Pandemic Crisis: Simulation Contingency Plans

BackgroundThe COVID-19 pandemic has disrupted the typical delivery of nursing education. Multifactorial issues related to the pandemic and clinical placements have forced nurse educators to employ innovative strategies for content delivery.MethodsThis article is an accounting of a simulation team response to the move to all remote or virtual simulated learning experiences over a two-week period and lessons learned on how to move forward with simulated learning contingency plans.ResultsLearning outcomes were achieved via the delivery of online commercial and faculty made experiences to simulate clinical practice. Simple and easy to use guides assisted both students and faculty for a positive experience.ConclusionCreating a detailed formal contingency plan for emergencies is essential for nursing programs. Additionally, the pandemic highlighted the importance of continuing faculty development and education in online, virtual, and simulation pedagogy. Finally, it is recommended that schools of nursing implement formal policies for replacement of clinical hours with simulation.     

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

AimTo consolidate the evidence around the experiences of nursing undergraduates and faculty members navigating through remote and online education during the COVID-19 pandemic.BackgroundThe 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.DesignA systematic review and meta-synthesis of the qualitative literature was undertaken using Sandelowski and Barroso’s approach.MethodsSix 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.ResultsForty-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.ConclusionTo 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.     

Nursing student experiences in turmoil: A year of the pandemic and social strife during final clinical rotations

BackgroundThe duration and magnitude of the coronavirus (COVID-19) posed unique challenges for nursing students, whose education was altered because of the pandemic.PurposeTo explore the perceptions and experiences of nursing students whose clinical rotations were abruptly interrupted by COVID-19's initial surge in the United States.MethodsThis qualitative study was conducted at a midwestern, academic medical center to elicit senior nursing students' experiences. An online survey was administered with eight open-ended questions asking about: initial impressions of the pandemic; experiences of being a senior nursing student; sources of stress and coping mechanisms; preparing to work as a registered nurse; and views on the nursing profession.ResultsAmong the 26 students who completed the survey, the majority were female (92%), aged 28 ∓ 4.1 years. A total of 18 subcategories emerged with four main themes identified as: a) breakdown of normal systems, b) feeling alone and the inability to escape, c) protective factors/adaptability, and d) role identify and formation.ConclusionsFindings indicate students implemented a variety of strategies while adapting to the abrupt interruption of in-person clinical rotations, mandated restrictions, and social unrest. The cascading themes illustrate the enormity of sudden changes and their significant impact on daily life.     

Undergraduate student nurses’ views of online learning

BackgroundThe COVID-19 pandemic and resultant public health restrictions saw the mass movement of higher education to online, remote delivery. There was wide variation in how this was implemented, and for many undergraduate programs, this was the first time teaching was conducted remotely. The aim of this study was to explore undergraduate student nurses’ views of online learning.MethodsReflexive thematic analysis was used to analyse focus group data from undergraduate nursing students.FindingsTwo central themes described student preferences for learning environments and challenges associated with asynchronous learning. Participants reported a preference for face-to-face learning. Suggestions for optimising remote learning include an emphasis on synchronous live sessions rather than asynchronous learning, incentivised learning, and a focus on ongoing formative informal assessment to maintain engagement. Specific challenges related to poor retention, difficulty remaining motivated, and maintaining focus on content and learning outcomes.ConclusionAs more opportunities arise to engage with online pedagogies for undergraduate nursing students, educators need to ensure their approaches are evidence-based and learner-centric.     

Nurse faculty perceptions of readiness for practice among new nurses graduating during the pandemic

BackgroundThe COVID-19 pandemic caused major changes in nursing education, namely a shift to remote learning and significant reduction of clinical practice experience. It is not known how these changes will affect new graduate nurses transitioning to practice.PurposeTo provide guidance to transition-to-practice programs, this study quantitatively described and compared nurse faculty perceptions of readiness for practice among students who graduated pre-pandemic and those who will graduate during the pandemic.MethodsA convenience sample of 116 nurse faculty across North Carolina completed surveys online. Surveys collected information on demographics, professional experience, and teaching changes experienced during the pandemic. The Nursing Practice Readiness Tool was used to measure perceptions of readiness for practice.ResultsNurse faculty reported a wide range of changes due to the pandemic, with limitations in clinical learning prevalent. There was a statistically significant decrease in practice readiness scores for the total scale, six subscales, and all tool items at p < 0.001 for all paired comparisons.ConclusionsWhile there was an overall significant decrease in scores for all competency areas, further analysis of the tool subscales and items can provide guidance for clinical nurses working with new graduates and nurse faculty working with continuing students.     

A year and a half later: Clinical experiences of intern nursing students in the COVID-19 Pandemic: A constructivist grounded theory

AimsThe aim of this study is to develop a theory to explore the clinical experiences of interns in clinical practice during the COVID-19 pandemic.BackgroundThe COVID-19 pandemic is a serious public health problem influencing the healthcare systems worldwide. Nursing students were excluded from clinical practice for a long time due to the pandemic. However, the prolonged and uncertain pandemic conditions required the inclusion of fourth-year nursing students in clinical practice.DesignA qualitative research design based on the Constructivist Grounded Theory approach was used in this study.MethodsThe research data were collected from fourth-year nursing students doing an internship at a university hospital in Turkey. Fourteen nursing students (12 females and 2 males) in the clinical practice during the COVID-19 pandemic with a mean age of 22.64 ± 0.225 were included in the study. In the collection of data, firstly, the purposeful sample selection method, then the theoretical sample selection method was used. On the online interview platform, the data were collected through individual interviews with those agreeing to participate in the study between July 2021 and August 2021 using a semi-structured interview form. The results were analyzed with initial, focused and theoretical coding. The research was reported based on the Consolidated Criteria for Reporting Qualitative Research guide.ResultsA core category and five main categories emerged in the study. The core category is a lonely bird and the main categories are emotions, challenges, coping methods, nursing experiences and solution suggestions.ConclusionsThis research can help create a conceptual framework of clinical practice experiences of intern nursing students during the COVID-19 pandemic. It is thought that intern nursing students need to be supported by reliable authorities before and during the internship. Intern students stated that they experienced many emotions together and felt alone. Our study results revealed that intern nurses need more psychological support, especially during the pandemic period. A remarkable finding of the research is that interns now think of themselves as professional nurses. For interns to develop effective coping methods, intensive and regular training should be organized in cooperation with the hospital and school administration.     

COVID-19 stories of success: Teaching and learning in a clinical setting during a pandemic

IntroductionThe onset of the COVID-19 pandemic halted in-person activities in universities and caused disruption in the usual iteration of the semesters. When the clinical environment resumed student placement, the potential health risks caused additional anxiety to the students and clinical faculty. This paper aims to examine the measures implemented to support the radiation therapy students during their first clinical placement during the COVID-19 pandemic.BackgroundThe 2nd year radiation therapy students’ first clinical placement was organized around pandemic restrictions that required new activities to support student safety and wellness. The clinical faculty team redesigned the clinical course to integrate enhanced communication, additional safety measures and mental wellness sessions, as well as making COVID-19 related resources available during the week-long orientation and throughout the semester.MethodsRegistered students were asked to participate in a 9-item survey questionnaire to gather their perspective on the effectiveness of the orientation and clinical activities during the pandemic. The responses were tabulated and independently analyzed for emergent themes by the clinical faculty.DiscussionThe students reported that the combination of activities, workshops, exposure to the treatment unit and feedback from both clinical faculty and learning mentors provided the support needed for physical safety and wellness in the clinic. Identified challenges included communication with continuous masking, the timeliness of communicating evolving clinical safety protocols, and the need for enhanced coordination of interprofessional education.ConclusionThe COVID-19 pandemic brought new challenges and opportunities for students and clinical faculty at the University of Alberta's Radiation Therapy department. The results of the quality improvement survey highlighted the importance and effectiveness of the redesigned clinical course, which integrated COVID-19 related activities, enhanced communication strategies, safety, wellness resources and check-ins throughout the course.     

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

BackgroundLittle is known about how nursing students learned psychomotor skills during the COVID-19 pandemic.AimsWhat is the lived experience of undergraduate nursing students learning psychomotor skills during the COVID-19 pandemic?MethodsUsing a phenomenological approach, eight undergraduate nursing students were interviewed about their experiences learning psychomotor skills during the pandemic.ResultsThematic analysis revealed three main themes. “Finding My Own Way” described adapting learning styles and advocacy for learning. Sub-themes included perseverance and comradery. “Learning the Skills” described modifications to skills learning. Sub-themes included grace by professors, smaller group sizes, less practice, and “my brain is split in half,” describing the challenges of giving dual attention to COVID-19 and skills learning. “Stress of the Pandemic” described the stress of quarantine, isolation and online learning.DiscussionFindings of this study may help nurse educators understand the challenges of learning skills during the pandemic. Implications are discussed.     

Perceived self-efficacy among nursing students during a pandemic: A pilot study

In March 2020, prelicensure nursing programs quickly transitioned from traditional, face-toface instruction to remote online learning for classroom, lab, and clinical requirements due to the COVID-19 pandemic. As a result, many nursing students ready to graduate or recently graduated missed their last opportunity to prepare for the national registered nurse licensing exam, NCLEX-RN, in a familiar academic setting. In addition, direct clinical experiences with assigned clients were lost due to COVID-19 safety concerns for students, faculty, and clients. This created a challenge for nurse educators to provide instructional experiences that would engage students in ways to promote learning and result in acceptable NCLEX-RN pass rates. This study describes associate degree nursing students' perceptions of self- efficacy regarding the ability to pass NCLEX-RN and perform clinical skills after being transitioned from traditional, face-toface instruction to remote online learning during the pandemic.     

Addressing mental and emotional health concerns experienced by nurses during the COVID-19 pandemic

BackgroundNurses are the majority of the world's health work force and the frontline responders during pandemics. The mental/emotional toll can be profound if it is not identified and treated.PurposeIn March 2020, with New York City as the epicenter of the COVID-19 pandemic in the United States, Columbia University School of Nursing organized support circles for faculty and students providing clinical care as a healing method to address trauma.MethodsColumbia University School of Nursing adapted guidelines and conducted Circles of Care to share, listen, and acknowledge the new challenges for nurses via Zoom. Analysis of these sessions produced major themes of concern for nurses.FindingsBetween March 31 and May 31, 2020, we facilitated 77 sessions with 636 attendees. Eight major themes emerged: coping mechanisms, patients suffering and dying, feelings of helplessness, frustration with COVID-19 response, silver lining, disconnection from the world, the thread that holds nurses together, and exhaustion.DiscussionThis report offers insight into the mental/emotional outcomes of being on the frontlines. Addressing these issues is essential for the well-being of nurses and all health care providers for an effective pandemic response.     

Undergraduate nursing students’ perceptions on nursing education during the 2020 COVID-19 pandemic: A national sample

BackgroundIn 2020, nursing educational programs were abruptly interrupted and largely moved online due to the COVID-19 pandemic.PurposeTo explore nursing students’ perspectives about the effects of the pandemic on their education and intention to join the nursing workforce.MethodsUndergraduate nursing students from 5 universities across 5 United States regions were invited to participate in an online survey to elicit both quantitative and qualitative data.FindingsThe final sample included quantitative data on 772 students and qualitative data on 540 students. Largely (65.1%), students reported that the pandemic strengthened their desire to become a nurse; only 11% had considered withdrawing from school. Qualitatively, students described the effect of the pandemic on their psychosocial wellbeing, adjustment to online learning, and challenges to clinical experiences.ConclusionFindings highlighted the need to develop emergency education preparedness plans that address student wellbeing and novel collaborative partnerships between schools and clinical partners.     

The impact of covid-19 on psychosocial well-being and learning for australian nursing and midwifery undergraduate students: a cross-sectional survey

AimTo explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university.BackgroundThe World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic.DesignCross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020.MethodsA cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed.ResultsOf 2907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students’ well-being and their ability to learn and study.ConclusionsStudents were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students’ stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.     

Self-reflection during first clinical practice: The experiences of nursing students

BackgroundSelf-reflection can be used as a tool for describing student experiences and have a significant impact on their learning. It enables nursing students to develop the ability to identify and analyse their problems and find possible solutions.ObjectiveTo present students' self- reflection in their first clinical practice as their first stage of our nursing study program.MethodologyThe research was based on a naturalistic philosophical paradigm using a qualitative methodological approach. The research took place at one of the Slovenian universities with an undergraduate nursing education program. Purposive sampling was chosen. The data were obtained through written self-reflection diary entries collected between March and June 2016. A thematic analysis was selected for data analysis. Ensuring that all ethical considerations were covered, seventeen students in the first clinical practice were included.FindingsThree main thematic themes were identified that define the experience of students in their first clinical practice: (1) emotional experience, (2) interpersonal relationships, (3) learning.ConclusionsThe research has found that the experiences and the perceptions of students in the first clinical practice are mainly expressed emotionally. Self-reflection helps students to express emotions and feelings to reliving and to identifying problems and also, to understanding themselves better. Further research should be focused on the importance of the students' self-reflections in their professional and personal growth.     

Exploring the meaning of undergraduate nursing students' experiences and confidence in clinical skills using video

BackgroundStudents and health care faculty staff report a lack of confidence in graduating nurses' clinical skills practice. Traditional approaches to support nursing students' clinical skills development have relied on small group, face-to-face, practice-based learning in clinical laboratories. However, with changing curricula, increased numbers of students, and pressure on laboratory timetables and availability, alternate methods of delivery are necessary to ensure students gain confidence in the development of their clinical skills. Video podcasting is an innovative approach that is being used to stimulate active and ongoing learning of clinical skills.DesignA hermeneutic phenomenological approach.MethodData were collected through in-depth interviews with 10 second-year, undergraduate nursing students about their experiences using three clinical skills video podcasts and their perceptions of how this impacted on their learning of these clinical skills and confidence in practice.FindingsThree themes emerged from the data: ‘Accessibility for learning the skill’; ‘Preparation for learning and practice’; and ‘Student-directed learning’. These themes provided an insight into the students' engagement with video podcasts, demonstrating their sense of confidence was increased in clinical skills development.ConclusionThe findings of this study provide an insight into the students' engagement with video podcasts in relation to their confidence in clinical skills development, and indicate that undergraduate nursing students value the use of video podcasts in their learning of clinical skills. However, it was evident that students still value face-to-face delivery to guide their study, which suggests that video podcasts could be used as an adjunct to teaching to support learning.