Abstract:

This research describes the processes and decisions involved in moving to virtual simulation augmentation suddenly during a 4th year Nursing program to help nursing students meet their clinical nursing practice requirements for graduation. Their Canadian university encountered a full lockdown and Nursing faculty had to suddenly pivot to online learning, despite the scheduled practicum experience. The Nursing faculty were guided by International Nursing Association for Clinical Simulation and Learning (INACSL) standards of best practice, and the faculty employed validated tools for quality measures.

Quality assurance processes in higher education are regulated in Canada, as in Europe where standards and guidelines apply across borders. It is important to establish shared understandings of what constitutes quality in order to build trust in education provided by institutions. Students attend higher education to prepare for careers, and education quality is critically important to build their competence to practice. Quality in education can be built in through the deliberate design of interactions between and among students, their teachers, the learning environment and the curriculum. Quality assurance is an essential process of ensuring that students have requisite learning opportunities, content, and the facilities required to meet the required learning outcomes under the guidance of skilled professors. High quality learning outcomes are an expectation regardless of the mode of learning (in-person learning, online learning or some blend of both).

There are multiple layers to quality assurance at Canadian universities. Higher education programs such as nursing must meet quality assurance regulations for the academy as well as accreditation standards from the Canadian Association of Schools of Nursing. In Ontario, one Canadian province, the College of Nurses of Ontario has established Entry to Practice Competencies for Registered Nurses. All nursing program graduates must demonstrate these competencies, which are the actions required for nurses to bring their knowledge, skills and decision-making together in order to safely practice nursing. These Entry to Practice competencies are central to nursing degree program design in universities. With a global pandemic, however, classes for students in Nursing programs came to an abrupt halt toward the end of the Spring 2020 semester, two months before their final exams and prior to the clinical practice component.

Quality assurance mechanisms are cyclical and self-regulating, but they are not designed for sudden changes in the mode of learning during a global pandemic. In the case study presented here, on March 17, 2020, the province of Ontario declared a medical emergency. Nursing students in their fourth year were not able to continue with either classes or clinical practicum assignments because of the national lockdown. The faculty needed to re-design the curriculum in order to satisfy their Entry to Practice Competencies. This case study chronicles how the nursing faculty shifted the clinical practice component of a nursing program online using polysynchronous modes of learning, including simulations. The process documented in this study includes the summary of decisions required in order to move to an online clinical nursing practicum, the curriculum and learning mode decisions, the findings based on pre and post assessments, and the overall summary and recommendations of the study.

Keywords:

Virtual simulations, nursing education, quality assurance.