Teaching in a pandemic

Clinical Instructor Sheila Tucker had used the Canvas learning management system before the pandemic. But it was only after classes moved online that she realized that taking full advantage of the system’s learning tools and distinguishing features would help her and her students make smooth transitions from in-person to online learning.

In summer 2020, Tucker and Jacqueline Sly, assistant department chair and clinical instructor, cotaught a graduate-level class, Pharmacology and Nutrition, entirely online. They used Canvas to help teach, taking advantage of its “flipped learning” method, in which students do readings, view recorded lectures, and answer questions on their own before the material is covered in class.

“Students would take a quiz to show where the learning gaps were. Then we’d spend our class time teaching to the gaps and doing active learning activities and case studies to build their understanding to a higher level,” Tucker says.

Tucker and Sly made sure to break up video lectures into short segments. “We know that after about eight minutes of watching something, people need a mental break,” Tucker says. On the plus side, recorded lectures gave students an opportunity for easy review. “I had students who would download them and listen to them on their phones while they were running,” said Tucker.

They also used two apps, Poll Everywhere and Kahoot!, to create game-like quizzes for students. As Tucker explains, “We wanted to keep students engaged while making sure they were learning.”

Simulation, an essential part of nursing education for more than 100 years, uses medical manikins and human actors to help nursing students learn as they experience scenarios ranging from routine primary care appointments to life-threatening medical emergencies.

When the pandemic began, Christine Repsha, a clinical instructor and director of the Connell Clinical Learning and Simulation Centers, was determined to make sure students would gain as much from online simulation programs as they would learning in person.

Repsha collaborated with lab staff and colleagues at the Connell School and at a consortium of colleagues at colleges throughout New England. After identifying a comprehensive list of virtual simulation resources (including programs associated with textbooks already used in CSON courses), Repsha and her team evaluated a variety of options.

“For programs we were not familiar with, my graduate student lab teaching assistants and I went in and did the simulations ourselves,” Repsha says. “Then we looked at each course individually to see what fit best for them based on their course objectives.”

Repsha also made sure students, after taking part in virtual simulations, met with their clinical instructors on Zoom or another online platform to debrief. “That’s probably the most vital part of the process,” Repsha says. “A student really needs to talk through what they were doing in a scenario in order to process it. That’s when the real learning takes place.”

In a typical academic year, nursing students gain essential practical experience during clinical rotations in hospitals and other real-world settings in which they may give medication, check patients’ vital signs, and provide wound care and dressing changes. But when the pandemic rendered many of these on-site clinical learning opportunities off limits, CSON classes such as the Nursing Synthesis Clinical Laboratory—better known as the Synthesis course—were tapped to replace in-person experiences with virtual programs.

In fall 2020, senior Jasmin Addai began her Synthesis clinical placement at Beth Israel Deaconess Medical Center in Boston. Addai performed a range of nursing duties in the hospital, including monitoring blood sugar and administering insulin in patients with diabetes, assisting patients with activities of daily living, preparing patients for discharge, and adding information to clinical documentation records. But after 60 in-person hours, she switched to electronic learning for the second half of her placement. Addai worked closely with teaching assistant Christina Dunn, who used case studies to design Addai’s virtual “clinical days” caring for patients.

“Each case study would focus on a patient with a particular problem, such as heart failure, and would give me the patient’s backstory and what I would expect to see if I walked into the patient’s room,” Addai says. After familiarizing herself with the case studies, she would answer questions about the care she would provide to her patients.

“Jasmin had to use the clinical knowledge that she’s learned through four years of education,” Dunn says. “She was really put on the spot to make decisions and explain what she thought was going on, what she would do next, and what she would prioritize. It was a different experience than in person, but it was really enriching to have her test her own decision-making and knowledge in this way.”