COVID-19 pandemic and remote teaching: transition and transformation in nursing education

Remote teaching and nursing education

Though online learning is a widely accepted alternative with a significant impact on the educational field, its feasibility for sound clinical nursing education remains questionable (How Nurses Can Still Go to School During COVID-19, 2020). Most medical and nursing schools have been forced to suspend clinical education due to anticipated risks to students’ welfare, thus affecting their learning (Anderson, Turbow, Willgerodt, & Ruhnke, 2020; Dedeilia, Sotiropoulos, Hanrahan, Janga, Dedeilias, & Sideris, 2020). Learning from clinical experiences through direct patient exposure is always the foundation of clinical nursing education. Clinical nursing education being the core educational strategies for developing key expected competency such as specific nursing skills, building confidence, cultivating the values of compassion, empathy, and caring attitudes of nursing students. The transition to RT negotiated all these competency of clinical nursing education with challenges in stringent strategic planning and implementation. Transforming the clinical experience through an online platform and meeting the clinical education objectives remains the main challenge (Jackson et al., 2020; Konrad et al., 2020). In the absence of “well-considered, durable learning plans,” faculty of different generations have faced many challenges in online teaching, with implementation huddles from all perspectives (Lee, 2020). Embracing RT to support the continuation of education during the crisis has opened a new chapter in the education system for educational leaders, policymakers, and faculty to develop their e-learning systems strategically (Affouneh, Salha, & Khlaif, 2020; Jackson et al., 2020; Khlaif & Salha, 2020; Maslov, 2020).

Due to the impact of the pandemic, replacing real clinical nursing practice with virtual clinical practice in RT is a paradigm shift and a landmark in clinical education. The inevitable shift to virtual learning precipitated an unprecedented demand for uncompromised high-quality, meaningful remote learning experiences in nursing curricula across the globe (Affouneh et al., 2020; Bowler, 2019; Dewart et al., 2020; Jackson et al., 2020; Konrad et al., 2020; Richter & Schuessler, 2019; Trust & Whalen, 2020). Faculty have been forced to work in highly stressful situations to compromise and complement clinical teaching (Jackson et al., 2020). Main challenges faced by students are difficulty in adapting to newer technology, connectivity, technical issues in learning, self-motivation, time management and often confused and struggled to achieve their course requirements and learning outcomes (Maslov, 2020; Resources for Parents and Teachers: Motivating & Supporting Children During Remote Learning, 2020; UNESCO’s support: Educational response to COVID-19, 2020). Students have also feared not knowing how well they will perform in the new platform and the mode of evaluation and grading (Jackson et al., 2020).

Globally, with the mandatory switch to RT by all nurse educators and universities, challenges have been faced by institutions, administrators, faculty, students, parents, and society. The sudden shift to online teaching and virtual education has demanded pragmatic guidance for teachers, institutional heads, and state officials who must manage the education consequences of the pandemic situation (Resources for Parents and Teachers: Motivating & Supporting Children During Remote Learning, 2020). The transformed online teaching as temporary solution to achieve learning objective compromised full faculty support and negotiated the careful course design and implementation (Hodges, 2020; Manfuso, 2020). Supporting the transition to RT and preparing for future crisis across the globe, addressing the challenges and strategies of nursing education during the COVID-19 pandemic and offering guidance to institutional heads and teachers is an emerging need.

Remote teaching: benefits, challenges and opportunities

Universities with strong Learning Management System (LMS), online courses, and trained faculty have been privileged with an easy transition to structured RT, whereas for most higher education institutions, the transition to completely online RT has been challenging. Challenges and opportunities of RT in nursing education were identified and described in three perspectives such as the institution, faculty, and students to implement effectively and to build for a better future. Based on current evidence, Table (Affouneh et al., 2020) is a preview of benefits, challenges and opportunities outlined from three perspectives: the university or institution, faculty, and students.

Benefits. The main strengths of RT approach are its flexibility, accessibility, student-friendly format, and feasibility as an emergency tool to sustain the continuity of education (Benefits and Challenges of Online Instruction, 2020). Within the nursing education, the main objective of the RT is to continue nursing education remotely with given accessibility and able to meet the desired learning outcomes (Bowler, 2019; Dedeilia et al., 2020; Jackson et al., 2020; Lee, 2020; Richter & Schuessler, 2019; UNESCO’s support: Educational response to COVID-19, 2020). Through the RT implementation, nursing colleges established effective interdisciplinary and interdepartmental collaboration, communication and support for the educational processes. RT mode acknowledged the need of well-established Center for Excellence in Teaching and Learning services (CETL) for professionally competent faculty (Anderson et al., 2020; Continued Remote Teaching Toolkit Summer, 2020; Dewart et al., 2020). RT favors student centered curriculum as most learning takes place through interactions of motivated students (Etherington, 2017; Motivating learners during remote learning due to COVID-19: tips for teachers | UNESCO HIV and Health Education Clearinghouse, 2020; Riggs, 2020).

Challenges: Several challenges have raised with RT implementation at the institutional level and within the nursing education. At the institutional level, the key challenges are to streamline RT policies with the existing teaching and learning policies and prompt communication with all stakeholders in the learning and teaching process (Benefits and Challenges of Online Instruction, 2016; Continued Remote Teaching Toolkit Summer, 2020; Trust & Whalen, 2020). The major challenges that have been identified at the institutional level and nursing faculty were the equity in connectivity to students, digital security issues both personal and institutional, academic integrity and plagiarisms (Affouneh et al., 2020; Benefits and Challenges of Online Instruction, 2016; Dewart et al., 2020; Khlaif & Salha, 2020; Means et al., 2010; Richter & Schuessler, 2019).

Within the COVID-19 crisis context, several challenges have been reported by the students during RT implementation, such as non-welcoming learning environments, poor quality of digital content, digital inequity, and digital gaps among students and their families (Affouneh et al., 2020; Jackson et al., 2020; Khlaif & Salha, 2020; UNESCO’s support: Educational response to COVID-19, 2020). These challenges have negatively influenced students, leading to non-engagement and lack of motivation to complete online classes, which necessitate RT improvements (Jackson et al., 2020; Khlaif & Salha, 2020). Students financially compromise to buy electronic gadgets and Internet access, challenged intrinsic and extrinsic motivation from limited interaction and socialization posed major threat to smooth transition to the RT (Continued Remote Teaching Toolkit Summer, 2020; Etherington, 2017; Motivating learners during remote learning due to COVID-19: tips for teachers | UNESCO HIV and Health Education Clearinghouse, 2020; Resources for Parents and Teachers: Motivating & Supporting Children During Remote Learning, 2020). Nursing students’ competence to face real-life practical situations after the crisis has been the major concern of RT (Bowler, 2019; Dewart et al., 2020; Morin, 2020).

Whereas, nursing faculty are challenged with the inability to use existing course material, problems with set-up and equipment and creating usable platforms, technical incompetence, extra hours of work, and the need for investment in self-development (Bowler, 2019; Dewart, 2020; Richter & Schuessler, 2019). Inadequate relevant e-resources, especially virtual facilities for clinical courses, and institutional technological support hinder effective RT implementation (Dedeilia et al., 2020; Faculty Self-Assessment: Preparing for Online Teaching | Hybrid Initiative, 2020; Richter & Schuessler, 2019). Additionally, the lack of emotional connection between faculty and students, and different generations of nursing faculty with varying technological competence, pose more challenges (Bowler, 2019; Jackson et al., 2020; Konrad et al., 2020). This highlight the need for faculty development in RT implementation (Continued Remote Teaching Toolkit Summer, 2020; Dewart et al., 2020; Trust & Whalen, 2020).

Nursing faculty were ethically challenged to build clinical practicum hours, inadequate virtual platforms to teach and practice clinical skills, limited technical skills of faculty and exposure of students, lack of integrated assessment strategy and grading threatened the clinical nursing education. This demanded reforms in curriculum such as clinical course objectives, teaching learning strategies with reasonable changes in examination, provision of technical support for institutions, and personal competence of faculty (Anderson et al., 2020; Dedeilia et al., 2020; Dewart et al., 2020; Jackson et al., 2020; Morin, 2020; Trust & Whalen, 2020). RT mandate course content modification amicable to online platform, the latest recommendations, focusing on competency-based education rather than content, rationalize curricular modification conducive to RT (Barton, Murray, & Spurlock, 2020; Jackson et al., 2020; Maslov, 2020).

Opportunities. Although the adoption of RT approach as alternative teaching method to the traditional teaching approaches has associated with a lot of challenges, many opportunities have been evolved. For example, the medical education has responded innovatively to COVID-19 challenges and reacted positively at different levels including the availability of virtual educational materials, video conferencing, social media, and teleconferencing (Dedeilia et al., 2020; Theoret & Ming, 2020). Nursing faculty have been forced to use various available synchronous and asynchronous online modes to continue education with their available technical competence (Bowler, 2019; Dewart et al., 2020; How Nurses Can Still Go to School During COVID-19, 2020; Konrad et al., 2020). These challenges raise opportunities for institutions to invest in effective learning management systems (LMS), relevant faculty development programs to update technical competency and establishing good CETL services (Affouneh et al. 2020; Continued Remote Teaching Toolkit Summer, 2020; Faculty Self-Assessment: Preparing for Online Teaching | Hybrid Initiative, 2020; Resources for Parents and Teachers: Motivating & Supporting Children During Remote Learning, 2020). To conclude the strategies to streamline online teaching and learning call for collaborative efforts from university administration, faculty and students (Basak et al., 2016; Jackson et al., 2020; Riggs, 2020; UNESCO’s support: Educational response to COVID-19, 2020).

Summary

The sudden transition to complete RT due to COVID-19 pandemic disturbed the education system globally. Without much technical competence and effective learning management system most nursing educators have been unable to design and implement the best online learning experiences, especially the clinical based courses. Inequity, connectivity, time management and lack of self-motivation were the most significant challenges encountered by students. Overwhelming workloads and technological incompetence were the major challenges encountered by faculty. However, the RT implementation triggered many opportunities to explore and develop in all spheres of nursing education. Reliable and effective LMS, equitable and uninterrupted connectivity, and cost-effective equipment can ensure continuity of education in a pandemic period. Explored peer support and reverse mentoring were effective strategies during COVID-19 pandemic crisis to bridge faculty technical competency. Being flexible with options for both synchronous and asynchronous modes, ensuring students’ accessibility, engagement, motivation and empowerment, and ensuring security and privacy are key factors for effective and safe RT implementation. Redesigning nursing curricula and adopting best practices, addressing the major challenges of RT implementation are key elements to attain the students’ learning outcomes. Choosing best practices will ensure that every future nurse is prepared as a safe and quality care provider.