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Clinical learning for pre-registration nursing students: a viva voce approach during COVID-19

09 March 2023
Volume 32 · Issue 5


The COVID-19 pandemic restricted face-to-face contact between students and educators, limiting continual assessment of student's clinical skill development. This led to rapid transformational online adaptations to nursing education. This article will present and discuss the introduction of a clinical ‘viva voce’ approach, which has been used at one university to formatively assess students' clinical learning and reasoning skills using virtual methods. The Virtual Clinical Competency Conversation (V3C) was developed using the ‘Think aloud approach’ and involved facilitated one-to-one discussion based on two questions from a bank of 17 predefined clinically focused questions. A total of 81 pre-registration students completed the formative assessment process. Overall, feedback from students and academic facilitators was positive and facilitated both learning and consolidation in a safe and nurturing way. Further local evaluation is continuing to measure the impact of the V3C approach on student learning now that some aspects of face-to-face education have resumed.

Although it is not yet possible to fully realise the long-term implications of the COVID-19 pandemic on global nurse education, there have been substantial changes to the provision of education for nursing students due to the pandemic spanning high-, medium- and low-income countries (Agu et al, 2021). Currently, both for many nurse educators and students, the scholastic journey has become unrecognisable from the pedagogical approach that we have become accustomed to. Although this pandemic has been one of the greatest challenges for nursing in over a century of professional practice, for nurse educators it has sown the seeds of change and forced many new adaptations to be made to what have been firmly established educational practices (Swift et al, 2020; Haslam, 2021).

Before COVID-19, clinical skills within higher education institutions were commonly assessed using a mixture of high- and low-fidelity simulation and assessment, involving both nursing-specific and interdisciplinary approaches to learning. During the first wave of the global pandemic, there was a move to limit all face-to-face contact between students and educators, leading to primarily online learning (Dewart et al, 2020; Ramos-Morcillo et al, 2020). This involved extended periods of using only screen-based learning and assessment (Alsafi et al, 2020). An example involves the move to using video footage of physical assessment skills to facilitate the learning of both technical and critical reasoning skills. Similarly, in academic assessment, in many instances, traditional written and/or on-campus examinations have been replaced by remote, online, open-book alternatives (Alsafi et al, 2020). Other innovations reported in the literature include online video-based assessments that enable students to create and perform in medication advertising, which utilises skills akin to those of influencers and social media professionals (Stuckey and Wright, 2020).

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