pre-COVID-19 group).

RESULTS

The overall NCS score was higher in the pre-COVID-19 group (68 out of 100, 95 % Confidence of Interval [IC] 66.4-69.5), lower in the first post-COVID-19 graduates (62.9, 95 % CI 60-65.8), higher in the second (66.6, 95 % CI 63.6-69.4) and lower again in the third post-COVID-19 group (63.8, 95 % CI 60.9-66.5). A sinusoidal pattern also emerged for the frequency of use of the competences from the pre-COVID-19 (2.3 out of 3) and the first group (2.1) and increased between the second and the third group (from 2.1 to 2.3) (p< 0.001). These sinusoidal trends are also evident in the pseudo-panel analysis.

CONCLUSIONS

A different degree of perceived competences at the point of graduation emerged, with higher competences in the pre-restrictions group, lower in the first post-COVID-19 generation, higher again in the second and third group. However, all scores were over 60 points out of 100, thus indicating sufficient competences. The frequency of use of such competences slightly changed over the years with limited practical relevance. The findings may inform reflections regarding innovations in the clinical placements pathways as well as in the strategies supporting newly graduates nurses in their transition from education to health-care settings.

Perspectives of Nursing Students on Hybrid Simulation-Based Learning Clinical Experience: A Text-Mining Analysis

Given the past limitations on clinical practice training during the COVID-19 pandemic, a hybrid format program was developed, combining a time-lapse unfolding case study and high-fidelity simulation. This study assesses the effectiveness of a new form of clinical training from the perspective of student nurses. A questionnaire was administered to 159 second-year nursing students enrolled in the "Basic Nursing Practice II" course. Text mining was performed using quantitative text analysis for the following items: (1) aspects that were learned more deeply, (2) benefits, and (3) difficulties encountered with the new practice format. The new clinical practice format enhanced participants' learning related to the daily changes required in nursing care and improved their nursing competency through simulated patient interactions. However, the participants faced difficulties dealing with patients accompanied by secular changes. Moreover, they found remote group work challenging. These findings can be applied to the development of new educational strategies.

Virtual simulation in healthcare education: a multi-professional, pan-Canadian evaluation

BACKGROUND

As we experience a shortage of healthcare providers in Canada, it has become increasingly challenging for healthcare educators to secure quality clinical placements. We evaluated the impact of virtual simulations created for the virtual work-integrated learning (Virtu-WIL) program, a pan-Canadian project designed to develop, test, and offer virtual simulations to enrich healthcare clinical education in Canada. Evaluation was important since the virtual simulations are freely available through creative commons licensing, to the global healthcare community.

METHODS

Students self-reported their experiences with the virtual simulations and the impact on their readiness for practice using a survey that included validated subscales. Open-ended items were included to provide insight into the students' experiences.

RESULTS

The evaluation included 1715 Nursing, Paramedicine and Medical Laboratory students enrolled in the Virtu-WIL program from 18 post-secondary universities, colleges, and institutions. Results showed most students found the virtual simulations engaging helped them learn and prepare for clinical practice. A key finding was that it is not sufficient to simply add virtual simulations to curriculum, careful planning and applying simulation pedagogy are essential.

CONCLUSION

Virtual simulation experiences are increasingly being used in healthcare education. Results from this rigorous, large-scale evaluation identified ways to enhance the quality of these experiences to increase learning and to potentially decrease the number of hours healthcare students need in clinical practice to meet professional competencies. Further research is needed regarding many aspects of virtual simulations and, in particular, curriculum integration and the timing or sequencing of virtual simulations to best prepare students for practice.

The Relationship Between On-Site Clinical Practice, Nursing Professional Value, and Nursing Clinical Self-Efficacy During COVID-19: A Cross-Sectional Study

Background

During COVID-19, nursing students experienced variations in on-site clinical practice, such as a combination of on-site and non-face-to-face clinical practice. Although on-site clinical practice is critical for increasing nurses' clinical self-efficacy and developing professional nursing values, there is a lack of knowledge that reflects the current clinical practice environment.

Aim

To examine the relationship between on-site clinical practice, nursing professional values, and nursing clinical self-efficacy during the COVID-19 pandemic.

Methods

This study is a cross-sectional correlational study design. Demographic characteristics, on-site clinical practice, nursing professional values, and nursing clinical self-efficacy were assessed using an online survey from October 3, 2022, to November 6, 2022. Data were analyzed using descriptive statistics, ANOVA, t-test, Pearson's correlation coefficient, and multiple regression.

Results

Of the 86 participants, 18 (20.9%) were male and 68 (79.1%) were female. The duration of the participants' average participation in on-site clinical practice was 39.67 days (61.04%). Nursing professional values significantly influenced clinical self-efficacy (β=0.379, p<0.001). However, on-site clinical practice was not significantly related to clinical self-efficacy (β=0.051, p=0.611). In terms of nursing clinical self-efficacy, measuring blood glucose had the highest score. On the other hand, establishing and maintaining intravenous catheters had the lowest scores.

Conclusion

Nursing students' professional values were significantly associated with nursing clinical self-efficacy; however, the extent of involvement in on-site clinical practice during the pandemic did not have a significant impact on nursing clinical self-efficacy. Given that this study focused on a single university, it is imperative to replicate this research using diverse samples in the future. In addition, there is a need to establish a range of teaching and learning approaches for clinical practice, including simulation, online learning, and the use of state-of-the-art technology for faculty-student feedback strategies, in anticipation of the need for alternative practices.