Nursing education in Covid-19 times in Latin America: experiences from Brazil, Chile and Colombia

Nursing education in Latin American countries and around the world, during the pandemic, had to reinvent itself. The area of health knowledge, in general, had to adapt to the reality imposed by Sars-CoV-2, that is, the practice of social distancing and the recommended remote classes ensured the prevention of this disease in students and their families. As a result, the need for an innovative approach to the development of curricula and new learning projects emerged, forcing us to give new meaning to teaching.

When educational conditions changed, pedagogical challenges and the opportunity for teachers to adapt quickly to these changes were launched in order to facilitate learning; however, this movement aimed at pedagogical and technological innovation in light of previously unthinkable demands1. In this adverse scenario, there was also a concern that it is not possible to train nursing students without practical activities, and this was a problem faced by educational institutions around the world.

The emergency changes in teaching models required teachers and students to massively use distance learning methods, which were often criticized for their low reach, especially in the public education system, given the difficulties of access by students.

Even in the realities of private services, evidencing what is referred to by some authors as "the enormous challenge of educational equity that exists worldwide", one can see the devaluation of the student in relation to the use of remote learning and the urgency of classroom teaching, based on in human interaction.

For this reason, it is important to reflect on the impact of the pandemic on nursing education and on how to provide a basis for new learning models supported by technologies, aiming to develop critical thinking in an interactive way and with superior performance than what we are seeing in practice2.

Higher education institutions were required to change from face-to-face to remote study devices. The use of three-dimensional simulation, asynchronous and synchronous online lectures, activities and quizzes, in a learning management system, are examples of alternatives that offer flexibility as teaching methods3.

Nursing programs are oriented towards education for care with a biopsychosocial, cultural and spiritual approach, mostly linked to a paradigm of reciprocity, which should continue to be strengthened through dialogue between teachers, pedagogical strategies and a more comprehensive understanding of nursing care4. In this sense, this becomes an even greater challenge for teaching, to be strengthened from the achievement of disciplinary competences in nursing.

Based on their theoretical components, Latin American nursing schools had to overcome several barriers and discovered some strategies that facilitate learning, requiring nursing to think about flexible curricula and international partnerships with cutting-edge innovation and education. In Colombia, the use of digital platforms that make learning an invaluable opportunity became widespread, such as synchronous and asynchronous classes, with the implementation of the Collaborative Online International Learning (COIL) strategy.

This strategy, which has been implemented around the world for more than two decades - and which for Colombia starts in nursing with the Juan N Corpas University Foundation and the Superior School d'Infermeria del Mar in Spain - made it possible to manage from the theme of nursing care for the child to work with themes that integrate cultural, social, political and health knowledge, but with a social meaning. An example of this approach took place in an activity linked to the care of children with heart disease, transforming tasks into challenges that teams from two different programmatic contexts could demonstrate, with innovative didactics, a new learning model that would lead to the development of competences. specific. In this format, the performance of COIL students is expected with study and proof that the results must correspond to the work carried out by Appiah-Kubi y Annan, in which a significant performance was observed and the project work improved with the COIL strategy5.

In this sense, the pandemic allowed the development of intercultural skills, collaborative work, use of technology and innovative products, which previously seemed a little distant and expensive. Therefore, an opportunity arises for nursing professors to take advantage of in-service teaching agreements and their internationalization offices to activate agreements with other countries, professions and other contexts and we invite them to get to know Red Latinoamericana COIL5.

Nursing practice is a fundamental pillar in the teaching-learning process, however, in many Latin American countries, there were fears, desolation, lack of protection and risks of returning to hospitals, clinics and primary care centers. Few institutions in Chile initially allowed entry only to final-year students who could continue with practical experiences under strict protection measures and adhering to the protocols of institutions for the management of COVID-19, but students with lower levels of education did not have the same outcome; those who entered 2020, for most of the year, have never had classes in the classrooms of training institutions and are recently being integrated, creating a relevant gap in practical learning in our country. On the other hand, also in Latin America, some schools have definitively suspended practical activities with students and teachers.

Teleconsultation, tele-advising and remote work emerged as strategies that managed to mitigate the lack of direct student learning. In the case of the School of Nursing at the University of Chile, tele-nursing was used through a comprehensive information system called Rayen, created for the clinical and administrative management of primary health care centers, getting students from this home to study, together with its professors, approached the health centers and the continuity of care through the monitoring of people who were absent due to the pandemic. This system has also been used to care for patients with severe addictions. A strategy that was not applied before the pandemic6.

In this sense, the University of Chile has understood this pandemic as an opportunity to learn about it and apply the knowledge that contributes to skills for the proper use of our scientific method, which is the Nursing Care Process, providing and bringing people closer together. of health systems, establishing itself, in the first instance, in the area of Primary Health Care, with the inclusion of students accompanied by their teacher in the Traceability, epidemiological control and follow-up program, follow-up of cases and contacts of patients with COVID- 19. From the telephone home monitoring, the expected learning was the correct application of the assessment, active listening, care management and, above all, the continuity of care, integrating the use of scientific evidence and guidelines of good clinical practices oriented to the Therapeutic Relationship, Crisis intervention and leadership.

Although this pandemic has limited some learning at the University of Chile, nursing students were able to gain experiential learning about the global health emergency by actively participating in the vaccination process against COVID-19 or Influenza, in the collection of samples by PCR and, as mentioned, participate in traceability.

In the midst of a 21st century pandemic, the best friend of students and teachers at first might be technology; but, over time, it is necessary to evaluate this knowledge, these strategies and also aspects of ergonomic and mental health, as well as social life and the emotional support of teachers and students, supplying extra-class practices, extended hours, connectivity before and during this pandemic7.

As the student is the center in the teaching process, teachers should be better trained to manage technology and innovative educational projects, which would allow them to have contextualized and quality nursing practices; the work of monitoring students in spaces that open confinement and the search for teaching strategies through virtual simulation must also be added7.

In the course of nursing teaching practices during the period of emergency remote teaching (ERE), it was identified that mandatory practical activities required orientation models supported by technology, allowing teachers to carry out continuous feedback (advising, monitoring and evaluating) the nursing students remotely. These guidance templates generally include applications in which students must complete daily electronic reports before starting and after finishing the clinical practice day.

Data is stored on a server and made available for review. By filling out electronic reports before starting the day's practice activities, students increase awareness of learning objectives and focus on carrying out their daily activities. Technology-supported applications have been widely used around the world; however, in Brazil, the race on the part of educational institutions and teachers for the development of these devices was perceived, which, prior to the pandemic, were underutilized and still little explored as a strategy to qualify teaching in nursing and health1.

In the midst of the Covid-19 pandemic, different teaching formats had to be implemented to ensure solid and quality training; however, it is known that nothing replaces the teacher in person, mediating the collective construction of knowledge in nursing. It is necessary to know how this new way of teaching and learning has impacted students and teachers, so that we can review short-term and future strategies; and look at the post-pandemic scenario in the training of nursing professionals.

In a study carried out recently with 2,649 students belonging to 67 public and private university training institutions in Chile, with the aim of understanding the impact of COVID-19 on the lives of higher education students, it was found that 72% declared that there is a decreased relationship with students and 74% said that the greatest difficulty for their learning is not the techniques, but to keep the pace of study; and 66% have problems with personal time management. This invites us to think about facilitating autonomous learning through an adaptive learning system, as mentioned by the World Economic Forum8. Another finding that surprises the researchers in the Chilean study is that 23% of students would be willing to take virtual courses from other universities in cooperation with other institutions, opening a new unexplored pre-pandemic space9.

The World Economic Forum proposes that the pandemic is an opportunity to strengthen the capacity of students in the face of crises like the current one to make informed decisions, creative problem solving and, above all, mention adaptability.

As high-level trainers, we have this commitment, delivering professionals capable of providing humane, safe and quality care to society, transforming realities, with a view to improving the population's health and living conditions. Today, more than before, face-to-face teaching proves its worth.

In this case, the strategic, tactical and operational management of educational programs in their educational projects must consider, for future public health situations, such as pandemics, contingency plans that allow responding to the fulfillment of the competences of future nursing professionals in a globalized world.

REFERENCES

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• 2. Villafuerte P. Educación en tiempos de pandemia: COVID-19 y equidad en el aprendizaje [Internet]. Observatorio, Instituto para el Futuro de la Educación; 2020 [citado 2021 jul 5]. Disponible en: https://observatorio.tec.mx/edu-news/educacion-en-tiempos-de-pandemia-covid19
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• 5. Appiah-Kubi P, Annan E. A review of a collaborative online international learning. Int J Eng Ped. 2020;10(1):109-24. doi: https://doi.org/10.3991/ijep.v10i1.11678
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• 6. Rayen Salud [Internet]. Santiago, Chile: Rayen; 2019c [citado 2021 jul 2]. Ficha Clínica Electrónica Rayen. Disponible en: https://www.rayensalud.com/productos/ficha-clnica-electrnica-rayen
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• 7. Melendez Chávez S. La importancia de la práctica en la formación de enfermería en tiempos de Covid-19: experiencias de alumnos. Dilemas Contemp Educ Política Valores. 2020;8(spe5):4. doi: https://doi.org/10.46377/dilemas.v8i.2479
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• 8. Seguimos Virtual. #PulsoEstudiantil: impacto del COVID-19 en la vida de las y los estudiantes chilenos [Internet]. 2020 [citado 2021 jul 2]. Disponible en: https://seguimosvirtual.com/comunicadopulso/
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• 9. Wilichowski T, Cobo C. Cómo la pandemia podría cambiar la forma de enseñar a nuestros hijos [Internet]. World Economic Forum; 2021 [citado 2021 jul 2]. Disponible en: https://es.weforum.org/agenda/2021/01/como-la-pandemia-podria-cambiar-la-forma-de-ensenar-a-nuestros-hijos/
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Publication Dates

• Publication in this collection
  29 July 2022
• Date of issue
  2022