Readiness for practice in undergraduate nursing students during the COVID-19 pandemic: a crossectional study
Keywords:
Coronavirus, nursing education, readiness for practice, clinical experience, nursing studentsAbstract
Background. The Coronavirus disease 2019 (COVID-19) pandemic negatively impacted nursing students’ opportunity to gain experience through clinical placement, potentially threatening their readiness for practice and their clinical competence. The aim of this study was to explore whether and to what extent the thirdyear undergraduate nursing students perceived that their readiness for practice was impacted by changes to clinical placement and classroom learning implemented in response to the COVID-19 pandemic.
Study design. Cross-sectional study.
Methods. The study was conducted in a university of North-western Italy that provides nursing education across five sites. All sites stopped in-person classroom learning at the beginning of March 2020, but each site was free to decide whether to continue in-person clinical placement based on the local epidemiological situation. All 228 third-year nursing students who completed their degree by June 2020 were invited to
participate. Data were collected via online questionnaire, which included the question “What impact do you think that COVID-19 safety measures employed by your nursing programme had on your readiness for practice?” Answers were given on a 5-point Likert scale (none, minimal, moderate, major, and severe). Explanatory variables were collected at the individual, nursing programme, and university site levels.
Results. A total of 126 (response rate 55.3%) nursing students completed the questionnaire. Overall, 84 (66.7%) perceived that COVID-19 safety measures had a moderate to severe impact on their readiness for practice. These students often had lower grade point averages (p=0.037) and received no clinical placement during the pandemic (72.6% vs 90.5% of students who reported no or minimal impact, p=0.022). Average duration of third-year clinical placement was also lower among these students, though it was not statistically significant. No differences emerged at the university site level.
Conclusions. Despite important advances in technology-based educational activities, clinical placement remains the best educational strategy to allow nursing students to feel prepared to work effectively during a pandemic.
References
1. Seah B, Ang ENK, Liaw SY, Lau ST, Wang W. Curriculum changes for pre-registration nursing education in times of COVID-19: For the better or worse?. Nurse Educ Today. 2021; 98: 104743. doi: 10.1016/j.nedt.2020.104743.
2. Carolan C, Davies CL, Crookes P, McGhee S, Roxburgh M. COVID 19: Disruptive impacts and transformative opportunities in undergraduate nurse education. Nurse Educ Pract. 2020; 46: 102807. doi: 10.1016/j.nepr.2020.102807.
3. Leigh J, Vasilica C, Dron R, et al. Redefining undergraduate nurse teaching during the coronavirus pandemic: use of digital technologies. Br J Nurs. 2020; 29(10): 566-9. doi: 10.12968/ bjon.2020.29.10.566.
4. Yancey NR. Disrupting Rhythms: Nurse Education and a Pandemic. Nurs Sci Q. 2020; 33(4): 299-302. doi: 10.1177/0894318420946493.
5. Cervera-Gasch Á, González-Chordá VM, Mena-Tudela D. COVID-19: Are Spanish medicine and nursing students prepared?. Nurse Educ Today. 2020; 92: 104473. doi: 10.1016/j. nedt.2020.104473.
6 Palancia Esposito C, Sullivan K. Maintaining Clinical Continuity Through Virtual Simulation During the COVID-19 Pandemic. J Nurs Educ.
2020; 59(9): 522-5. doi: 10.3928/0148483420200817-09.
7. Fogg N, Wilson C, Trinka M, et al. Transitioning from direct care to virtual clinical experiences during the COVID-19 pandemic. J Prof Nurs. 2020; 36(6): 685-91. doi: 10.1016/j. profnurs.2020.09.012.
8. Haslam MB. What might COVID-19 have taught us about the delivery of Nurse Education, in a post-COVID-19 world?. Nurse Educ Today. 2021; 97: 104707. doi: 10.1016/j. nedt.2020.104707.
9. Nursing and Midwifery Council. Information for students and educators. (2021). Available on: https://www.nmc.org.uk/news/coronavirus/ information-for-students-and-educators/ [last accessed: 2021 July 21].
10. Monforte-Royo C, Fuster P. Coronials: Nurses who graduated during the COVID-19 pandemic. Will they be better nurses?. Nurse Educ Today. 2020; 94: 104536. doi: 10.1016/j. nedt.2020.104536.
11. Sun Y, Wang D, Han Z, Gao J, Zhu S, Zhang H. Disease Prevention Knowledge, Anxiety, and Professional Identity during COVID-19 Pandemic in Nursing Students in Zhengzhou, China. J Korean Acad Nurs. 2020; 50(4): 533-40. doi:10.4040/jkan.20125.
12. Ramos-Morcillo AJ, Leal-Costa C, Moral-García JE, Ruzafa-Martínez M. Experiences of Nursing Students during the Abrupt Change from Faceto-Face to e-Learning Education during the First Month of Confinement Due to COVID-19 in Spain. Int J Environ Res Public Health. 2020; 17(15): 5519. doi:10.3390/ijerph17155519.
13. Mirza N, Manankil-Rankin L, Prentice D, Hagerman LA, Draenos C. Practice readiness of new nursing graduates: A concept analysis. Nurse Educ Pract. 2019; 37: 68-74. doi: 10.1016/j. nepr.2019.04.009.
14. Järvinen T, Eklöf N, Salminen L. Factors related to nursing students’ readiness to enter working life - A scoping literature review. Nurse Educ Pract. 2018; 29: 191-9. doi: 10.1016/j.
nepr.2018.01.010.
15. Jeppesen KH, Christiansen S, Frederiksen K. Education of student nurses - A systematic literature review. Nurse Educ Today. 2017; 55: 112-21. doi: 10.1016/j.nedt.2017.05.005.
16. Missen K, McKenna L, Beauchamp A. Registered nurses’ perceptions of new nursing graduates’ clinical competence: A systematic integrative review. Nurs Health Sci. 2016; 18(2): 143-53. doi: 10.1111/nhs.12249.
17. Graf AC, Jacob E, Twigg D, Nattabi B. Contemporary nursing graduates’ transition to practice: A critical review of transition models. J Clin Nurs. 2020; 29(15-16): 3097-3107. doi: 10.1111/ jocn.15234.
18. Warne T, Johansson UB, Papastavrou E, et al. An exploration of the clinical learning experience of nursing students in nine European countries. Nurse Educ Today. 2010; 30(8): 809-15. doi: 10.1016/j.nedt.2010.03.003.
19. Milton-Wildey K, Kenny P, Parmenter G, Hall J. Educational preparation for clinical nursing: the satisfaction of students and new graduates from two Australian universities. Nurse Educ Today. 2014; 34(4): 648-54. doi: 10.1016/j. nedt.2013.07.004.
20. Jamieson I, Sims D, Basu A, Pugh K. Readiness for practice: The views of New Zealand senior nursing students. Nurse Educ Pract. 2019; 38: 27-33. doi: 10.1016/j.nepr.2019.05.007.
21. Ortiz J. New graduate nurses’ experiences about lack of professional confidence. Nurse Educ Pract. 2016; 19: 19-24. doi: 10.1016/j. nepr.2016.04.001.
22. von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.
Int J Surg. 2014; 12(12): 1495-9. doi: 10.1016/j. ijsu.2014.07.013.
23. Ministry of Education, University and Research. Ministerial Decree 19 February 2009. Establishing decrees of bachelor’s for the health professions. Available on:
24. Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) [published correction appears in doi:10.2196/jmir.2042]. J Med Internet Res. 2004; 6(3): e34. doi: 10.2196/ jmir.6.3.e34.
25. Sullivan GM, Artino AR Jr. Analyzing and interpreting data from likert-type scales. J Grad Med Educ. 2013 Dec; 5(4): 541-2. doi: 10.4300/ JGME-5-4-18.
26. Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006 Oct; 29(5): 489-97. doi: 10.1002/ nur.20147.
27. Casey K, Fink R, Jaynes C, Campbell L, Cook P, Wilson V. Readiness for practice: the senior practicum experience. J Nurs Educ. 2011; 50(11): 646-52. doi: 10.3928/01484834-20110817-03.
28. Cooper J, Courtney-Pratt H, Fitzgerald M. Key influences identified by first year undergraduate nursing students as impacting on the quality of clinical placement: A qualitative study. Nurse Educ Today. 2015; 35(9): 1004-8. doi: 10.1016/j. nedt.2015.03.009.
29. Dimitriadou M, Papastavrou E, Efstathiou G, Theodorou M. Baccalaureate nursing students’ perceptions of learning and supervision in the clinical environment. Nurs Health Sci. 2015; 17(2): 236-42. doi: 10.1111/nhs.12174.
30. Cushen-Brewster N, Barker A, Driscoll-Evans P, Wigens L, Langton H. The experiences of adult nursing students completing a placement during the COVID-19 pandemic. Br J Nurs.
2021 Nov 25; 30(21):1250-5. doi: 10.12968/ bjon.2021.30.21.1250.
31. Collado-Boira EJ, Ruiz-Palomino E, SalasMedia P, Folch-Ayora A, Muriach M, Baliño P. “The COVID-19 outbreak”-An empirical phenomenological study on perceptions and psychosocial considerations surrounding the immediate incorporation of final-year Spanish nursing and medical students into the health system. Nurse Educ Today. 2020; 92: 104504. doi: 10.1016/j.nedt.2020.104504.
32. Roca J, Canet-Vélez O, Cemeli T, Lavedán A, Masot O, Botigué T. Experiences, emotional responses, and coping skills of nursing students as auxiliary health workers during the peak COVID-19 pandemic: A qualitative study. Int J Ment Health Nurs. 2021; 10.1111/inm.12858.
doi: 10.1111/inm.12858. Epub 2021 Apr 1.
33. Casafont C, Fabrellas N, Rivera P, et al. Experiences of nursing students as healthcare aid during the COVID-19 pandemic in Spain: A phemonenological research study. Nurse Educ Today. 2021; 97: 104711. doi: 10.1016/j. nedt.2020.104711.
34. Dos Santos LM. How Does COVID-19 Pandemic Influence the Sense of Belonging and Decision-Making Process of Nursing Students: The Study of Nursing Students’ Experiences. Int J Environ Res Public Health. 2020; 17(15): 5603. doi:10.3390/ijerph17155603
35. Jackson D, Bradbury-Jones C, Baptiste D, et al. Life in the pandemic: Some reflections on nursing in the context of COVID-19. J Clin Nurs. 2020; 29(13-14): 2041-3. doi: 10.1111/ jocn.15257.
36. Goni-Fuste B, Wennberg L, Martin-Delgado L, Alfonso-Arias C, Martin-Ferreres ML, Monforte-Royo C. Experiences and needs of nursing students during pandemic outbreaks: A systematic overview of the literature. J Prof Nurs. 2021; 37(1): 53-64. doi: 10.1016/j. profnurs.2020.12.004.
37. Hayter M, Jackson D. Pre-registration undergraduate nurses and the COVID-19 pandemic: Students or workers?. J Clin Nurs. 2020; 29(1718): 3115-6. doi: 10.1111/jocn.15317.
38. United Nations Educational, Scientific and Cultural Organization (UNESCO). Education: From disruption to recovery. Available on: https:// en.unesco.org/covid19/educationresponse [Last accessed: 2021 July 21].
39. Zerwic JJ, Montgomery LA, Dawson C, Dolter KJ, Stineman A. Planning and implementing a practice/academic partnership during COVID-19. J Prof Nurs. 2021; 37(1): 24-8. doi:
10.1016/j.profnurs.2020.11.007.
40. Reebals C, Wood T, Markaki A. Transition to Practice for New Nurse Graduates: Barriers and Mitigating Strategies. West J Nurs Res. 2021;193945921997925. doi: 10.1177/0193945921997925. Epub 2021 Mar 16.
41. Van Camp J, Chappy S. The Effectiveness of Nurse Residency Programs on Retention: A Systematic Review. AORN J. 2017; 106(2): 128-44. doi: 10.1016/j.aorn.2017.06.003.
42. Hayden JK, Smiley RA, Alexander, M, KardongEdgren S, Jeffries PR. The NCSBN national simulation study: a longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. J Nurs Regulat. 2014; 5(2): S3-S40. https://doi.
org/10.1016/S2155-8256(15)30062-4.
43. Hanshaw SL, Dickerson SS. High fidelity simulation evaluation studies in nursing education: A review of the literature. Nurse Educ Pract. 2020; 46: 102818. doi: 10.1016/j.nepr.2020.102818.
44. Gaffney MK, Chargualaf KA, Ghosh S. COVID19 Disruption of Nursing Education and the Effects on Students’ Academic and Professional Confidence. Nurse Educ. 2021; 46(2): 76-81.
doi: 10.1097/NNE.0000000000000986.
45. Collard SS, Scammell J, Tee S. Closing the gap on nurse retention: A scoping review of implications for undergraduate education. Nurse Educ Today. 2020; 84: 104253. doi:10.1016/j. nedt.2019.104253.
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