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COVID-19 Necessitates Changes to Nursing Education

Analysis  |  By Son Hoang  
   August 21, 2020

Betty Nelson discusses how the pandemic has changed nursing education, what changes may come, and how nursing educators are looking forward.

The intensity and volume of the COVID-19 pandemic has forced nurse educators to reexamine how to educate nurses and stay on track for completion. As a result, nurse leaders have stepped up to ensure learning educational milestones are met while maintaining patients' health and safety.

"This is a real opportunity. We have to make sure that we continue to demonstrate the intelligent and effective leadership capabilities of nurses as leaders in healthcare and being seen as a credible authority for decisions and actions," says Betty Nelson, PhD, RN, dean of the School of Nursing & Health Sciences at Capella University in Minneapolis. "Nurse leaders in this country are exceptionally talented, prepared, and skillful but are not always brought to the table. This crisis has brought more nursing leaders to the table; staying at the table is essential for continuing effectiveness, not just a response to the pandemic."

In a recent interview with HealthLeaders, Nelson discusses how nurse leaders have adapted education in response to the pandemic, how it may continue to change, and why nurse leaders need to stay proactive.

The following transcript has been edited for brevity and clarity.

HealthLeaders: Set the scene for us: What has nursing education been like during the COVID-19 pandemic?

Betty Nelson: The COVID-19 pandemic has created a number of new challenges for nursing education and exacerbated existing ones. Perhaps the most prominent challenge is our ability to provide learning experiences in clinical settings. Many clinical settings had already been stretched to capacity for students. COVID-19 necessitated a halt in student access to clinical settings. At Capella University, all our programs have clinical placement requirements that align with professional standards that must be met, and skills and competencies that must be tested.

Our programs are designed, however, in ways that allowed us to adjust the clinical experience requirements to leverage remote and virtual experiences. Many of my colleagues who offer pre-licensure programs have maximized the use of high-fidelity simulations and virtual experiences. But that can't replace human patient interaction 100%. The threshold can be raised higher, but hands-on patient care experience is necessary.

In addition to telehealth, which is the application of communication technology to direct patient care, the application of telecommunication skills and techniques are being adopted in healthcare management as well. The pandemic is challenging us to design and deliver creative solutions to decreased availability of clinical settings yet still deliver effective education that meets professional standards and desirable learning outcomes. Using tools and methods that leverage remote technologies is an exciting opportunity.

HL: How do you think nursing education will change going forward?

Nelson: That's a very difficult question. Nursing education is not homogeneous. Different schools structure their programs and experiences differently based on their school-level philosophies. All of us act to meet accreditation requirements, both programmatic and regional accreditation. However, the comfort level with utilizing assisted-education tools and techniques like simulation, virtual, and remote varies greatly among schools.

Some of that is not necessarily just philosophical, it's financial. It's expensive to have a simulation laboratory, and it's expensive to have some of the IT support required to seek these remote or technology-driven opportunities.

This is an exciting and challenging time for our accreditation and regulatory organizations. The strain on clinical site access set against the rising need by nursing schools for clinical site access, requires accreditors and regulators to evaluate standards and requirements relative to a safe balance between in-person patient care experiences and remote and simulated patient care experiences. Maybe some standards will have to change or new ones will be developed.

HL: What are your big concerns for nursing education in the near and long term?

Nelson: My biggest concern is that we need to be more planful and responsive. This isn't new; the pandemic is shining a bright light on it. We should be looking into the future to identify knowledge and skills needed to respond to and anticipate changes in the healthcare system, patient care sciences, patient and community needs, environmental impacts on health, and demographics.

This is not just a nursing problem, it's a healthcare system problem. We are the biggest group of healthcare providers, so we can be in a position of leadership in this area.


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