Beyond the classroom walls: Stakeholder experiences with remote instruction in Post RN baccalaureate nursing program during the COVID-19 pandemic: A qualitative inquiry.

The COVID-19 pandemic led to the closure of educational campuses and the suspension of conventional classroom teaching globally and locally, and many switched overnight to an online modality. The change was experienced differently by varied audiences, given the availability of resources. The study aimed to examine stakeholders' experiences of emergency remote instructions in the Post-RN Baccalaureate Nursing Program during the COVID-19 pandemic. A qualitative descriptive exploratory design with a purposive sampling technique was used at a private nursing university in Karachi, Pakistan. Focus group discussions with students and faculty were conducted separately, while in-depth interviews with key informants were held using semi-structured interview guides. The focus group discussions and in-depth interviews were recorded electronically and transcribed and translated, coded, and analysed manually. Findings uncovered two major themes. (a) Remote teaching and learning-a paradigm shift; and (b) Remote learning ecosystem-a challenging team sport. The first theme denotes a major shift in pedagogical approach migrating from blended learning model to a complete online modality. Theme two uncovers the efforts and teamwork of the various stakeholders who assisted in mitigating the challenges collaboratively when migrating to virtual learning environment. Findings suggest that to continue to thrive in the post-COVID world, faculty, students, and key informants must collegially enhance the teaching, learning, and assessment strategies and student-teacher interaction, capitalising on evidence-based practices, trial and error, multi-level support mechanisms, and partnerships. The study recommends building resilience in instructional and administrative infrastructure to prepare for future events like pandemics and suggests development of evidence-informed blended and online nursing programmes in the region.

Integrated course assessments in an undergraduate nursing program.

Curriculum integration is a partnership amongst multidisciplinary members to create a cohesive curriculum and improve education. Basic and clinical science integration helps students learn deeply. Integrated curricula facilitate students to become lifelong learners. It encourages critical thinking and clinical reflection and helps students become active, self-directed learners. A comprehensive integrated exam was conducted at Aga Khan University, School of Nursing and midwifery to establish meaningful learning and enhance theoretical knowledge application in clinical practice, using competencies from four different courses in second year of study. Comprehensive Integrated Exam prepared students to assess a client and design complete nursing care based on health assessment, adult health nursing, pharmacology, and pathophysiology course concepts. This integrated exam was very effective as 97 % of students who took the exam passed on their first attempt. Faculty members involved found the comprehensive integrated exam a successful strategy to evaluate students learning, whereas the students related that this exam helped them to bridge the gap between applying theoretical concepts from different courses to clinical practice.

Introducing ACTFAiREST2 to implement online assessments amid COVID-19: a case study from a low resource setting.

BACKGROUND: Amid COVID-19, soon after the closure of academic institutions, academia was compelled to implement teaching and assessments virtually. The situation was not the same for all countries. This transition was much more challenging in low-resource settings like Pakistan, where the students were geographically distant with minimal connectivity. A private university in Pakistan instituted a systematic approach for ensuring quality assurance and reliability before launching online assessments amid the COVID-19. The purpose of this study was to reflect on the phased transition to online/remote assessments to facilitate continuous student learning through distance modalities during the pandemic. METHOD: To assist faculty in re-designing their assessments, a workshop was conducted which was based on the modified Walker's nine principles. The principles coded as "ACTFAiREST2" were introduced to ensure that the faculty understands and adapts these principles in designing online assessments. The faculty modified and re-designed their course assessments, from face to face to online modality and submitted their proposals to the Curriculum Committee (CC). To guide the process of approving modified and re-designed assessments, a checklist was adapted. All the pre and -post workshop assessment proposals were analyzed using a content analysis approach to ensure the alignment of course learning outcomes with the assessments. RESULTS: A total of 45 undergraduate courses' assessment proposals were approved by the CC after deliberations ensuring their applicability in a virtual environment. From the analysis of the course outlines and assessment proposals submitted to the CC, faculty made four key changes to their assessment tasks in the light of ACT FAiREST2 principles (a) alternative to performance exams; (b) alternative to knowledge exams; (c) change in the mode of assessment administration; and (d) minimizing the overall assessment load. CONCLUSION: This transition provided an impetus for the faculty from a low resource setting to build momentum towards improved and innovative ways of online teaching and assessments for future nursing education to adapt to the new normal situation. This development will serve as a resource in similar contexts with planned and evidence-based approaches for enhancing faculty readiness and preparedness for online/remote assessments.

Telesimulation Innovation on the Teaching of SPIKES Model on Sharing Bad News.

Coronavirus disease 2019 (COVID-19) brought to the world, an unprecedented emergency, which dramatically affected the face-to-face teaching in higher education academia. University faculty and students had to shift overnight to an online and remote course instruction. They were neither trained nor prepared and had limited resources and infrastructure. Palliative Care and Oncology Stream Faculty at Aga Khan University, School of Nursing and Midwifery, Pakistan, piloted an innovative academic project using telesimulation (TS). Trainee nurse interns were taught communication skills and the art of breaking bad news to palliative clients using the SPIKES model through TS. To incorporate best practices for simulation-based experiences, we used the International Nursing Association for Clinical Simulation and Learning to standardize and implement TS with 141 interns. This review article documents how the faculty planned and implemented the TS strategy during COVID-19. It outlines the challenges and the lessons learnt from implementation and feedback from faculty and students. This information could be useful in the future execution of TS, in any communication and counseling course, since COVID-19 has impacted the future educational course design and pedagogy worldwide.

Challenges in Teaching Palliative Care Module Virtually during COVID-19 Era.

With the COVID-19 pandemic hitting the global community, routine activities of universities, offices, and industries have been hindered. People are being forced to rethink the ways of working virtually from home for providing education, business, and health services in this social distancing during the COVID era. This sudden shift also posed challenges of online teaching in a private university, in urban Karachi, Pakistan. The Aga Khan University, School of Nursing and Midwifery recently conducted an online palliative care module using a virtual learning environment and Microsoft Teams for Trainee Nurse Interns. Although the first experience of online teaching and learning was a successful venture for faculty and students, in a lockdown situation, numerous challenges were also encountered being a lower middle-income country. The issues of electricity shutdown, Internet connectivity, and quality assurance were anticipated on transition to online pedagogy, but backup plans were formed to make execution promising.

Experiences of the Breast Cancer Patients Undergoing Radiotherapy at a Public Hospital Peshawar Pakistan.

OBJECTIVE: This study aimed to explore the experiences of female breast cancer patients undergoing radiotherapy (RT) in a public hospital in Peshawar, Pakistan. METHODS: This study employed a descriptive exploratory method. A purposive sample of 14 breast cancer women undergoing RT was selected for this study. Data were collected over the period of 5 months, using a semi-structured interview guide and conducting in-depth face-to-face interviews. These interviews were audio taped and transcribed by a bilingual transcriber. The translated version of the interview was coded, and the analysis was done manually. RESULTS: Four main categories emerged from data analysis, which were: feelings and perceptions of the patients, their challenges, coping strategies, and teaching and informational needs. CONCLUSIONS: Women undergoing RT in this culture experience more intense psychological effects, as compared to the physical effects. Keeping in mind, the magnitude of the emotional stress experienced by the participants, recommendations for policy reforms, and training for female RT staff are suggested based on findings of this research.

Development of students' critical thinking: the educators' ability to use questioning skills in the baccalaureate programmes in nursing in Pakistan.

OBJECTIVE: To enhance the Critical Thinking skills of educators associated with the nursing baccalaureate programmes in Pakistan. By focusing on the type and level of questions asked by the educators. METHODS: Ninety-one faculty members from 14 out of 17 schools participated in the study. Data on the faculty's questioning skills was obtained through classroom observations and field notes. The duration of the observations was 45-60 minutes. Using Bloom's Taxonomy for cognitive thinking, questions were categorised into high and low categories. RESULTS: Most of the questions (68.9 %) asked by the participants were of lower levels, while some (5.37 %) were ambiguous. In many instances, the participants did not allow a sufficient wait-time for students to think and respond. CONCLUSION: The findings suggest that educators must learn to use the questioning strategy effectively. They should ask higher level questions if they wish to inculcate Critical Thinking in students.