The value of a redesigned clinical course during COVID-19 pandemic: an explorative convergent mixed-methods study

Abstract

Background: The COVID-19 lockdown in March 2020 had a significant consequence for nursing students worldwide including limited access to learning situations in clinical rotation. Therefore, this study aims to explore how an innovative redesign of a clinical course in a time of pandemic supported nursing students in learning the fundamentals of care in their first year. The redesign involved the transformation of a traditional hands-on clinical course into a technology-enhanced learning environment.

Design: This was an explorative convergent mixed-methods study using both quantitative and qualitative methods.

Methods: Twenty-four first-year nursing students responded to an online questionnaire with open-ended questions. Two nursing students and one faculty member participated in individual online interviews, and three faculty members participated in an online focus group interview. All the data were collected in June 2020. The quantitative data were analyzed using descriptive statistics and the qualitative data using content analysis. The GRAMMS guideline was applied.

Results: The students achieved the learning outcomes regarding fundamental care, basic physical assessment skills, and clinical reasoning with the help of academic assignments, multimedia learning resources, and virtual patients. Further, six central aspects of the facilitator role in the virtual simulation were identified. The aspect that was considered most valuable involved uncovering the "red thread" between different areas of knowledge in the first year of nursing education; this supported the students to better understand how to think and talk like a nurse.

Conclusion: This study offers insight into how a technology-enhanced clinical course can foster the learning of fundamental nursing care, basic physical assessment skills, and clinical reasoning skills; enhancing students' preparedness for clinical hours. Virtual patients' scenarios contributed to integrating different types of knowledge and skills that are important when providing nursing care for patients in clinical practice. This study also highlighted a gap in pedagogical competence among faculty members with regards to facilitating learning in a technology-enhanced learning environment. Study findings suggest promising pedagogical strategies that should be further developed post-pandemic, in response to the call for a renewal of nursing education using more technologically supported learning designs.

Keywords: Clinical competence; Clinical reasoning; Computer simulation; Education nursing; Education, clinical; Nursing; Nursing skills; Student nursing.

Fig. 1

The explorative convergent mixed-methods design used in the study. Figure adapted from Creswell and Plano Clark (2018), p. 70

Fig. 2

The clinical course before and after the redesign process

Fig. 3

The virtual patient encounters

Fig. 4

The extent of the qualitative data

Fig. 5

Uncovering the “red thread” within nursing education