Nursing students are back to learning, but not necessarily back to school in the traditional brick and mortar building. In a profession such as nursing, where so much of our learning happens with hands-on experiences, how is nursing education changing in the current climate of physical distancing due to COVID-19? How are institutions and educators adapting to maximize student success?

Virtual learning

Virtual learning is not new for nursing. This 2018 Wolters Kluwer survey found that 65% of nursing education programs were adopting virtual education technologies.

The increased use of new technologies in education comes in response to a shortage of clinical trial sites and demonstrates a progressive approach to meeting the demand for practice-ready nurses – prepared not just to pass board exams, but also to deliver hands-on patient care. Across the world, healthcare practice is becoming more technology driven. Digital learning is growing in popularity and with it, new and creative ways to engage students in acquiring, managing and using knowledge.

It turns out that nurse educators are adopting new technologies faster than those in general education.

Simulation

Simulation has also been used for years in nursing education, but it has definitely changed over time. Changes in technology are allowing incredible advances in simulating real-life scenarios and teaching electronic health record (EHR) use. According to Dr. Desiree Hensel, Dean of the Curry College, in this video, Integrating Clinical Judgement Skills in Nursing Curriculum and Improving Entry-Level Nursing Practices, with simulation, students can learn from their mistakes; in real-life scenarios, instructors step in to ensure patient safety, but in a simulated experience, students are allowed to make those mistakes and learn from them.

“When I'm in a clinical setting and I'm the nurse or the faculty member who's supervising a student and I look and I see she's going to make mistake, I step in right away to stop; safety comes first. In simulation, the student gets to make the mistake and then they get to understand what the mistake causes and that imprints in a very different way to help them understand the consequences and to help them not make that mistake again.”
-Dr. Desiree Hensel

Also, according to Hensel, “What you see in simulation is what students are really thinking,” and this in turn is useful for testing, and opens up conversations to help learning.

In 2014, the National Council on State Boards of Nursing published The NCSBN National Simulation Study: A Longitudinal, Randomized, Controlled Study Replacing Clinical Hours with Simulation in Prelicensure Nursing Education. The results of this study provided “substantial evidence that substituting high-quality simulation experiences for up to half of traditional clinical hours produces comparable end-of-program educational outcomes and new graduates that are ready for clinical practice.”

Academic/practice partnerships

Academic/practice partnerships are becoming more common as a mechanism to address the recommendations Institute of Medicine (2010) report, The Future of Nursing: Leading Change, Advancing  Health. These partnerships create systems for nurses to achieve educational and career advancement, prepare nurses of the future to practice and lead, provide mechanisms for lifelong learning, and provide a structure for nurse residency programs (AACN, 2012).

Key principles that guide the relationships between academic institutions are care settings (AACN, 2012) include:

1. Collaborative relationships through formal relationships, shared vision and expectations, and mutual goals
2. Mutual respect and trust
3. Knowledge sharing
4. Shared commitment to maximize the potential of each registered nurse to reach the highest level within his/her individual scope of practice
5. Collaboration to determine an evidence-based transition program for students and new graduates that is both sustainable and cost effective
6. Development, implementation, and evaluation of organizational processes and structures that support and recognize academic or educational achievements
7. Support of opportunities for nurses to lead and develop collaborative models that redesign practice environments to improve health outcomes
8. Establishment of infrastructures to collect and analyze data on the current and future needs of the RN workforce

In addition, the National Council on State Boards of Nursing has developed a model on Practice/Academic Partnership During the COVID-19 Crisis to benefit both students and hospitals during this time. 

How else can we support students during this time?

A recent tweet from biology professor, @FiRawle, reminds us that students have more on their shoulders now than ever before. Dr. Rawle asked students, "What is your biggest worry right now?" Responses included worry about parents who are essential workers, uncertainty about life, and inability to pay for both rent and food. I encourage you to read this thread to keep perspective and search for innovative solutions to engage and educate during these challenging times.

References:
Wolters Kluwer (2018, November 28). 65% of nursing education programs adopting virtual simulation. https://www.wolterskluwer.com/en/expert-insights/65-percent-nursing-education-programs-adopting-virtual-simulation

American Association of Colleges of Nursing. (2012). Guiding Principles to Academic-Practice Partnerships. https://www.aacnnursing.org/Academic-Practice-Partnerships/The-Guiding-Principles

Hayden, J.K., Smiley, R.A., Alexander, M., Kardong-Edgren, S.K., Jeffries, P.R. (2014). The NCSBN National Simulation Study: A Longitudinal, Randomized, Controlled Study Replacing Clinical Hours with Simulation in Prelicensure Nursing Education. Journal of Nursing Regulation, 15(2), S4-S41. https://www.ncsbn.org/JNR_Simulation_Supplement.pdf