The start of the COVID-19 pandemic disrupted the education of many nursing students as schools shifted to remote learning and hospitals were unable to accommodate clinical groups. In these circumstances, schools focused on preparing students for practice, putting aside other programming. The subsequent surge in late 2020 threatened to further interfere with carefully designed plans to sidestep the obstacles of remote learning for the high-touch educational needs of nursing students. This article provides details of the efforts to maintain the integrity of planned capstone projects for an inaugural cohort of a nursing honors program.
NURSING AND HONORS EDUCATION
Entry-to-practice nursing education is a demanding undertaking on its own. Expanding content to prepare nurse graduates to successfully pass licensure exams leaves little time for deep explorations of other nursing roles: research (Dowdy et al., 2018; Redley et al., 2021), education, and advocacy. Honors programs can bridge this gap though supportive environments with dedicated faculty, special planning, and/or consideration for enrichment activities with cohorts that bond during shared experiences, further adding peer support (Dowdy et al., 2018; Redley et al., 2021; Schepp et al., 2021; Stanford & Shattell, 2010). Such experiences are believed to set students on the road to leadership roles in their workplaces, graduate study, and research (Dowdy et al., 2018; Redley et al., 2021; Schepp et al., 2021; Stanford & Shattell, 2010).
The purpose of the LEAD Honors Program at the New York University Rory Meyers College of Nursing is to advance the leadership development of traditional baccalaureate nursing students and accelerate their professional advancement through graduate and doctoral education. The acronym LEAD stands for Leading, Engaging, Advancing, and Developing. The program includes advanced coursework in nursing that exposes students to history, theory, philosophy, practice, and research early in the curriculum. Students engage in the development of leadership practices in their coursework through the Student Leadership Challenge Program (Kouzes & Posner, 2017) and are supported through their academic journey by a designated teaching and advising team.
The program stemmed from a Sigma Faculty Development Fellowship project. The project committee performed a literature review on honors programs in nursing schools (Lim et al., 2016) and conducted surveys of faculty and students on beliefs and perceptions of mentoring (Navarra et al., 2018) and perspectives of mentoring in honors programs (Nelson et al., 2018). The resulting program foundation consists of the four pillars of nursing-practice, research, education, and service-along with interprofessional practice and mentoring. The curriculum and extracurriculars are grounded in these concepts. Special programming, lectures, immersion programs, research and laboratory experiences, leadership retreats, and workshops complete the program. The first cohort enrolled in fall 2017.
Although most honors programs in nursing seek to provide opportunities for students to engage in projects with nurse researchers (Dowdy et al., 2018; Redley et al., 2021; Stanford & Shattell, 2010), the LEAD Honors Program offers capstone projects in any of the program's pillars (e.g., for practice, a continuous quality improvement project on a nursing unit; for research, designing and conducting a small study; for education, creation of a simulation scenario topic lecture for a nursing course; and for service, health policy advocacy or patient advocacy at a clinic). Students work with mentors who are content experts and/or provide them access to the capstone project sites. Projects are planned over multiple semesters as students conduct literature reviews and learn more about their topics from their mentors in preparation for implementation and evaluation.
IMPACT OF THE PANDEMIC
For many schools of nursing, the COVID-19 pandemic led to a swift transition to online learning. Schools with robust simulation programs with online content shifted to modified clinical experiences for students, providing opportunities for continued learning and application of content in small groups. Using online meeting software, students and faculty could maintain supportive learning communities (Gaffney et al., 2021).
The first LEAD cohort was working on literature reviews when the pandemic arrived. Students' work proceeded through online meeting platforms for class time. However, plans to seek mentors and sites for the capstone projects ceased. Identifying capstone project sites is a challenge under usual circumstances (Shake & Lavin, 2018). It was difficult to know how to present this learning opportunity when offices were empty, patients were not seeing their health care providers, and hospital units were converting into COVID-19 units.
In mid-July 2020, our school was preparing to start hybrid learning with in-person clinical experiences, modified simulation learning experiences maintaining social distancing, and continued remote delivery of lectures. Discussions with clinical partnership administrators helped with comprehending the clinical landscape. Sites for capstone projects required active affiliation agreements even though students would not provide direct care; all capstone sites met these requirements, and the projects could proceed (see Supplemental Content, available at http://links.lww.com/NEP/A354, for a description of the capstone projects with planned and final deliverables).
All students had a mentor by midsemester and met regularly. Some students were at their sites and engaged directly with intended recipients of their project deliverables; others met their mentors virtually and never entered the site or met clients. Students reported on their progress and received peer and faculty feedback at biweekly class sessions. However, in November 2020, all clinical experiences ceased due to increasing numbers of COVID-19 patients, without a clear indication that there would be a return to clinicals during the academic year. Uncertainty threatened to halt the honors projects.
We then met with the university instructional technology team that worked with faculty to create interactive programming for online courses and arrived at a roster of digital resources that could serve as deliverables for the capstone projects. These included websites, interactive infographics, videos, and quick response codes for links to the infographics and surveys to assess learning. After some initial trepidation, students utilized these user-friendly digital resources to create sustainable versions of the deliverables. Once clinical experiences resumed in the spring, restrictions remained, reducing the number of people at clinics, medical offices, and community-based organizations. Students were still prevented from spending time at capstone sites, but the creation of digital versions of their deliverables made it possible for them to complete their projects with professional and visually appealing materials. Their deliverables were appreciated by mentors and intended recipients and remain in use; project evaluations indicated increased knowledge and intention to use included resources.
Students documented their capstone projects with a written paper and delivered presentations in professional conference style. The administration granted permission for students and the program director to be on campus for this event, as large group meetings were still prohibited in May 2021. The event was envisioned as a graduation celebration to include faculty, mentors, administrators, family, and friends. The hybrid event used an online meeting platform to include these important partners in the students' journey, allowing them to view the work and celebrate together.
CONCLUSION
The COVID-19 pandemic disrupted the delivery of patient care and nursing education, potentially weakening students' confidence in their ability to successfully complete their programs, pass the licensure exam, and safely care for patients (Gaffney et al., 2021). The pandemic also jeopardized the capstone projects of our honors program. Collaboration with partners in education and health care helped to identify innovative solutions (Shake & Lavin, 2018), providing this honors cohort with the success needed to demonstrate leadership as professional nurses (Schepp et al., 2021).
Collaboration, flexibility, and creative use of resources are strategies that contribute to the success of any project. For the first cohort of the LEAD Honors Program, these approaches helped students successfully use digital resources to complete their capstone projects. These resources have become standard for subsequent cohorts, leading to more innovative uses of digital tools in nursing.
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