COVID-19: Lessons Learned Today with Implications for Education Tomorrow

Written by Jo Ann Donnenwirth EdD, MSN, CNE and Dianne Gibbs, DNP, RN, CNE

Aultman College of Nursing and Health Sciences is a hospital-based college located in Canton, Ohio. The roots and proud history of Aultman College date back to 1892 with the founding of the Aultman Hospital School of Nursing. Over the past century, the college has undergone local crises, state emergencies, national catastrophes, and epidemics. In March 2020, college leaders were challenged with the COVID-19 pandemic, a public health emergency of international concern.

The college initiated a COVID-19 Task Force to determine the impact this pandemic would have on the college with the focus being the safety and health of students and employees. As a hospital-based college, college representatives participated in planning meetings with Aultman Hospital, Aultman Health Foundation, local health departments, and Ohio Department of Health. The Task Force met several times a week to address the ever-changing environment. Support was provided to academic programs with a focus on those including a direct patient care component. At times information was confusing, as the various individual organizations provided conflicting recommendations. The collaboration between the Task Force and the experts in the field resulted in a plan that was acceptable for all entities involved.

At the College Level

The Fall Convocation consisted of dialogue linking the COVID-19 pandemic to the college mission statement . The convocation academic jigsaw activities consisted of three components. Individual faculty conceived jigsaw activities to provide participants a metaphor through which they could demonstrate learning outcomes and engagement. In addition, each member of our community (students, faculty, and staff) was asked to read Communicating Science in the Time of a Pandemic (Saitz & Schwitzer, 2020). The third activity included viewing a recorded session of the college president, Dr. Jean Paddock, interviewing Dr. Susan Goekler, a public health expert. The jigsaw puzzle was completed during the second week of the semester, when all college employees were invited to a meeting. This moderated conversation encouraged dialogue of their personal perspectives and reporting of student responses. The academic and student support departments worked to determine what would practically be needed in general during the semester to support the mission of leading our community to improved health. It was then that we recognized how the jigsaw fell nicely together.

At the Program Level

Prior to the start of the COVID-19 pandemic, the associate nursing program delivery model consisted of face-to-face courses supported by the learning management system (LMS) and face-to-face clinical experiences. This delivery model was suspended as the program transitioned to a 100% online format with virtual clinical experiences. The instructional designer assisted nursing faculty in converting course content to an online format while virtual clinical products were purchased. The greatest challenge was transitioning nursing laboratory requirements. The nursing faculty were asked to be creative and “think outside the box” while respecting accreditation regulations and requirements. The faculty came up with several creative ideas, including recording a video the sterile dressing change competency. The nursing faculty and administrative team filled manila envelopes with competency supplies (see the table below), which were sent to individual students. The laboratory faculty watched and graded the individual YouTube videos as satisfactory or unsatisfactory. In response, nursing students creatively represented the patients they were caring for. The student pictured below used the face of Danny DeVito for her patient.

Sterile Dressing Change Envelope Contents Includes enough supplies to practice and demonstrate competency
4 pair clean gloves
2 pair of sterile gloves
2 sterile ABD pads
8 sterile 4×4 gauze pads
2 red biohazard bags
1 3 cc syringe (to represent normal saline)
1 role paper tape
1 laminated picture of an abdominal dressing with staples
Sterile dressing change competency checklist
Assignment instructions (due date, video recorded, uploaded to YouTube, nursing uniform and badge required, verbal confirmation of all steps in the competency)
Student Nurse YouTube Video

Statistics in Ohio

During 20 days in July 2020, the Ohio Department of Health and Ohio State University measured the prevalence of current and past COVID-19 cases in a representative sample of 727 Ohio adults. Participants provided a nasopharyngeal swab for polymerase chain reaction (PCR) detection of current COVID-19 infection, and they provided a blood sample for detection of antibodies indicative of past COVID-19 infection. Using a Bayesian latent class model with multilevel regression and poststratification, the statewide prevalence of current COVID-19 infection was 0.9% (95% credible interval, 0.1% to 2.0%). The statewide prevalence of past COVID-19 infection was 1.5% (95% credible interval, 0.3% to 2.9%).

The findings of this project agree with expectations for prevalence of current and past COVID-19 infection in Ohio and is similar to what has been reported in nearby states. Whereas 0.9% of Ohio adults with current infection and 1.5% with past infection reflect relatively low prevalence, these figures correspond to hundreds of thousands of Ohioans who have contracted COVID-19 during 2020. Community spread is ongoing, and millions remain susceptible. The continued embrace of prevention measures is essential to keeping Ohioans safe.

Transitioning to a “New Normal”

The nursing faculty have continued to improve online learning, better utilize virtual clinical scenarios, and further develop simulation education. In Fall 2020, nursing students returned to campus for laboratory and select clinical experiences. The geriatric, mental health, and pediatric clinical experiences remained virtual. This small, transitional step to a “new normal” was welcomed by students and faculty. The COVID-19 Task Force remained intact, meeting less frequently. As Ohio lifted social distancing requirements and mask mandates, the college made plans for the student body to return to campus for the Fall 2021 semester. The “new normal” included courses offered in a variety of modalities, face-to-face with LMS support, hybrid, and 100% online.

Then, along came the Delta variant. At the time of publication, the college plans to move forward to our “new normal.” However, if the situation should worsen, the college is prepared to return to the COVID-19 delivery model. We are in a better position today knowing what we did in the past worked well. The “new normal” delivery model is ultimately in service of our student’s success and is based on the lessons we learned transitioning to online delivery.

Written by Jo Ann Donnenwirth EdD, MSN, CNE, Dean of Nursing
and Dianne Gibbs, DNP, RN, CNE, Chair of Accreditation and Quality