How has the COVID-19 pandemic changed the way nursing is taught?


It goes without saying that the pandemic had a cataclysmic impact upon the education sector, and particularly for the delivery of courses that have an essential ‘hands on’ component.

Nursing has been one of the hardest hit subjects. While students have the theoretical element to their course, there is also the need for many to complete clinical sessions too – an impossibility at a time when medical facilities have been overrun with patients.

A switch to online teaching has helped with some aspects of tuition, but the need for on-the-job style learning is so important for nursing students.

Quality of care has been hit hard too. For example, family nurse practitioners (FNPs) play a vital role in both delivering effective support and improving the experience of those using medical facilities – few could disagree that FNPs improve patient outcomes.

The role of an FNP is akin to that of a primary care physician, offering ongoing assistance, typically over a long-term period – be it through annual wellness examinations, assistance for chronic conditions or simply being a ‘first responder’ when a patient is feeling unwell.

Win-win situation

It is not uncommon for nurses to expand or re-train in the FNP sphere, but their numbers are dwindling due to competition with other medical departments and roles. The importance of FNPs in under-privileged areas cannot be underestimated, and so a dearth in qualified practitioners is of grave concern.

FNPs are generally favored by patients too. They typically rate higher in terms of customer satisfaction than other treatment providers, and this too highlights their importance. Patients who should be seeking medical care, but don’t, may be put off by a lack of trust or dislike of their MD, for example.

Further down the line, FNPs can build long-term bonds with their assigned patients, and that is particularly important when working with individuals whose illnesses or ailments require them to make considerable changes to their diet or lifestyle – there can be resistance to this, and an FNP is often better placed to persuade their patient that the change is necessary. This bond of trust can often lead to shorter stays in hospital too, and expedited recovery times from treatment.

And in these challenging times, nurse practitioners also help to reduce repeat visits and re-admissions to medical facilities – vital in keeping patient numbers down during the pandemic.

What’s more, the cost of FNP care can be as much as 23% lower than primary care services, and so the benefits to local governments of nurse practitioners – compared to other caregivers – speaks for itself.

All of which confirms that the importance of studies that yield an FNP qualification are vital to the medical field. It is essential that solutions are found that ensure the quality of teaching and learning remains high despite the challenges that the pandemic presents.

Real world education

It is hard to envisage many professions in which it is so important for students learning the ropes to experience the vagaries of their chosen career path in a real-world environment – like nursing.

Social distancing, quarantine and even the need to wear a face covering – none of these things have been particularly helpful toward that, and the situation has been exacerbated further by the need for many tutors and educators to return to the field in these extraordinary times.

The situation has been particularly unhelpful to those who were closer to completing their studies, and who are ready to take their first steps as professional medical practitioners. Sadly, some still have not been able to achieve their degree certification because their assessed clinical practice has not yet gone ahead.

In some countries around the world, including the UK, some interesting steps were taken to utilize the learning and skills of trainee nursing practitioners during the pandemic in real world settings. Students could opt into Extended Clinical Placements (ECP), which allowed them to carry out nursing work and help the national effort in fighting the virus. Helpfully for those with sizable tuition fees and debt, the ECP program was paid work that boosted the resumés of those involved and put some money in their pockets – all while helping an already-overworked health service at a time of great emergency.

To ensure fairness for those that were unable to complete an ECP for whatever reason, other students were allowed to undertake a ‘theory only’ option that ensured they continued to work towards their final degree qualification despite the disruption.

During the early days of the pandemic, when chaos and uncertainty reigned, it was necessary for students to put down their tools altogether until a consensus was reached on the best course of action.

And so, alongside their theoretical work, many learners were tasked with non-patient-led activities – anything from working on research projects to discussing policy with university/college chiefs and staff was on the table. Many students noted that this work aided their understanding of the medical sector and gave them a sense of renewed belief that nursing was the right career path for them.

The situation has been particularly hard for first-year students, who were unable to really hit the ground running with their education given the gravity of the situation that was unfolding all around them. Not only that, but many modes of study also use the first year as an introduction to the patient-led approach in a medical facility, and so many have missed out on this key area of learning.

Many colleges and universities have taken the step of re-modeling their students’ long-term timetables. Some of the theoretical work usually undertaken in the second year of a course has been brought forward to the first, with practical hours then ringfenced for later on in their studies.

Students consigned to their desk, or at least to the classroom, have been able to undertake other avenues of learning too. Many health services around the world now deploy telecare services – for example, telephone hotlines via which patients can ask questions or get an approximate diagnosis based upon their symptoms. Students have been asked to operate these services, in some cases, which has enabled them to put some of their learning into practice while developing the customer care skills which are so vital in the sector.

And on a similar note, remote and online consultations have become essential during the pandemic, and many in the industry believe that they offer a viable – although admittedly not perfect – way of communicating with patients and helping to keep the flow of traffic in hospitals and clinics as low as feasibly possible.

Students have either sat in on these remote consultations or led them entirely, which adds another string to their bow while helping to build confidence for working with patients on a direct basis.

A new reality

One of the unique challenges posed to educational institutions and medical operators during the pandemic has been the need to innovate ways in which their students can gain experience of working in a nursing environment while remaining safe at home.

Amongst the ideas generated, one of the more unique has been the use of virtual reality and so-called ‘AR’ – augmented reality – to enhance the learning experience.

These virtual worlds have enabled students to take on tasks without requiring access to medical facilities or willing patients, extending their learning and understanding in a way that, perhaps, textbooks and other ‘rigid’ methods of education cannot.

Implementing VR and other tech in nursing teaching has been considered an overwhelmingly positive move, with a research study suggesting that ‘VR can effectively improve knowledge in nursing education.’3

Going online

Many degree courses and modes of further education made the quick and easy decision to move teaching online during the pandemic.

The accessibility of free video calling tools like Zoom and Skype makes it straightforward enough to host one-on-one sessions and group lectures, with ample scope for students to ask questions and articulate ideas in a less-than-perfect, but still interactive, environment.

The same principles have been applied to nursing studies, and the community aspect of online learning has been vital at a time when many students have been left fearful and uncertain after seeing medical workers struggling with the rising numbers of COVID-19 sufferers.

For course operators and educational institutions, it has also been a revelatory time. They have had to ensure their courses continue to meet required quality standards – despite the changing dynamic that their tutors and providers have had to face.

There is perhaps a grain of truth to the suggestion that many teaching courses would have eventually moved online anyway – either partially or in full. But for nursing-based courses? It is hard to imagine the shift online would have been accelerated this quickly, and the jury is still out on whether it is an ‘appropriate’ way for the next generation of nursing practitioners to pick up the theoretical learning they need.

Despite the nature of the job, there is still plenty that nursing students can gain from the online environment where patient care is not available to them. Online forums and discussion panels are often productive and opportunities for learners to grow together – reinforcing ideas while introducing one another to new ways of thinking. These seminars are often a vital tool in ensuring students don’t feel ‘cut off’ at a time when it would be easy for them to do so.

Many teachers and educators have had to embrace agility in their approach. A percentage of the teaching community have been practice-led, while learning other skills to help enhance the experience they can provide to their students. Some have had to adapt to creating tuition videos, podcasts, and interactive course modules, while hosting group webinars and other virtual learning options. The good news is that such an adaptive approach has armed educators with skills that will remain valid and important for years to come.

Professional feedback is something that is also considered to be vital for enhancing the abilities and understanding of learners. Video-based catchups and reflection have bridged the gap temporarily, and while face-to-face dialogue is nearly always more effective, at least there has been a ‘plan B’ for what is such a crucial aspect of learning and development.

Of course, web-based tuition takes some things for granted – notably that students have access to a smartphone or laptop, and that their internet connection is of a suitable speed to allow for video streaming and the like to occur without any issues. The reality is that less affluent students, and those from underprivileged areas, are put at a disadvantage when technology becomes part and parcel of the learning process.

And so, institutions have had to be flexible and acknowledge the difficulties that some of their students can face, and many have gone the extra mile to help ensure that everybody has access to the same kind of tech required – even if it is via a shared computer in a communal space on the campus, for those able to attend in person.

An uncertain future

Even now, more than two years since the start of the pandemic, many countries are seeing spikes in the number of COVID cases they are experiencing. This suggests that, while the various vaccination programs have been considered a major success, a complete return to ‘normality’ is a little off the radar just yet.

There is no end date and no confirmation of when nursing students will be able to resume their degree courses – at least, not without any limitations on how they spend their time in practical sessions at a medical facility.

The assumption, therefore, is that the current ‘hybrid’ model of learning will remain in place for the foreseeable future. It is not ideal – not by any means – but at least it provides nursing students with the opportunity to gather the theoretical knowledge they will need for when, fingers crossed, things improve in the years ahead.


Leave a Reply