Implementation of Clinical Practice in Adult Nursing (Chronic Care) During the COVID-19 Pandemic: Report on the Development and Implementation of a Training Program for Clinical Shadowing

Abstract

Before the outbreak of COVID-19, "Clinical Practice in Adult Nursing (Chronic Care)", a professional course to acquire basic nursing practice skills for the care of adult patients with chronic diseases, was conducted on site in the wards of internal medicine, outpatient departments, and the admissions support office for a total of three weeks. Due to the spread of the COVID-19 epidemic, however, clinical practice was carried out online from May 2020, and was resumed on site at our university hospital in October 2020. A restriction was placed on the length of time spent at the hospital for on-site training, referring to the training standards based on our university's new coronavirus response manual, and a training program was developed for hospital ward training, consisting mainly of shadowing practice performed without speaking or coming into contact with patients. In principle, two students were assigned to one patient: one in the morning and the other in the afternoon. In addition, for practicing the acquisition of patient information through conversation and the provision of nursing assistance, the perspectives used in the process of shadowing were clearly defined so that students could maintain active attitudes in clinical practice, and support was provided so that students could have the experience of engaging with patients, using nurses as mediators. In the results, the students evaluated the contents of the prepared assistance based on their own nursing plan in reference to the practice of the nurse as a mediator, and compared that with the assistance practiced by the nurse based on clinical judgment, which contributed to acquiring practical learning supported by the grounds for clinical judgment. However, the students could not experience the process of building supportive relationships and the implementation of nursing skills, which remained an issue.