By Alex Coleman
If COVID-19 has taught us anything, it is that change is not always bad. In fact, if we fail to provide ourselves with the opportunity to slow down and look at how we can improve our programs and institutions, ultimately, it will be to our detriment.
BYU’s College of Nursing has always endeavored to encourage our students to strive for the highest standard of nursing possible: The Savior’s standard. It is a high bar, to be sure. Though we doubt we’ll ever reach “perfect” nursing, the college is constantly striving to seek ways in which we can better instruct our students in their performance of the Healer’s art. Petr Ruda, assistant teaching professor, is one member of a very capable team that is working on one of those improvements.
Along with nursing professors Julie Valentine, Katreena Merrill, Daphne Thomas, Peggy Anderson, Sheri Tesseyman, and Matt Anderson, Ruda is implementing a mentorship program between the N292 class (clinical practicum of older adults course) and N492 (the nursing capstone class). For nursing students, N292 is their first clinical experience. Whereas normally, the students would have the opportunity to conduct this clinical in nursing homes, COVID-19 has forced nursing homes to close their doors to any visitors.
These students are now getting their first experience with a patient through a program called Shadow Health, a computerized simulation that gives feedback and suggestions to students based on the disparity of their care with professional care. According to Ruda, what these professors have found is that “if N292 students have good N492 mentors, they do much better in the scenarios.” Ideally, the N492 students have overviewed what’s happening in each scenario that Shadow Health generates for the N292 students in order to be able to have conversations with the students about each scenario, help them reflect on their first attempt, and improve on their next sessions.
Professor Ruda continues, “Thus far, we know that when students from our N292 class have a very good mentoring experience, it totally reflects in their second attempt. It’s fantastic.” In order to prepare these students to have a successful mentoring relationship, the N292 students are instructed to make sure they are available, teachable, and prepared for mentor meetings. The mentors are given different instructions—they are asked to understand the Shadow Health scenarios, to care about the success of the N292 student, to address some of the educational opportunities listed in Shadow Health, and most importantly, to address the opportunity for the student to practice empathy.
Part of the Shadow Health program is that the student is graded on their ability to empathize with the avatar “patient.” “They are graded on whether or not they asked themselves questions like, ‘what was most of the patient’s concerns about?’” says Ruda. “We ask the students to think about different questions they could ask to get that information.” Following the beginner student’s first attempt, the N492 mentor facilitates a conversation about what they would have done differently and why.
What is the potential for this program to be so beneficial? “In the perfect world, every student in our college has a mentor, and every student has the opportunity to be a mentee as well.” For the N292 students, they have a companion who hopefully never leaves them, even when they eventually graduate and enter the workforce as new nurses. The capstone students, too, have the opportunity to help guide a younger professional into competent nursing.
Students state that these mentor/mentee relationships have been very beneficial. Especially in such a time where the stress of COVID-19 can add to an already heavy academic load, nursing students can use all the help they can get. N292 student Olivia Snow comments, “I personally love the mentorship program. I only know nursing students in my group, and so I wouldn’t have anyone to ask questions if I didn’t have a mentor… [She’s] helped me know what’s on the path ahead of me and has helped prepare me in that aspect.” Olivia meets with her mentor once a week to talk over any questions she has about clinicals, class, registration, or whatever has helped her mentor throughout Olivia’s upcoming semesters.
Student Tim McCormick has also found the program to be incredibly helpful—“I have enjoyed the mentorship program this semester because it helps online clinical simulations come to life a bit more.” Tim also finds that especially in this unique time of social distancing and pandemic precautions, that it can be “really beneficial to have somebody to interact with during a semester like this when interaction is relatively non-existent. It is nice to be able to ask questions in a low-stress environment and get good insight on how to be a better nurse, even if it is just online.”
“It’s interesting because we have never had this program in our college before, and I see a huge benefit for both mentors and mentees,” says Ruda.
In fact, this program is particularly groundbreaking because it’s surprisingly never really been done before in this kind of setting at all.
“The research [surrounding student mentor/mentee relationships] is limited… Everything that comes out of this experience we are hoping to publish as soon as possible,” says Ruda. Whereas the research about student/professional relationships is well-developed, these professors were basically unable to find any available research about mentoring relationships between students.
“That said,” says Ruda, “we understand that N292 students are novices, and we don’t expect N492 students to be experts, but we consider them to be at least advanced beginners. They have a lot of experiences that they can share and are able to correctly direct the younger student’s thinking as far as what they need to improve.” Though the program is relatively new in its development, thus far the one definite finding that this group of professors has discovered is that students from N292 that had “really good mentors are doing much better and are more thorough on their second attempt in Shadow Health.”
Professor Ruda is sure that BYU’s College of Nursing is not the only one going through this process of needing to find new ways to develop their students. “How rich, timely, and useful this information could be,” he says. During this time, when many nursing schools are being cut off from their resources, it can be really valuable to be able to draw new teaching methods from within the college. “Even being able to replace the clinicals with Shadow Health has been really important, and I don’t think these programs are going anywhere. Hopefully, eventually, they are used as a supplement to the clinical course, but even as a refresher between semesters on how to do assessments or how to be empathetic, these types of programs can be very useful.”
These professors observed this need far before COVID-19 ever necessitated any massive upheavals to the way our students are educated. “It’s been a piece that was missing, according to additional research that’s being conducted right now by my colleague, Daphne Thomas,” says Ruda.
The hope is that the students, both mentors and mentees, will be able to take all that they learn from these relationships with them into the workforce. It will make them better new nurses, as in better at asking the right questions, receiving instruction, etc. and better mentees, eventually, when they get their “professional” feet underneath them and another new nurse needs their help. “It’s coincidental that all of this is unfolding now with COVID-19,” says Ruda, “but honestly, it fits just right.”