Running head: ONLINE NURSING IS THE NEW NORMAL

Online Nursing is the New Normal

Raymonta Green

Kennesaw State University

WellStar School of Nursing

NURS 7875: Nurse Educator Practicum III

Dr. Anne White

October 16, 2023

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Introduction

In times, nursing education has experienced changes due to the rapid integration of digital

technologies and the need for adaptable learning environments. This shift has been accelerated

by events, especially the COVID-19 pandemic, which compelled educators and institutions to

shift implementations and address the challenges that may occur when teaching through online

modalities. Okoye et al. (2021) discuss that due to COVID-19, several educational institutions

have had to close their campuses to faculty, staff, and students. Consequently, these institutions

have implemented strategies and initiatives to facilitate teaching and learning, emphasizing

remote or online education. As we approach an era in healthcare education that is fast-tracking

towards hybrid and even all online formats for education, this paper will aim to explore the

evolving role of hybrid nursing education as the "new normal" for the future. In doing so, we

will delve into existing nursing literature, addressing what we already know and what remains

undiscovered. Additionally, we will discuss how this transformation affects nursing students,

educators, and healthcare systems. Finally, we recommend promoting online and hybrid nursing

education practices to ensure that future generations of nurses are well-prepared for the changing

healthcare demands. Through this analysis, we aim to shed light on how technology-mediated

education shapes the future of nursing while acknowledging the complexities and challenges

inherent in this transformative journey.

Overview

Nursing education is transforming due to the integration of technologies and the need for

flexible learning environments. This change has been accelerated by the COVID-19 pandemic,

which required a shift to learning. This paper explores the emerging concept of nursing education
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and its potential as the " normal" in this field. By referring to research, we highlight the

advantages of online and hybrid learning, including adaptability, cost-effectiveness, and

improved collaboration. However, we also address the challenges associated with this approach,

such as the divide concerns about replicating hands-on experiences and potential feelings of

isolation among students. Through an analysis, this paper emphasizes how hybrid nursing

education plays a role in shaping the future of this profession. It also underscores the importance

of actions to maximize its benefits while addressing any limitations it may present. Our

recommendations include investing in simulations, prioritizing faculty development, ensuring

access to technology for all students, fostering a sense of community within programs, and

maintaining high-quality standards through rigorous quality assurance measures.

Review of Current Nursing Literature

The field of healthcare education is transforming with the rise of hybrid nursing

programs. The COVID-19 pandemic has expedited this shift for educators and institutions to

embrace learning methods. Online and hybrid nursing education offers benefits. One significant

advantage is its adaptability. These learning methods enable students to access course materials

and resources from anywhere, providing flexibility in balancing family or work responsibilities

alongside their education. Furthermore, these platforms facilitate collaboration among students

and instructors by fostering dialogues on nursing practices. Online learning also equips students

with the skills for success in contemporary healthcare settings where technology plays a crucial

role. Nadelson et al. (2021) discuss how students can collaborate in groups, pairs, or during

simulations. Depending on the objectives and schedule of the course, students can engage in

simulations during traditional learning hours such as evenings and weekends. The asynchronous
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nature of simulations gives students autonomy and allows them to study at their preferred pace.

Additionally, online platforms utilize learning technology to customize information based on

student needs and learning pace. This personalized approach improves understanding and

retention elements in nursing education. Guerrero et al. (2023) examine that teachers can keep

track of students' progress and assess their learning regularly by using tests and providing timely

feedback through online delivery. Another advantage is cost-effectiveness. Online and hybrid

programs can reduce student expenses. Commuting and housing costs may be minimized, while

open educational materials can help lower schooling expenses. Guerrero et al. (2023) also review

that studying nursing remotely is cost-effective and provides much flexibility. Apart from the

tuition fees and materials required for training, there are expenses related to travel, food,

accommodation, and commuting directly associated with attending college. However, with

distance learning, these costs are eliminated, leaving the expenses related to the courses and

study materials.

However, there are also drawbacks associated with hybrid nursing education. The

significant challenge lies in replicating experiences virtually. Practical skills development and

patient interactions are components of nursing education that may be limited when conducted

online. Chen et al. (2020) concluded in their study that using virtual reality and online simulation

in nursing education can enhance knowledge. However, it has little impact on traditional

educational classroom methods regarding skills development, satisfaction levels, confidence, or

task completion time. The unequal access to the internet, devices, and digital literacy make it

challenging for everyone to have educational opportunities, which worsens existing inequalities.

Transitioning successfully to training may require faculty development and support, which can

be particularly difficult for those who need more skills or resources. Masenya (2021) examined
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the impact of having a grasp of skills on the effectiveness of utilizing these tools in higher

education. They found that obstacles such as literacy, time limitations, resistance to change,

educators' lack of confidence, inadequate technological infrastructure, and limited access to

digital or mobile devices hinder the integration of mobile technologies in teaching and learning.

When students rely on learning, they may feel isolated and miss out on the sense of community

that comes with in-person interactions. Additionally, staying motivated and engaged while

learning remotely can take time and effort. McLoughlin et al. (2006) compare the student

evaluations of advancements in online learning and have revealed that the most challenging

aspect lies in effectively applying the technology. Specifically, contextual factors impacting

students and instructors need to be considered more. There are also concerns about the quality of

nursing education programs compared to education methods. The absence of control and

rigorous assessments raises doubts about the rigor and consistency of these programs. Bradley et

al. (2013) assert that to prepare students better to join the practice in today's complicated

healthcare environment, and the team examines the urgent need for curricular reform and

transformation of education via online and hybrid methodologies. Educators face the challenge

of helping their students become self-directed, lifelong learners as the content-heavy nursing

curriculum they have been using becomes more irrelevant in today's fast-paced world.

Online and hybrid nursing education has changed the nursing and healthcare field. It has

expanded access to nursing education, potentially addressing shortages in this profession. The

COVID-19 pandemic highlighted its versatility. It has increased its acceptance as a component of

nursing education's future. Innovative ideas and opportunities should be explored to promote

discussions around hybrid nursing education further. This includes enhancing simulations,

providing faculty training for online instruction, bridging the digital divide, fostering
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collaboration among different healthcare professions, evaluating long-term outcomes, and

developing hybrid models that combine online learning with hands-on clinical experiences.

Online and hybrid nursing education presents both benefits and challenges for nursing

professionals. Assessing its strengths and limitations, measuring its impact on nursing practice,

and seeking solutions to address any issues will ensure that nursing education evolves effectively

in response to the ever-changing healthcare environment.

Analysis of Literature:

The rapid integration of technology has impacted the progress of nursing education,

leading to a growing need for flexible learning environments. COVID-19 educators and

institutions have further accelerated this shift to swiftly adapt to the challenges of remote

learning. This portion of the paper explores the evolving role of nursing education by examining

what we already know and what we still need to learn and identifying gaps in our knowledge.

What is Known?

In today's landscape, hybrid and online methods of nursing education have become more

than emerging trends; they are now essential tools for comprehensive learning. Their flexibility

surpasses limitations, allowing students to engage with course materials from anywhere. This

accessibility mainly benefits those balancing their education with commitments and family

responsibilities. Furthermore, these digital platforms are not merely information repositories;

they serve as communities connecting students and educators worldwide. These platforms have

become melting pots of nursing ideas, experiences, and practices. For example, a student in Asia

can gain insights into European care practices, or a new nurse in Africa can understand care
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challenges in North America. These cross-cultural exchanges do not enrich the learning

experience. Also, it equips students with a global perspective—a crucial trait in our

interconnected world. When delving deeper into the tools used in nursing education, simulations

emerge as game changers. Nadelson et al. (2021) emphasize that simulations create an

environment where students can experiment, make mistakes, and learn without real-world

consequences. Taking a hands-on approach and allowing individuals to learn at their own pace

enables an understanding and longer retention of knowledge. According to Guerrero et al.

(2023), personalized learning paths have benefits. The results are consistently more significant

when students tailor their journey to their needs and interests. From a perspective, the shift

towards learning brings affordability. Apart from saving on commute and accommodation

expenses, there are advantages. Let us consider the example of a nurse who lives in a village.

Traditional education would require her to relocate to a city, incurring costs. On the other hand,

online education provides access to high-quality resources at her doorstep, eliminating any need

for disruptive relocation.

What is Unknown?

In the realm of innovation, hybrid nursing education is a step forward. However, like any

pioneering endeavor, it faces its set of challenges. One significant challenge is the difficulty of

recreating the hands-on experiences provided by classrooms. Chen et al. (2020) explored this

aspect. While virtual reality and online simulations are tools for sharing knowledge, they may

still need to develop practical skills like real-world practice. The digital divide poses a threat to

specific demographics. While urban students can quickly adapt to platforms, those in remote or

underprivileged areas may need more internet access, outdated devices, or a lack of basic digital
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literacy. Masenya (2021) vividly illustrates these challenges. Sheds light on the barriers that

hinder the seamless integration of digital technologies in education. Another aspect that online

platforms struggle to replicate is the sense of camaraderie and community found in classrooms.

Just imagine the discussions that arise after a lecture, in a setting, or the bonds formed

during group assignments. On the other hand, the digital world, despite its ways of

communication, can sometimes feel sterile and disconnected. This feeling of isolation can

decrease students' enthusiasm and motivation, turning them into learners or active participants in

their educational journey. McLoughlin et al. (2006) share this viewpoint. Suggest a holistic

approach to online education that goes beyond just integrating technology. Another area of

concern is the narrative surrounding quality assurance in nursing education. With the increase in

courses, how can we ensure that the standards are consistently high? The lack of checks and

balances during assessments raises doubts about the credibility of these programs. Bradley et al.

(2013) also express these concerns. Emphasize the need for a revision of the curriculum. Their

research highlights the importance of incorporating practices to maintain nursing education at a

level competitive with evidence-based practice, relevance in modern medicine, and robustness

amidst the ever-changing healthcare landscape of the 21st century.

Gaps

As we stand at the brink of an era in nursing education, the allure and challenges of

learning come into view. To fully embrace this approach, we must delve into its complexities,

recognizing its strengths and addressing its weaknesses. At the core of this transformation lies

the importance of simulations. While theoretical knowledge lays the foundation for nursing

education, it is through hands-on experience that a capable nurse indeed emerges. For example,
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while a traditional classroom may teach the mechanics of administering an IV, a crafted

simulation can immerse students in high-pressure scenarios that require them to provide

emergency care. In these scenarios, students must refine their skills and develop their decision-

making abilities and bedside manner. However, these simulations' effectiveness heavily depends

on the expertise of educators who design and supervise them. Therefore, there is a need to

enhance the skills of our professors so that they possess not only medical knowledge but also

proficiency in digital education. Consider the difference between delivering a lecture in person

versus conducting one online. The latter requires mastery of tools, comprehension of engagement

metrics, and the fostering of virtual collaboration capabilities. Regarding collaboration, the old

way of working in silos for each profession is no longer feasible. The future of healthcare relies

on teamwork, where nurses, doctors, therapists, and pharmacists work together. Hybrid learning

platforms can foster collaboration by facilitating conversations and joint projects between

professionals from different fields. Just imagine a project where nursing students and medical

students join forces to manage a clinic, combining their unique expertise. However, establishing

a nursing education system has its fair share of challenges. As we move forward, we must

evaluate and adjust our strategies to ensure they align with the changing healthcare landscape.

This is not a one-time effort but an ongoing process of adaptation and growth.

Discussions

The field of nursing education has changed due to the progression of technology in our

everyday lives and the increasingly complex needs of our society, especially considering the

COVID-19 pandemic. This has resulted in hybrid learning, which combines traditional methods.

While this shift shows potential, it also brings complexities. Online and hybrid nursing education
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has made learning more accessible and inclusive by breaking down barriers and providing

opportunities for those who may have been excluded from educational settings. The collaborative

nature of these platforms, where students and educators from diverse backgrounds interact,

enhances the learning experience by offering a perspective crucial in today's interconnected

healthcare environment. However, some challenges need to be addressed. The digital divide is a

concern, as not everyone can access technology or reliable internet connectivity. Replicating

hands-on experiences virtually can also take time, questioning these programs' rigor, process,

competitiveness, and admission standards. Additionally, the sense of community found in

education may diminish in environments, potentially leading to feelings of isolation and

disengagement among students.

Conclusions

Although groundbreaking, hybrid and online nursing education presents advantages and

disadvantages. On one hand, it offers flexibility, fosters collaboration, and has the potential to

address nursing shortages by expanding educational opportunities. Conversely, it also brings

forth concerns regarding quality assurance, the divide, and the potential loss of a sense of

community. The COVID-19 pandemic has been devastating. It has also showcased the versatility

of hybrid learning and solidified its role in shaping the future of nursing education. However,

like any journey, some obstacles must be addressed.

Recommendation

When addressing the challenges and opportunities brought about by online nursing education, we

can identify several strategic recommendations. Firstly, investing in improved simulations by

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collaborating with technology experts is crucial. This collaborative effort aims to create

experiences that bridge the gap between theory and practice. By focusing on high-quality

simulations, we can ensure that students receive an education that closely resembles real-world

scenarios, equipping them with the intricacies of the healthcare field. Equally important is

prioritizing faculty development. As the digital landscape of education continues to evolve,

educators need expertise in their areas and navigating online teaching methods effectively.

Implementing training programs tailored to equip faculty with instruction tools and techniques

will ensure the success of hybrid learning models. Moreover, we must address the issue of the

divide. In this regard, collaborative efforts between institutions, governments, and private entities

are necessary. By providing students from all socio backgrounds with access to technological

tools like tablets or laptops and ensuring affordable internet connectivity, we can promote equal

access to quality education. In education, explicitly creating a sense of community holds

importance. We should establish platforms encouraging interaction, such as group projects,

discussion forums, and mentorship programs. These interactions do not enhance the learning

experience. It also helps combat feelings of isolation that can sometimes arise in online learning

environments. Ensuring quality is also paramount. By implementing standards and conducting

evaluations, we can guarantee that online nursing programs maintain the highest level of

excellence. External audits and accreditations can further enhance the credibility of these

programs. Promoting collaboration is also vital for a rounded education. By encouraging nursing

students to work alongside peers from healthcare disciplines, we can provide them with a

perspective and better prepare them for the collaborative nature of modern healthcare settings.

Lastly, continuous feedback plays a role. By establishing mechanisms for students and educators
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to share their insights and concerns, institutions can remain adaptable and responsive to the

evolving demands in education.

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Bradley, C., Hedrick, J., & Tally, K. (2013). Board 126 - Program Innovations Abstract

Simulation and Technology Integration to Improve Clinical Outcomes (Submission

#362). Simulation in Healthcare: Journal of the Society for Simulation in Healthcare, 8(6),

416. https://doi.org/10.1097/01.sih.0000441391.47382.18

Chen, F. Q., Leng, Y., Ge, J., Wang, D., Cheng, L., Chen, B., & Sun, Z. L. (2020).

Effectiveness of Virtual Reality in Nursing Education: Meta-Analysis. Journal of Medical

Internet Research, 22(9), e18290. https://doi.org/10.2196/18290

Guerrero-Quiñonez, A. J., Bedoya-Flores, M. C., Mosquera-Quiñonez, E. F., Ango-

Ramos, E. D., & Lara-Tambaco, R. M. (2023). Hybrid education: current challenges. Ibero-

American Journal of Education & Society Research, 3(1), 276–

279. https://doi.org/10.56183/iberoeds.v3i1.629

Masenya, T. M. (2021). Digital literacy skills are a prerequisite for teaching and learning

in higher education institutions. Mousaion, 39(2). https://doi.org/10.25159/2663-659x/8428

McLoughlin, C., & Luca, J. (2006). Applying situated learning theory to the creation of

learning environments to enhance socialization and Self-Regulation. In IGI Global eBooks (pp.

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Nadelson, S. G., Nadelson, L. S., & Connor, K. (2021). Asynchronous online simulation

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mediated teaching and learning process: A conceptual study of educators’ response amidst the

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