Mobilising the nursing student workforce in COVID-19: The value proposition

Exploring the impact of digital concept mapping methods on nurse students' learning anxiety, learning motivation

In involuntary distance education, like during epidemics and wars, students often feel heightened learning anxiety, impacting outcomes. Despite innovative teaching methods, many face hurdles in distance learning. We want to propose specific strategies to solve learning difficulties in distance education.

AIM

This study explored whether using digital concept maps (DCM) in physiology courses can reduce learning anxiety among nursing students.

DESIGN

The study was quasi-experimental, including a pre-and post-test control group.

METHODS

71 nursing students aged 16-18 enrolled in a physiology course were recruited in the study. DCM was the intervention as a tool for in-person learning (first 12 weeks) and distant learning (final six weeks). Each student was required to complete the assignments independently to compare learning outcomes. Questionnaires were administered, and an assignment evaluation was completed before and after the course's different formats.

RESULTS

DCM using software using mobile vehicles (mobile, notebook, pad) is digital learning to help nursing students learn difficult subjects. DCM improved the students' learning motivation and effectiveness more in distance learning than in-person learning, decreasing learning anxiety in both face-to-face and distance learning.

CONCLUSIONS

DCM promoted students' self-regulated learning and positively affected learning outcomes by increasing motivation and reducing stress. This study offers a tailored teaching framework for international settings to reduce student anxiety and improve learning effectiveness.

Final year nursing students' preparedness for medication administration during COVID-19: A multi-site survey study

AIM

To examine final-year undergraduate nursing students' characteristics and their perceived preparedness for medication administration across three universities during COVID-19.

BACKGROUND

Medication administration is a complex process and medication errors can cause harm to the patient. Nurses are at the frontline of medication administration; therefore, nursing students must be well-prepared to administer medicines safely before graduation. Little is known about final-year undergraduate nursing students' perceived medication administration preparedness during COVID-19.

DESIGN

A multi-site study using a cross-sectional survey of student demographics, the 'Preparedness for Medication Administration' (Revised) tool and an open-ended question.

METHODS

The questionnaire was distributed to nursing students in their final semester of the program in 2022 across two universities in Australia and one in New Zealand. Completed surveys n=214. Descriptive statistics were used to analyse the demographic data. Differences in demographic data and preparedness scores between the three universities were analysed using ranked means, correlation coefficient, Chi-Square, Mann- Whitney U and Kruskal- Wallace H. Directed content analysis was used to analyse the data from the open-ended question.

RESULTS

Overall, students reported high preparedness scores for medication. International students reported significantly higher preparedness scores (Md =119, n=29) compared with domestic students (Md=112.00, n=164), U=1759.50, z=-2.231, p=02, r=.16. Mean ranked scores for each item were above average across the three universities. The impact of COVID-19 on curriculum and students' opportunity to practice may be one explanation for the difference in preparedness scores between universities. International participants reported significantly higher scores on the Preparedness for Medication Administration (Revised) tool than domestic participants. Older students were more confident in applying principles of pharmacology to practice. Students' comments generated three major categories and five subcategories indicating preparedness gaps.

CONCLUSION

This study provides insights into students' medication management preparedness during restrictions and before transitioning to the role of Registered Nurse. It highlights the need to provide integrated and comprehensive medication education and assessments throughout the curriculum and the need for additional support for newly graduated nurses in medication management due to the restrictions.

Nursing Students' Opinions About Covid-19: A Qualitative Study

Healthcare professionals play important roles during the COVID-19 pandemic. This study aims to evaluate nursing students' opinions about COVID-19. This study was planned using a descriptive phenomenological design. The data were collected using a semi-structured interview form during individual interviews carried out through phone calls or online. After the interviews were recorded, they were documented. The study found that students experienced anxiety because of the pandemic, that they protect themselves through personal hygiene and isolation methods, that most of them found the social measures sufficient, that they were worried about their relatives, and that they wanted to go back to their social lives. Positive occupational value and investment in the health sector are positive effects of the pandemic on nursing, while an increased workload and the high risk of death are negative effects. Nursing students should be supported with both theoretical information and psychological support during the pandemic.

Preparing nursing students for clinical placement using synchronous role-play telesimulation: A descriptive survey study

BACKGROUND

Contemporary teaching modalities in nurse education include teaching clinical skills via telesimulation. The effectiveness of this modality has not been evaluated.

OBJECTIVE

To evaluate undergraduate nursing students' and clinical facilitators' perceptions of student preparedness for placement when clinical skills are taught via role-play telesimulation using home equipment packs.

DESIGN

A descriptive survey study was employed to measure and explore perceptions using Likert scales and open-structured questions delivered via an anonymous online survey.

SETTING

Clinical placement after undertaking preparation via role-play telesimulation for students at an Australian university.

PARTICIPANTS

Data were collected from 180 undergraduate nursing students and 22 clinical facilitators.

METHODS

Quantitative data were analysed using statistical analysis software, SPPS. Open ended responses to survey questions were analysed through the application of Elo and Kyngas (2008) three phases of content analysis.

RESULTS

Seventy-eight percent of students felt prepared for placement, and 86 % of clinical facilitators believed that students were adequately prepared. Three major categories were identified from students' responses: sense of community, learning logistics, and sense of comfort. Three categories emerged from clinical facilitators' responses: nervous and anxious, confidence and preparedness.

CONCLUSIONS

Findings from this study suggest that role-play telesimulation with home equipment packs is a viable, achievable, sustainable and effective modality for teaching hands-on practical skills to prepare undergraduate nursing students for industry placement.

Development of the Harm Prevention Partners Clinical Model: An Academic-Practice Partnership for Prevention of Patient Harm Events

This innovative academic-practice partnership applied user-centered design, resulting in a new clinical model, the "Harm Prevention Partners Program." The model engaged students working as teams with faculty to intervene on nurse-sensitive indicators by documenting care on a novel smartphone tool and generating an intervention dashboard to visualize impact. Faculty utilized the dashboard to guide postclinical debriefing and highlight students' impact on patient outcomes.

Emotional wellbeing of student midwives during COVID-19

BACKGROUND

Mental health of students in higher education was affected during the COVID-19 pandemic.

AIM

To examine the emotional wellbeing of midwifery students in the Netherlands and Flanders (Belgium) during COVID-19.

METHODS

A cross-sectional online-based survey with 619 Dutch and Flemish midwifery students. Sociodemographic details were obtained. Anxiety and depression were measured twice (T1, T2) during the COVID-19 pandemic.

FINDINGS

Flemish students had significantly higher mean depression and anxiety scores than Dutch students during the total period of study (p < .001; p < .001). Total group mean depression and anxiety scores were significantly higher at T2 compared to T1 (p < .001; p < .001). In the Dutch student group, there was a significant increase of depression from T1 to T2 (p < .001). In the Flemish student group, both depression and anxiety scores significantly increased from T1 to T2 (p < .001; p < .001). A history of psychological problems predicted both depression and anxiety, irrespective of COVID-19 period or country (p < .001; p < .001). Being single (p.015) and having a job (p.046) predicted depression, irrespective of period or country. A history of psychological problems predicted depression (p.004; p < .001) and anxiety (p.003; p.001) during the total period of study. Being single also predicted depression during T2 (p.024).

CONCLUSION

These findings inform how emotional wellbeing of midwifery students was affected during the COVID-19 pandemic and identify those students that might need extra attention after the pandemic, during another pandemic or similar situations with social restrictions.

Clinical experiences of final-year nursing students during the COVID-19 pandemic: A systematic review and meta-synthesis

OBJECTIVES

This systematic review aimed to qualitatively synthesise existing literature to examine the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic and provide recommendations for the effective management of clinical placement of nursing students.

DESIGN

A qualitative systematic review was conducted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

DATA SOURCES

Five electronic databases were searched and qualitative studies were included for analysis if they focussed on the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic.

REVIEW METHODS

Data synthesis was conducted by extracting all findings, developing categories, and producing synthesised findings.

RESULTS

Four synthesised findings were concluded: 1) facing the unknown and willingness to help, 2) challenging the clinical environment, 3) transition improving professional identity, and 4) finding ways out of the pandemic.

CONCLUSIONS

The transition of nursing students to clinical nursing practice during the pandemic is a personally and professionally challenging process, while nursing students try to adapt to the changing clinical environment and enhance their professional identity. Nursing managers and health policymakers should acknowledge the challenges encountered by nursing students during the pandemic and support the professional growth of future nursing teams by providing high-quality supervision.

Spotlight on noncognitive skills: Views from nursing students and educators

BACKGROUND

Noncognitive skills have a considerable role in influencing nursing students' performance in clinical and educational settings. Understanding how nursing students and educators perceive noncognitive skills is important given the broad classifications of noncognitive competencies.

OBJECTIVE

This study sought to examine nursing students' and educators' perception of noncognitive skills.

DESIGN

This study adopted a descriptive qualitative approach.

SETTING

This study was conducted virtually via Zoom in one university in Singapore.

PARTICIPANTS

Purposive sampling through a maximum variation technique was used to select 35 nursing students and 12 educators.

METHODS

Semistructured interviews were conducted through eight virtual face-to-face focus group discussions. Interviews were audio- and videorecorded and transcribed verbatim. Data were analysed through thematic analysis.

RESULTS

The participants stated that individual and interpersonal skills contribute to one's noncognitive skills. Two themes emerged from the participants' narratives: (1) the ability to manage oneself and (2) social interactions with others. The first theme describes the various individual characteristics such as growth mindset, adaptability, resilience, and emotional regulation. The second theme describes the importance of empathy and meaningful relationships as types of non-cognitive skills.

CONCLUSIONS

The findings of this study provide the basis for the development of noncognitive assessment tools by educators. In addition, they pave the foundation for the curation of future programs that promote the noncognitive skills of nursing students. Hospital-based educators may use these findings to curate suitable programs for improving the noncognitive abilities of nurses.

Maternal and Child Health Nursing education before and during COVID-19: An exploratory descriptive study

Background

Major disruptions to higher education during COVID-19 resulted in a rapid shift to online learning and associated adaptations to teaching and assessment practices, including for postgraduate programs requiring practical skill development such as nursing and midwifery. Educator perspectives of this transition have not been widely studied.

Purpose

This qualitative descriptive study aimed to describe Australian postgraduate Maternal, Child and Family Health nurse educators' perceptions of COVID-19 impacts on student knowledge of theory and practice, and lessons learned through their responses.

Method

Semi-structured interviews were reflexively thematically analyzed.

Results

All participants recognized struggles, opportunities and innovations within three key themes: “We've learned how to be flexible”: Grappling with COVID-safe teaching and assessment; “Chat rooms and Zoomland”: Learning in a virtual community; and “We've had a few struggles”: Clinical placement tensions. Educators described a sense of uncertainty, increased flexibility, opportunities for change and new ways of connecting. They adapted by developing new online resources and broadening clinical practicum and assessment requirements to address new practice approaches including telehealth.

Conclusions

Rapidly changing practice requirements and concerns about risk of disease transfer between workplace and placement venues restricted placement opportunities. Educators learned and incorporated new skills and strategies into their teaching, while aiming to meet professional expectations and maintain quality of education. Some strategies are likely to be maintained for future education programs.

Preparing BSN students for a new workplace: Experiences in a COVID-19 designated unit as an RN extender

Academic nursing programs were impacted by the onset of the pandemic with the challenges of social distancing, detecting, and controlling the spread of the virus. Many traditionally campus-based, face-to-face programs transitioned quickly to include virtual activities for classes, laboratories, and clinical experiences for students. Initially direct patient care clinical activities came to a halt due to concerns for student safety and overwhelming numbers of COVID-19 cases stressing health system resources. However, as COVID-19 cases began to rise and hospitals struggled with staffing shortages, it became necessary to explore how nursing students could contribute to relieving the staffing burden while obtaining critical education as RN Extenders. Students that participated in the RN Extender program were seniors entering the nursing workforce within the next two months. Significant student screening and preparation was provided to support students serving as RN Extenders in COVID-19 units.

The prior working relationships and personal contact between academic and practice leaders, a sense of equal participation, clear and realistic expectations of the benefits and responsibilities of each group were crucial. Building ongoing and frequent opportunities for formal and informal communication among all stakeholders was vital and the major contributor to the success of this program.

'I can't go, I can't afford it': Financial concern amongst health students undertaking rural and remote placements during COVID-19

INTRODUCTION

As the coronavirus pandemic unfolded during 2020, widespread financial uncertainty emerged amongst university students across the globe. What is not yet clear is how Australian health students were financially impacted during the initial stages of the pandemic and whether this influenced their ability to undertake planned rural or remote placements.

OBJECTIVE

To examine (a) financial concern amongst health students during COVID-19, (b) the financial implications of changes to planned rural or remote placements and (c) the impact of these factors on students' ability to undertake placements during the pandemic.

DESIGN

Mixed-methods design involving an online survey (n = 1210) and semi-structured interviews (n = 29). Nursing, medical and allied health students with a planned University Department of Rural Health-facilitated rural or remote placement between February and October 2020 were invited to participate.

FINDINGS

54.6% of surveyed students reported financial concern during COVID-19. Financial concern correlated with both changes in financial position and employment, with 36.6% of students reporting a reduction in income and 43.1% of students reporting a reduction in, or cessation of regular employment. Placement changes yielded a range of financial implications. Cancelled placements saved some students travel and accommodation costs, but left others out of pocket if these expenses were prepaid. Placements that went ahead often incurred increased accommodation costs due to limited availability. Financial concern and/or financial implications of placement changes ultimately prevented some students from undertaking their rural or remote placement as planned.

DISCUSSION

Many nursing, allied health and medical students expressed financial concern during COVID-19, associated with a loss of regular employment and income. Placement changes also presented unforeseen financial burden for students. These factors ultimately prevented some students from undertaking their planned rural or remote placement.

CONCLUSION

Universities need to consider how best to align financially burdensome placements with the personal circumstances of students during periods of economic uncertainty.

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

Aim

To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university.

Background

The 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.

Design

Cross-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.

Methods

A 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.

Results

Of 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.

Conclusions

Students 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.

A New Framework for Practice-Academic Partnerships During the Pandemic-and into the Future

ABSTRACT

During the COVID-19 pandemic, many health care facilities closed their doors to nursing students, depriving them of the experience of caring for patients, a foundation of nursing education. The purpose of this article is to report on how the National Council of State Boards of Nursing convened nurse leaders from around the country to explore this problem and develop possible solutions.Coming together virtually, these leaders recommended a national model, the practice-academic partnership, to provide nursing students with in-person clinical experiences during the pandemic. This model is unique in its recognition of the important role of nursing regulatory bodies in these partnerships. The practice-academic partnership model creates clinical education opportunities for students during a public health crisis, such as the COVID-19 pandemic. Further, the model could be applied to meet the chronic challenges nursing education programs have often faced in securing clinical sites, even in the absence of a global or national public health emergency. We provide the context in which the practice-academic partnership model was developed, along with keys to its successful implementation and suggestions for its evaluation. We also discuss the implications of using this model once the pandemic ends.

Improving Nursing Students' COVID-19 Knowledge Using a Serious Game

Improving nursing students' understanding of the novel COVID-19 is an essential component of their education. We designed and developed a serious game-based computer learning application that requires nursing students to solve problems through simulated cases. This study aimed to compare knowledge mastery among nursing students who used this teaching method versus those who received online lectures. A retrospective observational study was conducted using preclass, postclass, and final test scores of 130 students retrieved from the university's database of test scores. Both teaching methods produced significant increases in short-term knowledge of COVID-19. There was no statistical difference between the two methods in pre- and postclass scores; however, the serious game group scored higher than the online lecture group in knowledge retention. In summary, the serious game application is a potentially effective method for COVID-19 education among nursing students, particularly in terms of its capacity for improved knowledge retention.

Exploring the STEP-uP to practice: A survey of UK Lead Midwives for Education views of the STudent midwife Extended Practice Placement during the first wave of the COVID-19 pandemic

OBJECTIVE

to assess the effect of implementation of the extended placement option available to midwifery students during the first wave of the COVID-19 pandemic.

DESIGN

Online survey open from 2nd June 2020 to 15th July 2020.

SETTING

United Kingdom.

PARTICIPANTS

Lead Midwives for Education (LMEs).

FINDINGS

A total of 38 of 55 LMEs responded (response rate 69%). The majority of Approved Education Institutions (AEIs) offered an extended placement to students, but with some variation in the choices offered, unrelated to geographical location or size of student cohort. AEIs appeared to provide the majority of decisional support for students. Many practice learning environments became unavailable, particularly community, gynaecology/medical wards and neonatal units. LMEs experienced both internal and external pressures to instigate rapid change.

KEY CONCLUSIONS

The impact of COVID-19 on midwifery education is significant and will need continual scrutiny to minimise future detriment. The pressures of providing midwifery education throughout the early phase of COVID-19 were substantial, but it is important that we learn from the immediate changes made, value and pursue the changes that have been beneficial, and learn from those that were not.

IMPLICATIONS FOR PRACTICE/RESEARCH

Student learning experiences have undergone significant change during the pandemic. It is essential to assess what effect the extended placement has had on student readiness for practice, their confidence, resilience, mental health, and attrition and retention. Educators transitioned to remote working, and rapidly assimilated new skills for online education; exploration of the impact of this is recommended.

Associations between health behaviors and mental health in Australian nursing students

AIM

Nursing students experience high levels of stress, anxiety and depression. This study examined associations between health behaviors and stress, anxiety and depression in Australian nursing students.

DESIGN

this was a cross-sectional study.

METHODS

Participants completed an online survey providing demographic information and responses to the 21-item Depression Anxiety Stress Scale, Fagerström Test for Nicotine Dependence, short Food Frequency Questionnaire, Alcohol Use Disorders Identification Test, International Physical Activity Questionnaire and Workforce Sitting Questionnaire. Associations were evaluated using multivariate linear regression.

RESULTS

Mild to extremely severe stress (46.6%), anxiety (52.8%) and depression (42.2%) were prevalent. Intake of snack-foods was associated with higher depression (β = 8.66, p < 0.05) and stress (β = 3.92, p = 0.055) scores. More time spent sitting was associated with higher depression (β = 0.48, p < 0.001) and stress (β = 0.28, p < 0.05) scores. Skipping meals correlated with higher stress, anxiety and depression scores.

CONCLUSION

More support must be provided to nursing students to manage psychological distress and mental health during university study.

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

BACKGROUND

In 2020, nursing educational programs were abruptly interrupted and largely moved online due to the COVID-19 pandemic.

PURPOSE

To explore nursing students' perspectives about the effects of the pandemic on their education and intention to join the nursing workforce.

METHODS

Undergraduate 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.

FINDINGS

The 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.

CONCLUSION

Findings highlighted the need to develop emergency education preparedness plans that address student wellbeing and novel collaborative partnerships between schools and clinical partners.

Nursing student experiences of remote learning during the COVID-19 pandemic

Background

The emergence of the COVID‐19 pandemic resulted in a sudden transition to remote learning. These circumstances presented many challenges for higher education faculty and students around the world but especially for nursing education programs which are traditionally conducted in a face‐to‐face learning environment that includes hands‐on experiential learning.

Methods

Guided by Meleis' Transition Theory, a qualitative descriptive design was utilized to explore prelicensure nursing students’ experiences of the transition to remote learning during the Spring 2020 semester. Participants were recruited from one baccalaureate program in the Pacific Northwestern United States. Interviews were conducted and transcribed using a web conferencing platform. Data were analyzed using Colaizzi's phenomenological reduction.

Results

Eleven students participated. Interviews revealed four overarching themes: technological challenges, academic relationship changes, role stress and strain, and resilience.

Conclusion

The sudden transition to remote learning resulted in a number of challenges for nursing students. Despite these challenges, students demonstrated a remarkable sense of resilience and perseverance. Faculty have an opportunity to address student stressors and design remote courses in such a way to facilitate student engagement and community building.

Public Health Student Response to COVID-19

To understand the role public health students play in response to COVID-19 despite cuts in funding for graduate student emergency response programs (GSERPs), we reviewed the websites of the Association of Schools and Programs of Public Health, Council on Education in Public Health, and individual schools and programs to identify student participation in COVID-19 response activities. Thirty schools and programs of public health are supporting public health agencies in response to COVID-19, primarily through the provision of surge capacity (n = 20, 66.7%), contact tracing (n = 19, 63.3%), and training (n = 11, 36.7%). The opportunity to participate in formal and informal applied public health experiences like practica, service-learning, and field placements can benefit both public health students and agency partners. Although recent publications have identified gaps in academic public health response to COVID-19, in part due to the cessation of funding for workforce development and other university-based programs in public health preparedness, schools and programs of public health continue to support public health agencies. Future funding should explicitly link public health students to applied public health activities in ways that can be measured to document impacts on public health emergency response and the future public health workforce.