Revista Latino-Americana de Enfermagem · 6 authors, 4 centres
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This scoping review of 33 studies found that the COVID-19 pandemic had both positive and negative effects on nursing training. Positive aspects included the development of new virtual teaching strategies and real-world crisis training, while negative repercussions centered on increased anxiety, stress, and loneliness among students. The findings highlight the need to address psychological impacts and practical skill gaps in future nursing education planning.
**Background:** The COVID-19 pandemic forced a rapid shift to emergency remote teaching in nursing education worldwide. This scoping review aimed to map the knowledge produced about the positive and negative repercussions of the pandemic on nursing training, including both technical and higher education levels. The study was motivated by concerns that remote teaching may not fully meet the requirements of nursing education, which relies heavily on clinical practice and direct patient interaction.
**Methods:** This scoping review followed the Joanna Briggs Institute Reviewer’s Manual and the PRISMA-ScR checklist. The protocol was registered in the Open Science Framework. Searches were conducted between March and April 2022 across 15 electronic databases and thesis/dissertation repositories, including PubMed, SCOPUS, Web of Science, Science Direct, LILACS, and others. The PCC strategy (Population: Nursing; Concept: Education in Nursing; Context: COVID-19 pandemic) guided the research question: "Which is the available scientific evidence about the repercussions of the COVID-19 pandemic in Nursing training?" Four different search strategies were used with MeSH and DeCS descriptors. Inclusion criteria were full-text studies published in any language that met the objective. Excluded were editorials, letters to the editor, and opinion articles. Two independent reviewers screened titles/abstracts and extracted data; a third reviewer resolved disagreements. Data were synthesized into two pre-established categories (positive and negative repercussions) and analyzed using descriptive statistics. Level of evidence was classified according to JBI criteria.
**Key Results:** From an initial 650,729 studies, 604,813 were available in full. After screening, 33 studies comprised the final sample. Publication years were 2020 (5 studies, 15.15%), 2021 (20 studies, 60.60%), and 2022 (8 studies, 24.24%). Seven studies (21.21%) were in Portuguese and 26 (78.78%) in English. Brazil contributed the most studies (10, 30.30%), followed by the USA (4, 12.12%). Most studies (30, 90.91%) had level of evidence IV (expert opinion, descriptive studies, case reports); only 3 studies (9.09%) had level III (analytical studies, quasi-experimental).
Positive repercussions identified included: development of new teaching strategies adapted to the virtual environment (cited in nearly half of publications); flexibility of home-based study and variable class times; opportunity to develop competencies and skills in a crisis context; development of technological skills; encouragement of self-directed learning; improved teacher-student communication; shift from instructor-centered to student-centered teaching; and creation of new technologies like virtual reality.
Negative repercussions were predominantly psychological: increased anxiety and stress levels, loneliness, fear of infection, depression, sadness, vulnerability, and helplessness. Internet access difficulties were frequently reported, with unstable connections and lack of access for some students. The home environment often hindered learning due to distractions and household chores. Clinical practice was significantly impaired, with lack of face-to-face practice, sudden pauses due to contamination waves, reduced practice time, and difficulty developing clinical competence. Other negatives included work overload, physical effects from PPE use, financial burden, and decreased concentration and motivation.
**Clinical Implications:** The review demonstrates that while remote teaching was a necessary emergency measure, it had substantial negative impacts on nursing students' mental health and practical skill development. The findings underscore the need for higher education institutions to develop contingency plans for future crises that address both technological access and psychological support. Strategies such as Problem-Based Learning and university extension courses for recent graduates are proposed to remediate practical skill gaps. The predominance of low-evidence-level studies highlights the need for more rigorous experimental research to evaluate long-term impacts on clinical competence and patient care. Public policies should focus on ensuring internet and digital equipment access for all students and providing teacher training for emergency remote teaching.