Nursing/midwifery students' perceptions of caring pedagogy and online learning during the COVID-19 pandemic.

This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce. Mixed methods. A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students' experience of learning during the COVID-19 pandemic. There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID-19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID-19. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID-19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives. Not applicable. Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment.

Jones R ，Jackson D ，Rice K ，Fisher M ，Calleja P ，Hopkins M ，West C ，Irwin P ，McGough S ，Luck L ，Walker F ，Whiteing N ，Usher K ... -  《-》

The impact of covid-19 on psychosocial well-being and learning for australian nursing and midwifery undergraduate students: a cross-sectional survey.

To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university. The World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic. Cross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020. A cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed. Of 2907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students' well-being and their ability to learn and study. Students were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students' stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.

Rasmussen B ，Hutchinson A ，Lowe G ，Wynter K ，Redley B ，Holton S ，Manias E ，Phillips N ，McDonall J ，McTier L ，Kerr D ... -  《-》

The mental health impact of COVID-19 on pre-registration nursing students in Australia: Findings from a national cross-sectional study.

The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students. The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently. A cross-sectional study was conducted across 12 Australian universities. Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval. Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors. The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce. This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce. The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

Usher Am K ，Jackson D ，Massey D ，Wynaden D ，Grant J ，West C ，McGough S ，Hopkins M ，Muller A ，Mather C ，Byfield Z ，Smith Z ，Ngune I ，Wynne R ... -  《-》

An international exploration of blended learning use in pre-registration nursing and midwifery education.

To explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy. The global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere. Cross-sectional, sequential, mixed methods study PARTICIPANTS/SETTINGS: Nursing/nurse education leaders from across International Council of Nurses regions METHODS: Exploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants' knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes. Participants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation. Blended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact. Blended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.

Janes G ，Ekpenyong MS ，Mbeah-Bankas H ，Serrant L ... -  《-》

The effect of midwifery students' changing life conditions and e-learning experiences on the state of their anxiety and hopelessness during the Covid-19 pandemic.

Giving the existing formal education through the internet without a planned transition to distance education negatively affected the learning processes of the students. The study aims to identify the midwifery students' changing life conditions and e- learning experiences on the state of their anxiety and hopelessness during the Covid-19 pandemic. Designed as cross-sectional research, the study was performed with the participation of 1,296 midwifery undergraduate students. The survey form comprised of questions that explored the students' demographic characteristics, life conditions changing during the Covid-19 pandemic and distance education experiences, the Generalized Anxiety Disorder Scale-7, and the Beck Hopelessness Scale were used in the data collection. It was discerned that, of the participant midwifery students, 55.2% spent the period of the pandemic in the province center, 51.7% used smartphones to have access to the distance education, 50.3% had trouble in following up the courses due to the limited computer and internet access, 63.5% failed to follow up the courses because of the infrastructure problems related to the distance education. It was found that, of the participant midwifery students, 54.6% exhibited anxiety symptoms and 26.3% had hopelessness symptoms. It was identified that having trouble in following up the courses increased anxiety by 1.438 times (CI:1.103-1.875) and hopelessness by 1.980 times (CI:1.459-2.687), having tensions in the family relations increased anxiety by 2.362 times (CI:1.780-3.134) and hopelessness by 1.789 times (CI:1.235-2.594), and having psychological support for anxiety and worry increased anxiety by 2.914 times (CI:2.208-3.8477) and hopelessness by 1.875 times (CI:1.083-3.247). It was ascertained that hopelessness increased anxiety by 2.878 times (CI:2.075-3.991) whilst anxiety increased hopelessness by 2.755 times (CI:1.985-3.823) (p<0.05). As well as the Covid-19 pandemic, health, social life, and economic changes; the digital separation that accompanies distance education also affects the students' mental health. Solving the technical problems experienced in distance education, facilitating the follow-up of the courses, and equipping the midwifery students with problem-solving and coping skills will be useful for reducing the midwifery students' hopelessness and anxiety levels.

Uluşen M ，Özçoban FA ，Çilesiz E 《-》