Undergraduate nursing students' learning experiences of a telehealth clinical practice program during the COVID-19 pandemic: A qualitative study

Nursing students' awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare: A cross-sectional study

BACKGROUND

Increasing technology use in healthcare has led to a focus on improving aspects of telehealth delivery to facilitate healthcare. Thus, students' understanding of the importance of telehealth and telenursing must be improved, as this plays a crucial role in shaping the future of healthcare. This study aimed to examine nursing students' awareness, knowledge, and attitudes regarding telehealth and telenursing use for high-quality healthcare.

METHODS

A cross-sectional study was conducted on a convenience sample of 204 nursing students attending a public university in Saudi Arabia. An online questionnaire, supplemented by additional instruments, was used for data collection. The required bivariate and multivariate analyses were used to analyze the collected data.

RESULTS

The study revealed that nursing students exhibited moderately high levels of awareness, knowledge, and attitudes regarding technology use for high-quality healthcare. Significant differences in the mean frequencies of internet use and knowledge (p < .05) and technology proficiency and knowledge (p < .05) were reported. The Pearson coefficient correlation test demonstrated that awareness was associated with knowledge (r = 0.350, p < .001), attitude (r = 0.660, p < .001), and years of technology use (r = -0.157, p = .025). Furthermore, attitude was significantly associated with knowledge (r = 0.295, p < .001) and years of technology use (r = -0.150, p = .032). In the regression, the awareness, knowledge, and attitude models were all significant (p < .05).

CONCLUSIONS

The study's findings emphasize the need for targeted interventions to enhance nursing students' technological proficiency and awareness of telenursing. The predictive relationships among awareness, knowledge, and attitude also emphasize the need for a comprehensive and integrated educational approach. Future qualitative research studies should explore nursing students' perceptions of telenursing and how this could lead to high-quality healthcare.

Nurses' perspectives on ethical aspects of telemedicine. A scoping review

BACKGROUND

Changes in health needs led to an increase in virtual care practices such as telemedicine. Nursing plays an essential role in this practice as it is the key to accessing the healthcare system. It is important that this branch of nursing is developed considering all the ethical aspects of nursing care, and not just the legal concepts of the practice. However, this question has not been widely explored in the literature and it is of crucial relevance in the new concept of care.

OBJECTIVE

The purpose of this scoping review is to identify the ethical aspects of the development of telemedicine from a nursing practice perspective.

METHODS

A scoping review of the literature based on Arksey and O'Malley's framework. The search was conducted in Scopus, PubMed/MEDLINE and CINAHL databases, from 2012 to 2022. A total of 1322 articles were retrieved, of which 12 met the inclusion criteria.

ETHICAL CONSIDERATIONS

The research was conducted in accordance with the best scientific practices.

FINDINGS

The most relevant aspects were the safety of the patient, the benefits for the user and the digital competence of the professionals. Informed consent and patient's willingness to use new technologies were relevant to the practice, as was person-centered care and how telemedicine can influence the quality of the therapeutic relationship. Another relevant issue was the concern about professional competence for optimal outcomes.

CONCLUSION

It is necessary to further explore and develop the ethical aspects of the new practices, disassociating them from the legal aspects only. Professionals demand more training providing them with more competence and confidence.

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.

Nursing students' experiences of teaching and learning during the COVID-19 pandemic: a systematic review and meta-synthesis of qualitative studies

INTRODUCTION

During the COVID-19 pandemic, the sudden transition to virtual learning led to several challenges for nursing students. This study aimed to synthesis nursing students' experiences of teaching and learning during the COVID-19 pandemic.

CONTENT

A meta-synthesis of qualitative articles were conducted. Three online databases were searched from December 2019 to December 2022. Qualitative studies and qualitative sections of mixed method studies were included.

SUMMARY

Twenty-four qualitative studies and seven mixed-method studies were included in the review. The findings consisted of one main theme "educational transformation", and three categories "challenging face-to-face clinical training", "transition from face-to-face to virtual education", and "support continua". The evidence indicated that during this health-related crisis, most of the training was provided as distance learning in various forms. According to the findings, distance education alone cannot replace face-to-face education and is suggested to be considered as a supplementary learning method.

OUTLOOK

This study provides a comprehensive understanding of nursing students' experiences during the COVID-19 pandemic, offering practical implications for educators and institutions globally. The lessons learned can inform strategic decisions, policies, and practices to enhance the resilience and adaptability of nursing education in the face of unforeseen challenges.

Alternative Clinical Practice Experiences of Korean Nursing Students during the COVID-19 Pandemic

Background: Routine clinical practice (RCP) experiences provide nursing students with the opportunity to gain confidence in their professional roles. The purpose of this study was to explore the alternative clinical practice (ACP) experiences of nursing students during the COVID-19 pandemic using the Q methodology. Methods: Fifty-two nursing students located in four cities across South Korea participated. The participants sorted the order of and ranked 41 Q statements about their experiences with ACP into a Q sort table; the data were analyzed using the PQ method. Results: The following three distinct viewpoints were extracted: (1) ACP helps with balancing learning and life (favorable view of ACP); (2) ACP does not help with balancing theory and clinical field practice (critical view of ACP); and (3) RCP cannot be replaced by ACP (negative view of ACP). Conclusions: The findings of this study indicate that developing a curriculum for clinical practice that can enhance the strengths of ACP while compensating for its weaknesses will help promote learning among nursing students.

Stress and Coping Strategies of Online Nursing Practicum Courses for Taiwanese Nursing Students during the COVID-19 Pandemic: A Qualitative Study

BACKGROUND

The coronavirus disease (COVID-19) pandemic has resulted in significant changes in nursing education. Maintaining social distance could slow down the spread of COVID-19, and it was necessary, but it significantly reduced students' hands-on clinical practice experience in healthcare settings. Traditional classroom teaching in schools has transitioned to distance or online learning methods, which significantly reduced students' hands-on clinical practice experience in healthcare settings. Although distance education had been implemented for a long time, there are many problems and challenges to be resolved. The experiences and needs of nursing students in remote clinical training urgently require further understanding.

PURPOSE

To understand the stress and coping strategies of online nursing practicum courses for Taiwanese nursing students during the COVID-19 pandemic.

METHODS

A qualitative research approach with purposive sampling was supplemented by snowball sampling. Semi-structured interviews were conducted, and the data were collected following the eight-step process outlined by Waltz, Strickland, and Lenz (2010). The participants were 12 nursing students on a two-year nursing RN-to-BSN program at a university in Eastern Taiwan, consisting of 11 females and 1 male student.

FINDINGS

The stress and coping behaviors of nursing students consist of four main themes, each with three subthemes, including "urgent changes", "the gaps between online courses and practical operations", "mixed feelings of joy and anxiety" and "unexpected gains".

CONCLUSIONS

The pandemic has impacted nursing students' learning and living. Engaging in online nursing practicum brought about significant stress; nevertheless, students employed various coping strategies to navigate through this challenging period. The findings of this study would also help nursing educators understand the learning gaps in clinical practicum among students.

Moving forward the Italian nursing education into the post-pandemic era: findings from a national qualitative research study

BACKGROUND

During the CoronaVIrus-19 (COVID-19) pandemic, nursing education has been dramatically transformed and shaped according to the restrictions imposed by national rules. Restoring educational activities as delivered in the pre-pandemic era without making a critical evaluation of the transformations implemented, may sacrifice the extraordinary learning opportunity that this event has offered. The aim of this study was to identify a set of recommendations that can guide the Italian nursing education to move forward in the post-pandemic era.

METHODS

A qualitative descriptive design was undertaken in 2022-2023 and reported here according to the COnsolidated criteria for REporting Qualitative research guidelines. A network was established of nine Italian universities offering a bachelor's degree in nursing for a total of 6135 students. A purposeful sample of 37 Faculty Members, 28 Clinical Nurse Educators and 65 Students/new graduates were involved. A data collection was conducted with a form including open-ended questions concerning which transformations in nursing education had been implemented during the pandemic, which of these should be maintained and valued, and what recommendations should address the transition of nursing education in the post-pandemic era.

RESULTS

Nine main recommendations embodying 18 specific recommendations have emerged, all transversally influenced by the role of the digital transformation, as a complementary and strengthening strategy for face-to-face teaching. The findings also suggest the need to rethink clinical rotations and their supervision models, to refocus the clinical learning aims, to pay attention towards the student community and its social needs, and to define a pandemic educational plan to be ready for unexpected, but possible, future events.

CONCLUSIONS

A multidimensional set of recommendations emerged, shaping a strategic map of action, where the main message is the need to rethink the whole nursing education, where digitalization is embodied. Preparing and moving nursing education forward by following the emerged recommendations may promote common standards of education and create the basis on for how to deal with future pandemic/catastrophic events by making ready and prepared the educational systems.

Factors associated with the perceptions of eHealth technology of Chinese nurses and nursing students

AIM

The current study sought to assess the perceptions of eHealth technology of nurses and nursing students in China and to examine the association between these perceptions and demographic factors.

BACKGROUND

Despite the increasing use of eHealth technologies in China and across the globe, the perceptions of practicing and student nurses remain minimally explored. Findings from such an inquiry can potentially inform actions and policies to improve the uptake of eHealth technologies among Chinese nurses.

DESIGN

This was a cross-sectional study with a real-time online survey.

METHODS

A convenience sample of 1338 nurses and nursing students from Mainland China participated in the study. Their perceptions of eHealth technology were collected using the Chinese version of the Perceptions of eHealth Technology Scale. The Kruskal-Wallis test and multiple linear regression analysis were used to examine the relationship between demographic variables (age group, gender, occupation, education level, position and clinical experience) and perceptions of eHealth technology. All study procedures adhered to the STROBE guidelines.

RESULTS

Most participants were aged between 20 and 29 (55.8%). Nearly half (42.5%) were frontline clinical nursing staff, some were nursing students (36.2%), academic nursing staff (12.3%) and clinical nursing management staff (9.0%). Regardless of the differences in their demographic characteristics, the participants had higher mean scores in "Perception of eHealth applications" and lower mean scores in "Knowledge of eHealth technology". Participants with doctoral degree had a higher mean total score and higher sub-scale scores in knowledge of eHealth technology, perception of the advantages of eHealth technology and perception of eHealth applications; and the lowest scores in perception of the disadvantages of eHealth technology and perception of eHealth applications. Occupation, position and clinical experience were found to be the demographic characteristics associated with eHealth perceptions, before adjusting for age and gender. Education level was associated with eHealth perceptions regardless of adjustment.

CONCLUSION

Overall, participants had higher scores on perceptions of eHealth applications but lower scores on knowledge of eHealth technology. Considering the association between education and all subscales and overall scores, it may be essential to implement continuing professional education for nurses to improve their knowledge of eHealth applications. Encouragement to use available eHealth digital technologies may also be helpful to improve perceptions of eHealth.

Changes in Clinical Training for Nursing Students during the COVID-19 Pandemic: A Scoping Review

(1) Background: The COVID-19 pandemic has cost social, economic, cultural, and educational life, distressing nursing training and practice. This study aimed to map the literature on changes in clinical training for nursing students during the COVID-19 pandemic. (2) Methods: A scoping review was conducted according to JBI methodology’s latest guidance. A set of relevant electronic databases and grey literature was searched to report results published in English, Spanish, and Portuguese. (3) Results: A total of 12 studies were included in the study, addressing changes in clinical training in undergraduate nursing students due to COVID-19 pandemic activity, published between 2020 and 2022. (4) Conclusions: Nursing schools made an effort to replace traditional clinical training with several activities, primarily based on simulation or virtual activities. However, contact with others is essential, and simulation programs or scenarios cannot provide it.

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

AIM

To consolidate the evidence around the experiences of nursing undergraduates and faculty members navigating through remote and online education during the COVID-19 pandemic.

BACKGROUND

The 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.

DESIGN

A systematic review and meta-synthesis of the qualitative literature was undertaken using Sandelowski and Barroso's approach.

METHODS

Six 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.

RESULTS

Forty-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.

CONCLUSION

To 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.

An innovation on clinical placement for occupational therapy mental health during the COVID-19: A mixed-methods feasibility study

The COVID-19 pandemic altered the health profession's education. Educational activities were shifted to online, and clinical placements were compromised in certain countries. A mixed-methods study included 17 undergraduates undergoing a mental health placement. The first 3 weeks of clinical placement applied online case-based learning in written and in video format. The last 2 weeks involved hybrid remote and physical onsite clinical placement. SPICES model utilizing various active learning activities, case studies and client attendance, facilitator engagement, discussion and feedback were implemented. A self-administered System Usability Scale (SUS), e-learning preference level, focus group discussion, and reflective writing was conducted at the end of each week and the students' final marks were compared with the past cohort who attended conventional physical clinical placement. Two-way mixed ANOVA indicates no significant interaction was found on the SUS (p = 0.062, ηp2 = 0.062) and preference scores (p = 0.285, ηp2 = 0.079) according to week and practical site. There was no significant difference in the final mark among the online and onsite placement of the current cohort (p = 0.350, d = 0.47). The current cohort reported better marks than the previous cohort who attended conventional placement (p = 0.006, d = 0.99). Qualitative findings show positive responses where online activities have minimal restriction on the learning process. This innovative approach is acceptable for substituting conventional clinical learning during this restricted situation.

Clinical Field and Alternative Clinical Practice Experience in a Pandemic Situation of Nursing Students Who Have Experienced Clinical Practice before COVID-19

This study aimed to understand the experiences of nursing students who experienced clinical practice before the outbreak of COVID-19 on clinical field practice and alternative clinical practice adopted during the COVID-19 pandemic. A phenomenological study was conducted on 14 graduates who experienced clinical field practice and alternative clinical practice during a pandemic. Data were collected using individual in-depth interviews that were semi-structured. Data were analyzed according to Colaizzi's procedure. As a result of data analysis, five themes and 17 sub-themes were selected. The five themes were: alienation during the process of clinical practice change, regret caused by alternative clinical practice, alternative clinical practice as a supplementary measure, difficulties due to COVID-19, non-replaceable clinical field practice. It is necessary to consider using alternative clinical practices to complement the clinical setting and improve the quality of clinical practice in the post-corona era. To this end, it is necessary to supplement the disadvantages of alternative clinical practice, such as reduced concentration and lack of sense of presence, by applying integrated education using Edutech.