1. Oermann, Marilyn H. PhD, RN, ANEF, FAAN

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Rarely does a day go by without news about the devastating effects of the coronavirus disease 2019 (COVID-19) on individuals and their families, and on our communities and systems. We have all experienced significant disruptions to nursing education, our academic institutions, and our health care systems. However, the pandemic has also validated my observations about the creativity and willingness of nurse educators to meet challenges, always keeping the student as central in their decisions.


With the inability to provide clinical practice for students, faculty outlined priorities for student learning and essential competencies to be achieved and moved quickly to virtual simulations, online simulations from vendors, and unfolding cases, among other methodologies. Some faculty produced video recordings to simulate clinical experiences specific to their course outcomes and combined these with small group discussions to promote clinical judgment. These decisions were not made lightly by faculty. One of the outcomes of shifting clinical practice to a virtual and online environment has been a clearer focus on the specific knowledge and competencies to be achieved versus how much time students spend in the clinical setting. The length of time students spend in clinical practice does not assure learning or development of essential competencies. Going forward, we need to decide what are critical competencies for students to develop through clinical practice and plan learning activities based on those competencies and individual student needs.


Despite the pandemic, nursing students continued to learn and, importantly, develop their clinical judgment. They had fewer clinical practice hours, but carefully crafted discussions with the teacher and peers about students' thinking in virtual simulations and online cases may have been more effective for clinical judgment than some of the discussions we have with students in the busy clinical setting. In discussions, educators can ask students about cues in the scenario, additional data to collect, and why that information is needed to decide on patient problems. Small group discussions about scenarios allow students to apply their learning from class to identify possible interventions and evidence supporting them. They can reflect on their decisions and consider what they would do differently next time, learning from each other.


Nurse educators moved quickly to virtual and online strategies for clinical education, but now is the time to evaluate their impact on learning, clinical competencies, and transition to practice. Studies should be designed to follow graduates at all levels as they transition into their first positions to determine whether the changes we made in clinical education during the pandemic had an effect on student competencies and ease of transitioning into practice. Do graduates have the essential competencies for beginning their practice as a newly licensed nurse or nurse practitioner? Are they able to perform the essential professional activities expected of a new graduate? These studies are critical to provide the evidence for making careful decisions about clinical practice going forward. This research cannot be done by schools of nursing in isolation from clinical settings; studies need to be planned and conducted collaboratively with clinical partners.


The creativity of nurse educators and willingness to try new approaches (with limited time for planning) were confirmed in the pandemic. Terenzini1 identified characteristics of teaching strategies that contribute to their effectiveness: they require active engagement of learners, occur in a supportive learning environment, foster real-world learning (application to clinical practice), involve others in learning, and promote reflection. The approaches nurse educators used for clinical education during the pandemic are consistent with this evidence. Thank you to nurse educators worldwide who ensured that nursing students continued to learn during the pandemic and met challenges never before imagined.




1. Terenzini PT. Rethinking effective student learning experiences. Tomorrow's Professor. Accessed October 1, 2020. [Context Link]