Abstract
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Purpose
The purpose of this study was to examine the experiences of nurse managers in clinical nursing education during an emerging infectious disease outbreak.
-
Methods
Individual semi-structured interviews were conducted with 12 nurse managers from seven general or tertiary hospitals, each with 300 or more beds, in South Korea. Data were collected between February 17 and June 10, 2023, and analyzed using qualitative content analysis.
-
Results
Four themes and 11 subthemes were identified. Nurse managers faced significant challenges in departmental management during the infectious disease outbreak, encountered a wide range of student attitudes toward learning, adapted their teaching methods flexibly in response to changing infectious disease conditions, and ultimately found meaning in the irreplaceable value of clinical practice education.
-
Conclusion
During the emerging infectious disease outbreak, nurse managers not only encountered substantial difficulties but also experienced professional growth as clinical nursing educators. To enhance clinical nursing education in such challenging environments, it is essential to minimize uncertainty caused by infectious diseases and foster positive perceptions among nursing students regarding clinical practice education under restrictive circumstances. Institutional support is also necessary to reduce the work burden on nurse managers.
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Key Words: Communicable diseases, emerging; Qualitative research; Nurse administrators; Education, nursing
INTRODUCTION
Clinical practice education is a fundamental component of nursing education, functioning as a critical link between theoretical learning and actual patient care. It allows nursing students to observe and participate in the roles of professional nurses, develop a deeper understanding of nursing practice, and build professional competence [
1-
3]. To maintain the quality of clinical education, the Korean Accreditation Board of Nursing Education sets standards for clinical practice sites and educator qualifications [
4]. In South Korea, clinical educators include both university faculty and nurse managers, who supervise students directly in clinical settings [
5]. Nurse managers, also known as head nurses, typically oversee student orientation, provide guidance throughout the practicum, and facilitate communication between nursing schools and clinical institutions. Drawing on extensive clinical expertise, they help foster students’ clinical reasoning and judgment [
5,
6].
Previous studies have predominantly focused on the experiences of nursing students during the coronavirus disease 2019 (COVID-19) pandemic, as well as the challenges faced by university faculty involved in clinical education. For example, research has indicated that students suffered decreased quality of education due to reduced clinical exposure and limited patient interaction [
3,
7], while educators reported that infection control measures often took priority over student training during the crisis [
8]. However, there is limited research centered on nurse managers, who directly supervise students in clinical settings. Despite their vital role in coordinating practice sites and mentoring students, their experiences and perspectives as clinical educators have not been sufficiently explored. Furthermore, nurse managers are known to experience greater job stress than general staff nurses, as they are responsible for both patient care and the education of students from multiple institutions [
9]. Yet, there is little information regarding how they perceived and addressed their educational responsibilities during public health emergencies.
The emergence of novel infectious diseases has highlighted the critical need to manage the quality of clinical nursing education. Simultaneously, the necessity to strengthen the competencies of clinical educators who guide nursing students has become increasingly apparent [
10]. In particular, nurse managers were required to move beyond their routine administrative duties and take on expanded roles as educators, actively leading clinical training during such crises [
11]. Despite these heightened responsibilities, little research has addressed how nurse managers experienced their roles as educators in the context of emerging infectious disease outbreaks.
This study sought to explore the experiences of nurse managers as educators in clinical practice education during an emerging infectious disease outbreak. By focusing on their perspectives, this research aims to offer foundational insights to inform the development of effective training strategies and support systems for educators during future public health emergencies.
Given the unprecedented and emotionally complex nature of the COVID-19 pandemic, it is likely that nurse managers’ experiences in clinical education encompass personal, institutional, and ethical dimensions that cannot be fully captured through quantitative methods. Therefore, a qualitative research approach was selected to explore these multifaceted, context-dependent experiences in depth. The findings of this study are expected to provide meaningful implications for enhancing the quality of nursing education and strengthening educator preparedness in times of crisis.
METHODS
1. Study Design
This qualitative study applied the methods of Hsieh and Shannon [
12] to explore nurse managers’ experiences as educators during emerging infectious disease outbreaks in nursing clinical practice.
Participants were recruited using a combination of purposive and snowball sampling, and all had at least one semester of experience providing nursing student practice education during the COVID-19 outbreak. Nurse managers who volunteered and met the eligibility criteria were included, while additional participants were referred by those who had already completed interviews. Recruitment continued until data saturation was achieved, resulting in a total of 12 participants.
All participants were female, with a mean age of 49.92±3.52 years. Most were married, and all held at least a bachelor’s degree. Eight participants were employed at general hospitals and four at tertiary hospitals, working mainly in internal medicine and surgical wards, as well as in emergency departments, intensive care units, and health screening centers. The mean clinical experience was 27.50±3.48 years, and the average duration of managerial experience was 8.48±5.61 years. The period spent supervising nursing clinical practice education during the pandemic ranged from one to five semesters (
Table 1).
Data collection occurred between February 17 and June 10, 2023, and qualitative content analysis was used for data interpretation. Individual semi-structured interviews were conducted with 12 nurse managers employed at seven general or tertiary hospitals, each with 300 or more beds in South Korea. All interviews were conducted by a researcher (JYP) who has seven years of clinical experience and prior publication experience in qualitative research. A semi-structured interview guide, developed by the research team through a review of relevant literature and previous studies [
3,
9,
13] on clinical practice education during the pandemic, was used to facilitate the interviews. During each session, the researcher also observed and recorded participants’ non-verbal expressions in field notes. Interviews began with the prompt: “Please tell us about your experience as an educator in nursing clinical practice education during the emerging infectious disease outbreak.” Key questions included: “Tell me about how the emerging infectious disease outbreak has changed your approach as an educator in nursing clinical practice education,” “Tell me about the benefits and challenges of being a clinical practice educator for nursing students during the emerging infectious disease outbreak,” and “Tell me about what it means to you to be an educator in nursing clinical practice education during the emerging infectious disease outbreak.”
Each interview lasted between 36 and 70 minutes, depending on the participant. The interviewer repeatedly reviewed the recordings and transcribed them verbatim, resulting in a total of 227 A4 pages. Three participants who were available for a second interview were asked to review and provide feedback on the data analysis.
4. Ethical Considerations
This study was approved by the Institutional Review Board of Kunsan College of Nursing (KCN2022-0829-01-3). Researchers explained the study procedures to all participants in person, informed them of their right to withdraw at any time, and guaranteed anonymity and confidentiality. Interviews were conducted only with participants who voluntarily agreed and provided written informed consent online. All personally identifiable information was coded alphabetically and numerically (e.g., Hospital A, Participant 1) to ensure anonymity. Each participant received an online gift card as a token of appreciation.
5. Data Analysis
Data were analyzed using conventional content analysis, employing an inductive approach based on the methods described by Hsieh and Shannon [
12]. First, all investigators read the transcripts several times to gain an overall understanding of the data. SC and JL then independently reviewed the transcripts to extract and code semantic units, which were used to derive subthemes. Each identified subtheme was compared and grouped to generate and name abstract themes. When discrepancies arose, the two researchers discussed their findings until consensus was reached. Field notes were also reviewed during the analysis. The results were further reviewed by a nursing school professor with expertise in qualitative research.
The rigor of the study was maintained using the criteria of credibility, fittingness, auditability, and confirmability, as outlined by Sandelowski [
14]. To ensure credibility, open-ended questions were employed during interviews, allowing participants to freely share their experiences and perspectives. All recorded interviews were transcribed verbatim and systematically analyzed, and three participants who were available for a second interview reviewed the results for confirmation and feedback. To ensure fittingness, representative participant statements were presented, and participant demographics were described to facilitate the evaluation of findings for their relevance and applicability to other populations or contexts. Auditability was addressed by providing a detailed account of the study process to enable replication or follow-up research. The analysis included direct quotations from participants so that readers could verify the investigators’ interpretations. Confirmability was ensured through collaborative data analysis by two investigators and independent review of the findings by a nursing school professor with experience in qualitative research. All research team members were nursing faculty, trained in qualitative research, experienced in educating nursing students, and familiar with collaboration with nurse managers in clinical settings.
RESULTS
A total of 247 meaningful statements describing the experiences of nurse managers as educators in clinical practice education during an emerging infectious disease outbreak were extracted and categorized into 70 codes, which were further organized into 11 subthemes and four overarching themes by grouping similar items. The identified themes were: “Challenges in managing the department during the infectious disease outbreak,” “Navigating student learning attitudes during the pandemic,” “Having the flexibility in teaching to adapt to changing epidemic conditions,” and “Discovering the meaning of irreplaceable clinical practice education” (
Table 2).
Nurse managers were concerned about the spread of infection among patients, healthcare providers, and students in their departments during the outbreak, dealt with infection-related complaints from inpatients or their guardians; and felt overwhelmed and responsible for supervising nursing clinical practice education.
1) Balancing infection risks and educational responsibilities
Participants described persistent worries about outbreaks and the risk of infection transmission among patients, students, and healthcare staff during nursing clinical practice education. They expressed concerns about students being exposed to infectious diseases while commuting as well as through contact with hospital patients.
Patient infection control and stuff like that was a little bit of a challenge. I was worried about patients and students, about infections and outbreaks... I was very concerned about a lot of these things. (Participant 1)
I was worried about the students being a source of infection for us. On the other hand, they took a risk by coming to the hospital. We could also be a source of infection for them. So, it was a situation where everyone had to be careful. (Participant 9)
2) Managing infection control amid increased patient scrutiny
Participants reported that, despite adhering to infection control guidelines, hospitalized patients and their caregivers frequently voiced concerns and complaints about infection risks during the outbreak. Nurse managers had to address these concerns directly. Some patients, highly sensitive to infection risk, closely observed the infection control practices of healthcare staff and nursing students. There were occasions when patients complained about students’ hand hygiene, perceiving it as inadequate. In response to heightened patient vigilance and anxiety about infection spread, nurse managers emphasized to students the necessity of consistently performing proper infection control, especially in the presence of patients.
The students were a little reluctant to get in contact (for fear of infection) and reacted that way... When there were confirmed cases (of COVID-19), although we tried our best to control the infection, the patients blamed the healthcare workers for it, which was difficult. (Participant 1)
Patients are becoming too sensitive these days. They suspect us of reusing equipment; hence, we have to wipe [it down] while they watch us. We have to wash our hands in front of patients to reduce the complaints. I used to tell this to the students... Regarding infections... (Participant 2)
3) Increased pressure and responsibility as a clinical practice educator
In addition to their existing duties as nurse managers, participants reported increased anxiety regarding the prevention of infections in their departments during outbreaks. They described feeling burdened and stressed as they had to monitor respiratory symptoms, check COVID-19 test results, enforce infection control measures, and explain movement restrictions, all while supervising students. Nonetheless, they strove to fulfill these responsibilities diligently.
I was under a lot of pressure (to manage clinical practice education during the epidemic)... I felt pressured, but I still had to do it well. They are our invaluable students who come for clinical practice. We will have new students coming soon, I will do my best. (Participant 4)
Managing the students was a bit stressful, to be honest. It was hard enough to manage the patients and their guardians. When the students came for their clinical practice, even if they came in with a (negative) PCR test result for COVID-19 at the beginning, their behavioral patterns and living radius did not include only the hospital and their home... It was stressful to manage all that. When COVID-19 spread from one individual to patients, it caused the greatest stress. (Participant 5)
2. Navigating Student Learning Attitudes during the Pandemic
Nurse managers observed a broad spectrum of learning attitudes among nursing students during clinical practice amid the emerging infectious disease outbreak. Some students, who had previously participated mainly in online classes, viewed in-person clinical training as highly valuable and were eager to engage actively. In contrast, other students appeared passive, hesitant, or lacking in confidence within the clinical environment. While nurse managers expressed satisfaction when students demonstrated proactive engagement, they also reported disappointment from an educator’s perspective when encountering students with passive or withdrawn behaviors.
1) Seeing students take advantage of valuable clinical practice opportunities
Participants reported that, during the height of the COVID-19 pandemic, many universities were unable to provide in-person clinical practice education, instead relying on online or on-campus training. Students who anticipated hospital-based clinical practice viewed it as a rare and valuable opportunity and approached it with eagerness.
When the pandemic was at its peak, I heard that they seldom practiced face-to-face and did everything online. Last fall, when the students came (for clinical practice), they were really eager, with sparkling eyes. They actively participated in the training. I really appreciated it. (Participant 1)
Now, the students ... I had served as an educator in other hospitals as well. As there were a lot fewer opportunities for clinical practice than before, I saw more students trying really hard to learn a lot from the clinical practice. They were much more eager. (Participant 7)
2) Seeing students being intimidated by the unfamiliarity of clinical practice
Conversely, some students, accustomed to virtual and non-face-to-face classes, focused primarily on completing assignments rather than actively observing nurses’ work in the clinical setting. Others appeared intimidated by the context of infectious disease.
I told them to observe closely what treatment was administered; however, they just sat at the computer and did assignments, which was rather disappointing. (Participant 1)
The students were a little bit... shall we say, unmotivated? ... They were not there to learn something. Rather, they were there because they had to. I do not know what kind of students I am getting this time, but I think it is getting worse... They seem to just try to fill the clinical practice period because it is part of the curriculum. (Participant 4)
3. Having the Flexibility in Teaching to Adapt to Changing Epidemic Conditions
Nurse managers described being flexible in supervising clinical practice education in response to evolving infectious disease conditions. They adjusted clinical education according to infection control guidelines, restricting department access to minimize student exposure to infected patients, controlling the number and movement of students within clinical settings, and limiting direct contact with certain patients. Given the inevitable risk of hospital-acquired infections, nurse managers also reinforced infection control training for students, emphasizing the use of personal protective equipment (PPE). Additionally, to compensate for restricted opportunities to observe or perform clinical procedures, they provided supplementary explanations and educational materials to ensure students gained as much practical understanding as possible under the circumstances.
1) Imparting limited clinical practice education
Participants reported limited student-patient interaction due to concerns about infectious disease transmission. Students were only allowed in certain hospital areas, were not permitted to care for patients in isolation rooms, and were restricted from entering clinical laboratories. Most training was observation-based, with hands-on experience reduced. These measures were implemented in accordance with institutional infection control policies, recognizing that students are not healthcare employees and are more vulnerable to infection.
We cannot really expect 100% compliance from student nurses. I mean, we need to protect the students... We could not afford for them to come into contact with patients, and it was not appropriate to keep them out of the areas where patients were. We decided to keep them away from the isolation rooms. (Participant 3)
This led to fewer opportunities to manage the patients, and the students could not practice many of the nursing techniques in dealing with patients, which could have been different from before COVID-19... Before COVID-19, they could interact with patients, share laughter, monitor vital signs, and administer shots—all during 2 weeks. During the pandemic, they could not talk to patients as much, the clinical practice period was reduced, and the clinical practice was stopped when anyone was infected. (Participant 10)
2) Reinforcing hands-on infection control training
Participants noted that while infection control guidelines had always been present, the COVID-19 pandemic led to even stricter protocols through infection control departments. The importance of using PPE and receiving improved infection control training was heavily emphasized for both healthcare workers and students.
Before 2020, hand washing was not strictly practiced even by nurses. It was not really emphasized to nursing students. It was just part of the orientation for the clinical practice education. Amid the epidemic, last year, I kept asking them, ‘Did you wash your hands?’ or ‘When will you wash your hands?’ as I would do with our nurses. I really watched out for it. It definitely made me focus a lot on hand hygiene... (Participant 9)
We used to simply have maybe one volunteer try on personal protective equipment, like a face shield, gloves, and a mask when performing suction... When infected patients have a fever and we are concerned about it, we ask the students to continue wearing the four pieces of personal protective equipment, at least the gloves and the gown. They had a lot of such experiences. We ensured that they experienced it and paid attention to it. (Participant 12)
3) Increased use of educational materials to supplement the limited clinical practice
Participants reported making efforts to compensate for the inevitable limitations of hands-on learning during clinical practice. They utilized diverse teaching strategies, relying heavily on additional educational materials to reinforce key concepts about disease characteristics and inpatient care.
For the things that they could not experience themselves, I provided verbal education while presenting educational videos. It was the least I could do. They could not come into contact with patients. There should have been something they learned from here. (Participant 2)
There are some sets of education we do... We explain to them the tasks and characteristics of each department. During the COVID-19 pandemic, a couple of things were added to our usual education. I did. I felt sorry that students had less experience getting close to patients and just observed them from afar. I developed a couple of chapters to give them more education (on inpatient care). (Participant 5)
4. Discovering the Meaning of Irreplaceable Clinical Practice Education
Even amid the challenges posed by emerging infectious diseases, nurse managers reaffirmed the necessity of clinical practice education. While providing the same level of experience as before the COVID-19 outbreak was difficult, they believed that clinical exposure was crucial for nursing students to translate theoretical learning into real-world practice. As the pandemic continued and infection control protocols became standard, nurse managers gained experience and confidence in their ability to supervise clinical education under such conditions. Drawing on this, they felt prepared to overcome similar situations in the future and to foster infection control competence in both students and nurses.
1) Rediscovering the importance of clinical practice education in a clinical setting
Participants emphasized the value of students directly experiencing patient care, nursing tasks, and interdisciplinary collaboration—not merely acquiring knowledge in the classroom but engaging with the realities of the clinical environment. They believed that new nurses who missed these opportunities faced greater challenges in adjusting to practice after graduation. Therefore, despite unavoidable limitations during outbreaks, nurse managers stressed the continued importance of exposing students to authentic clinical settings.
For nurses, caring for and responding to patients are also important... There’s a difference between simply reading text materials and seeing real patients. how nurses explain things to patients and what to pay attention to... (Participant 2)
It is also important for students to acquire theoretical knowledge in clinical practice but I think it is actually a major goal of the clinical practice education to get a feel for the clinical environment of this hospital, to adapt a little bit. (Participant 7)
2) Feeling confident and rewarded as a clinical practice educator
Participants stated that as time passed after the initial COVID-19 outbreak and as prevention guidelines became established, their experience caring for patients during the pandemic strengthened their expertise. This, in turn, increased their confidence as educators in clinical practice education. They found it especially rewarding to educate students on up-to-date infection control practices. Positive feedback from students regarding their clinical practice experiences was also highly motivating, giving nurse managers a sense of achievement and reinforcing their commitment to quality education.
Now, I have gained a lot of experience in supervising students, and I naturally know how to deal with situations. Based on this experience, I feel like I know where to pay more attention and to what extent I should provide education. (Participant 11)
The students left with a high level of satisfaction, saying that it was really helpful. When I saw the students after a long while, I allowed them into the endoscopy room and other areas, and they genuinely seemed to appreciate it. It was really rewarding. (Participant 4)
3) Professional growth with students during an infectious disease outbreak
Participants did not view the experience of guiding clinical practice during the outbreak solely as a crisis or challenge. Instead, they saw it as an opportunity to provide students with real-world learning, reflect on their own practices, and grow as educators through mentoring. Although the COVID-19 pandemic posed unprecedented difficulties, participants believed that offering clinical training under institutional guidelines prepared students for their future roles as nurses in meaningful ways. The pandemic also prompted nurse managers to re-examine and improve infection control practices, promoting growth through mutual observation and feedback between students and nurses. Drawing on their frontline experience, nurse managers were able to share practical, real-life insights, enriching students’ learning beyond what could be taught in the classroom.
As it was a first for me too, it felt like we were going through it together. My students and I went through it together. However, when you think about it, what we did during the pandemic, hand hygiene, and things like that, were things that we should have been doing all along when we were interacting with patients, right? Now we realize that we have been too careless and that we have missed a lot of things... (Participant 8)
I was happy to tell the stories of my firsthand experience to my students... I told them what we had experienced, what happened over the two years, how this hospital was used and how it operated, how the place where we were doing the clinical practice had been used, how the patients were moved, how things were managed, what we needed to pay attention to, and how the things were managed there now. My students really enjoyed listening to these stories. (Participant 7)
DISCUSSION
This study explores and describes the experiences of nurse managers as educators in nursing clinical practice education during an emerging infectious disease outbreak in a Korean healthcare setting. Four themes were identified: “challenges in managing the department during the infectious disease,” “facing diverse student attitudes toward learning,” “having the flexibility in teaching to adapt to changing epidemic conditions,” and “finding the meaning of irreplaceable clinical practice education.”
Nurse managers reported that members of their department were deeply concerned about infectious disease transmission among patients, students, and staff. They struggled to address patient dissatisfaction and complaints, all while ensuring that both nurses and nursing students complied with hospital infection control guidelines. Despite these challenges, nurse managers remained responsible for supervising students in infection control, including suspected cases. They also served as liaisons between patients and families and managed infection control for employees and visitors [
15]. During the pandemic, nurse managers faced additional burdens beyond their standard managerial roles [
16]. Previous studies, such as those conducted following the Middle East Respiratory Syndrome outbreak, have reported that nurse managers experienced psychological strain as they balanced their primary duties with supervising nursing clinical practice education [
9]. These findings suggest that nurse managers are subject to excessive workloads during emerging infectious disease events. Therefore, organizations should support nurse managers by streamlining non-essential tasks or hiring additional staff.
Nurse managers also noted considerable variation in student learning attitudes during the pandemic. While they valued students who viewed the crisis as a learning opportunity and engaged actively in clinical practice, they were discouraged by students who avoided patient contact and relied primarily on electronic records. The prevalence of virtual classrooms during COVID-19 [
17] may have caused some students to feel intimidated by real clinical settings, a finding that aligns with other research showing preferences for virtual learning due to fears related to epidemics [
18]. Even outside pandemic periods, some nursing students have focused solely on assignments that affect their grades, missing out on genuine patient interaction [
6]. Thus, it is necessary to address and shift students’ perceptions so that they view challenging clinical practice as a valuable opportunity, especially during emerging infectious disease situations.
To protect students, nurse managers sometimes reduced certain clinical activities or intensified infection control training. Even when hands-on practice was limited, nurse managers provided students with educational materials on up-to-date infection control guidelines, exposed them to real hospital environments where these guidelines were implemented, and ensured that students had opportunities to wear PPE with verbal explanations as needed. During the COVID-19 pandemic, nurse managers conducted ongoing staff training on the proper use of PPE and managed essential educational programs in response to changing circumstances [
3,
15]. In this way, they played a pivotal role in addressing the challenges brought about by the COVID-19 pandemic [
15]. Their experiences enabled them to supply students with authentic infection control resources and deliver appropriate clinical practice education, even during times of crisis. For more effective clinical education, universities and hospitals should coordinate key learning objectives and content in advance. Integrating interactive tools such as simulations and quizzes may further enhance infection control training [
19], and these strategies should be considered for adaptation to the Korean clinical context.
Supervising students during an infectious disease outbreak reminded nurse managers of the unique and irreplaceable value of hands-on education. Despite limitations in clinical settings, nurse managers believed it was essential for students to observe nurse-patient interactions and interdisciplinary collaboration. Experiencing clinical practice during crises allows students to redefine their professional identity [
10]. Non-face-to-face learning restricts patient interaction and can hinder students’ ability to manage real clinical situations [
20]. Although students typically value clinical practice during outbreaks [
3] and often have positive attitudes toward it [
21], they may also experience negative emotions such as fear and anxiety [
21-
23]. Despite these difficulties, clinical education remains a critical component in the formation of professional identity and career planning [
21]. Nurse educators should acknowledge these emotional challenges, provide appropriate support [
7,
23], and identify the most effective approaches to clinical practice [
21].
Nurse managers reported that sharing the expertise and experience they developed during the outbreak not only enhanced their own confidence and fulfillment as educators but also contributed to their professional growth. This is supported by previous research in South Korea and Indonesia, which found that clinical teaching helped nurses re-examine their knowledge, improve practical skills, and foster self-reflection, thus contributing to ongoing professional development [
24,
25]. Similarly, managing challenges such as infectious disease outbreaks was regarded as a meaningful experience that identified areas for improvement and informed future educational practices [
11]. These findings are consistent with the present study and align with reports by Kagan et al. [
26] and others [
10], which found that nurse managers experienced both an increased sense of burden and professional pride during the COVID-19 pandemic, along with a heightened sense of competence. Overall, the pandemic acted as a catalyst for educator growth, as nurse managers adapted to rapidly changing clinical conditions and shared real-world experiences with students.
This study has several limitations. First, it was conducted after the resumption of clinical practice following the stabilization of the outbreak, rather than during the initial emergence of the infectious disease. Second, due to nationwide restrictions on clinical training during the COVID-19 pandemic, some participants had supervised clinical practice for only one semester. However, considering the study’s aim to explore nurse managers’ experiences under exceptional circumstances, even brief supervisory experience was deemed meaningful. The diversity in participants’ backgrounds contributed to a broader understanding of the clinical education environment during the pandemic. Finally, all participants were female nurse managers, which may limit the inclusion of perspectives from male nurse managers.
CONCLUSION
This qualitative study explored nurse managers’ experiences in clinical nursing education during an emerging infectious disease outbreak, identifying four themes and 11 subthemes. Nurse managers faced significant challenges in department management, encountered diverse student attitudes, flexibly adapted teaching methods to evolving conditions, and discovered the irreplaceable value of clinical practice. To ensure effective clinical nursing education in future pandemics, it will be essential to minimize uncertainty within organizations and foster positive student perceptions, even when circumstances are restrictive. Sufficient educational time and resources are needed to meet curriculum objectives, and institutional support is crucial to alleviate the workload of nurse managers.
-
CONFLICTS OF INTEREST
The authors declared no conflict of interest.
-
AUTHORSHIP
Conceptualization - SC and JL; formal analysis - SC and JL; methodology - SC and JL; supervision - JL; project administration - SC; resources - SC and JYP; data curation - JYP; investigation - JYP; validation - SC and JL; visualization - JL; and drafting or critical revision of the manuscript for important intellectual content - SC and JL.
-
FUNDING
None.
-
ACKNOWLEDGEMENT
None.
-
DATA AVAILABILITY STATEMENT
The data can be obtained from the corresponding authors.
Table 1.General Characteristics of the Participants (N=12)
|
No. |
Sex |
Age (year) |
Educational level |
Marital status |
Type of hospital |
Department |
Clinical experience |
Managerial experience |
Duration of service as clinical practice educators during the pandemic (semesters) |
|
1 |
F |
46 |
Graduate student or higher |
Single |
Tertiary hospital |
Medical ward |
23 years and 4 months |
1 year and 10 months |
3 |
|
2 |
F |
52 |
Graduate student or higher |
Married |
General hospital |
Surgical ward |
30 years |
3 years |
1 |
|
3 |
F |
47 |
Graduate student or higher |
Married |
Tertiary hospital |
Intensive care unit |
23 years and 10 months |
7 years and 9 months |
2 |
|
4 |
F |
56 |
Bachelor’s degree |
Married |
General hospital |
Medical ward |
33 years and 5 months |
20 years and 9 months |
1 |
|
5 |
F |
47 |
Bachelor’s degree |
Married |
Tertiary hospital |
Health screening center |
25 years and 11 months |
7 years and 10 months |
4 |
|
6 |
F |
53 |
Graduate student or higher |
Married |
General hospital |
Surgical ward |
31 years and 2 months |
3 years and 4 months |
3 |
|
7 |
F |
54 |
Graduate student or higher |
Married |
General hospital |
Surgical ward |
31 years and 2 months |
8 years |
2 |
|
8 |
F |
46 |
Graduate student or higher |
Married |
General hospital |
Medical ward |
24 years |
1 year and 10 months |
3 |
|
9 |
F |
54 |
Graduate student or higher |
Married |
General hospital |
Medical ward |
31 years and 9 months |
13 years and 5 months |
3 |
|
10 |
F |
49 |
Graduate student or higher |
Married |
General hospital |
Surgical ward |
25 years and 11 months |
15 years |
4 |
|
11 |
F |
46 |
Bachelor’s degree |
Married |
General hospital |
Emergency room |
25 years and 2 months |
12 years |
5 |
|
12 |
F |
49 |
Graduate student or higher |
Married |
Tertiary hospital |
Medical ward |
25 years |
7 years |
3 |
Table 2.Themes and Subthemes in the Findings
|
Themes |
Subthemes |
|
Challenges in managing the department during the infectious disease outbreak |
Balancing infection risks and educational responsibilities |
|
Managing infection control amid increased patient scrutiny |
|
Increased pressure and responsibility as a clinical practice educator |
|
Navigating student learning attitudes during the pandemic |
Seeing students take advantage of valuable clinical practice opportunities |
|
Seeing students being intimidated by the unfamiliarity of clinical practice |
|
Having the flexibility in teaching to adapt to changing epidemic conditions |
Imparting limited clinical practice education |
|
Reinforcing hands-on infection control training |
|
Increased use of educational materials to supplement the limited clinical practice |
|
Discovering the meaning of irreplaceable clinical practice education |
Rediscovering the importance of clinical practice education in a clinical setting |
|
Feeling confident and rewarded as a clinical practice educator |
|
Professional growth with students during an infectious disease outbreak |
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