When nursing students at Aultman College started the spring semester, no one expected the coronavirus pandemic to reshape their education. Some students had just begun their journey, while others had one final semester to complete.
As the coronavirus spread throughout the United States in the spring of 2020 and life came to a halt, our faculty and staff had to pivot to continue providing the same level of education for those enrolled in our nursing programs. As a small-sized college, we were grateful for the ability to be nimble and quick as the state of Ohio started to enforce a shelter-in-place policy.
On Tuesday, March 10, the governor of Ohio asked all universities and colleges to move their classes online. Through the rest of the week, we quickly transitioned all classes and labs to an online or remote format. Online courses began Monday, March 16, and by March 17, all faculty and staff started working remotely.
At the time, news about the coronavirus was ever-changing. That meant updates at the state and federal levels regarding personal safety and the ability to hold classes constantly came through as well. We tried to keep up with the pace of information, while reducing as much confusion as possible. Throughout it all, however, we learned many lessons from an academic standpoint and even found some moments of levity as well.
Our nursing programs involves very hands-on activities and clinical rotations to ensure students absorb lessons and gain real world experience. We had to get creative in an effort to provide a variety of learning opportunities.
Getting Creative with Nursing Education
When the last competency skill to complete in a course is a full catheter insertion, who will you use for practice when attempting to complete the semester from home? Your mom or sister? No; instead, you practice on a life-size model named “Peggy Pelvis.”
Less than a dozen nursing students had to complete this competency, so Dr. Jo Ann Donnenwirth and Dr. Theresa Benzel delivered the pelvis model and lab supplies to students throughout a few counties. Each student had a few days to practice the catheter insertion and record themselves completing the competency exercise. Then, “Peggy” would be picked up, sterilized, and delivered to the next student with a new set of lab supplies.
“This solution worked out phenomenally well,” Dr. Benzel, dean of foundational education and health professions, said. “The students were very gracious that we were able to pivot into this solution so they could complete their course on time.”
During their education, nursing students are required to perform a dressing change. This usually happens in the nursing lab, but with students learning from home, we had to find a different solution. For this exercise, we assembled dressing change kits—which included the items they would need to use as well as a picture of a wound—and mailed them to students.
Once the students had the kits, they had to record themselves performing the dressing change. They had to go through the process like they would in the lab, but this time using the image of a wound taped to a table or hard surface at their home. The surprising part was that students made it fun, including one nursing student who began her video with “Hello, Mr. DeVito, I’m going to be doing your dressing change today.” She hadn’t just placed the image on a bed, but she had also placed a pillow with actor Danny DeVito’s face near the headboard.
A somewhat simpler exercise involved no equipment from Aultman College. Instead, students had to enlist a volunteer over 18 years old to complete a head-to-toe assessment. Once again, students had to film themselves completing the assessment, most likely using a friend or family member.
For classes that involve more hands-on learning, such as Chemistry and Anatomy & Physiology, we purchased science kits for the fall semester using funding from the CARES Act that was developed in response to the pandemic. Students will be able to examine and interact with items from the kits while engaging with virtual classes.
The textbook we use for A&P also offers a virtual application that can render organs and body parts in 3D, so students can manipulate them on the screen to get a 360-degree view. This works similar to our Anatomage Table but on a smaller scale. In the classroom, we can use this virtual anatomy dissection table to explore nursing concepts. Now, students can do similar exercises at home.
The state-wide shut down happened halfway through the spring semester. Students participating in clinicals at the time were forced to stop. Clinical sites—including hospitals, long-term care facilities and community agencies—could no longer take students, since the possibility of spreading the coronavirus was a huge risk. Dr. Donnenwirth, dean of nursing, decided to count the students’ midterm grade as their semester grade for clinical.
As businesses throughout the state began to re-open over the summer, clinical sites continued to stay closed to students. We were able to use virtual clinical opportunities during this semester, including virtual case studies and modules—which are similar to video games—to cover the material students would have learned in person. It wasn’t the ideal situation, but it gave us the chance to use resources that had been available to us pre-pandemic.
Over the summer, deans throughout Stark County met with healthcare professionals to negotiate when students could once again participate in clinicals. We understood that access would be limited, and different requirements would be put in place to protect patients and employees—and of course the students. However, we still wanted to negotiate the best scenario for our students to gain that critical exposure and education experience.
The ability to participate in clinicals was vital for some students who wanted to learn more about specialties such as obstetrics. For example, we’ve witnessed some students who were convinced they wanted to be a Labor and Delivery nurse completely change their mind after an OB clinical. The in-person experience can be an important factor in a nursing student’s journey.
Thankfully, acute care hospitals, such as those part of Aultman Health Foundation and Mercy Medical Center and select community agencies began letting students back in for the fall semester. (Long-term care facilities are not yet letting students return.) This semester, nearly all of our students will be in a clinical setting. If any part of the experience is lacking, we will fill in the gaps with virtual clinicals and our simulation lab. This is wonderful for our students and their families; things can get tricky when they are trying to practice with mom or dad instead of interacting with an actual patient.
Planning for the Future
To accommodate for the return of students for the fall semester, we implemented social distancing measures through new guidelines and by rearranging furniture in labs and classrooms. We also implemented safety guidelines regarding temperature screenings, hand washing, and other now-standard recommendations.
Local and national situations regarding the coronavirus continue to change. We are monitoring the news and any new requirements from the government. As flu season approaches, anything could happen. It’s possible that the fall semester could be forced to go virtual or the spring semester starts from home.
Once the pandemic is over, we hope to never use the individual lab kits again. Nursing students need to be in the classroom or lab to fully grasp what they’re learning. On the other hand, now that virtual learning has forced us to use resources that had been available for years, we have found that some of them are incredibly beneficial. We even discovered that we weren’t using some to their fullest potential, such as the virtual A&P application.
An unfortunate effect of the pandemic was the ever-changing situations in students’ personal lives. Some lost their jobs, while others struggled with finding childcare. We understood that some did not return for the summer semester while they juggled all of these challenges.
And yet, one point we found enlightening was the support students received while learning from home. As our virtual classes streamed into their living rooms, we realized “there are probably a lot of family members who should get honorary nursing degrees,” said Dr. Benzel.
We are proud that our faculty and students persevered through an incredibly challenging time not just at Aultman College but throughout the world. The coronavirus has felt like a once-in-a-lifetime event, yet we’re more prepared than ever before should something similar happen again.