The importance of the health care workforce is clearer than ever, given the current pandemic. Ensuring that we continue to have new graduates ready to enter health care fields is triggering creative changes at Minnesota private colleges — so students continue to receive the experiences and learning they need.

Take the nursing programs at Bethel University that moved to a virtual instruction learning environment last spring as clinical sites closed due to a statewide shutdown order. The university added an engaging, screen-based simulation product that can be used as a clinical lab replacement. The challenge for faculty was to learn the simulations and quickly create assignments around them.

“Interestingly, more than 97 percent of our seniors last spring achieved a passing rate on their board scores,” said Diane Dahl, dean of nursing, social work and community health, and chief nursing officer. “This was convincing proof that our instructors provided students what they needed to be successful.”

For the many Minnesota Private College Council member institutions that offer health care degrees, the ability to find creative responses to continue educating students matters. That’s because our institutions educate and prepare thousands of students who become doctors, nurses, physician assistants, occupational, physical therapists and more. In fact, the Minnesota Private College Council’s member institutions award 35 percent of the state’s health-related undergraduate degrees and 43 percent of the state’s master’s level health-related degrees.

Consider all the changes that have been required. This fall Bethel University is using a hybrid format of online and face-to-face instruction. Learning spaces had to be reconfigured to ensure proper social distancing, including all new furniture in labs with space for only one student at each table, and tables were spaced six feet apart. The maximum number of occupants for each room was calculated based on size, and this information is posted outside each classroom.

The lab spaces were also redesigned to accommodate small group face-to-face learning for lab sections. Each student is in a pod with one lab partner to limit exposure. Dahl believes it’s really important to have the face-to-face component, while staying safe. So far the college has been very successful, with no classroom transmissions detected.

Among the challenges Dahl faced is making quarantined students feel connected to the rest of the students in face-to-face classes. Teaching assistants monitor questions from the Zoom students, and carefully communicate answers through their masks.

“The relationships with students are what our instructors miss the most. It’s been tough, but I think our students are really well prepared to care for patients’ body, mind and spirit,” Dahl said. “We really want the best possible clinical experience and education for our students so they’re well prepared. They want to be on the front lines, providing patient care during this pandemic.”

At St. Catherine University, last spring’s statewide stay-at-home order threatened clinical opportunities for students in the college’s nine nursing programs plus 11 other health science programs.

Krista Anderson, director of simulation at St. Kate’s Henrietta Schmoll School of Health, has been creating simulated experiences for programs that can use simulation for their clinical experience for their degree. This includes cross-disciplinary education for some nursing programs, the occupational therapy program and the occupational therapy assistant program.

“We’re using simulations to meet the learning outcomes and replicate clinical experiences and outcomes to create intentional experiences with patient care,” Anderson said. “Our students learn specialties with, from and among students from different disciplines to improve patient outcomes and reduce costs. Bringing health care students together for these conversations fosters teamwork and team-based care.”

Simulations consist of a briefing on a simulation scenario, followed by the students’ response to a lifelike situation, then a debrief with instructors on the decision making process and key assessment. Simulations involve realistic, lifelike mannequins as well as simulated patient actors and screen-based virtual simulations where students watch a scenario and make care decisions.

To limit exposure, students are in clinical cohorts of two or three, and only one cohort group can be in a room at a time. Participants must be free of COVID symptoms and wear face shields and surgical masks.

“Last spring we had to pivot to make this happen. Our students have been very flexible as we’ve been challenged to think and do things differently while providing clinical learning that’s just as good and maybe better than in the past,” Anderson said. “We miss the connection with our students. We’re trying to support them the best we can, and we miss their smiles.”

“After students lost their clinical learning opportunities we had to quickly pivot on a dime and get really creative to take a skill normally taught in person and flip it to work at home and ensure students would meet requirements so they could graduate,” said Katie Molitor, assistant professor of nursing and the lab and simulation coordinator who worked closely with Anderson to develop and implement simulations. In addition to working with faculty to ensure the simulations are correct and appropriate for students’ education level, Molitor was also involved in planning, ordering supplies and equipment, and reconfiguring spaces and facilitating debrief sessions. “Now we’ve learned how to use all the virtual options we have and evaluate how they fit students’ needs.”

While this has been challenging, Molitor sees the benefits of being forced by circumstances to think about simulation in new ways. She’s also excited to see St. Kate’s faculty thinking outside the box to provide excellent education and develop better ways to do things.

Meanwhile, Gretchen Moen is an assistant professor of nursing at St. Kate’s and a pediatric nurse practitioner and clinical director of Dakota Child and Family Clinic. Because the pandemic closed clinical opportunities for her students, Moen is using telehealth and rotating students through her clinic to observe and interact with patients.

Moen has brought students into her clinic, and signed students up to help perform COVID testing in the clinic parking lot. Students have been getting valuable clinical experience and the learning they need to keep their educations on track.

Telehealth allows Moen to provide the experiences her students need. She approached the national organizations to learn how many telehealth hours would count for their clinical experience and to make sure she could evaluate students’ ability to do the things they needed to do. She is proud that nearly all her students will graduate on time because of the ability to rapidly transform to telehealth in the spring.

“I’ve also used telehealth and shared information on best practices with other faculty members and clinics,” Moen said. “We’re a small, nimble clinic and the bigger clinics are still struggling with telehealth. In March there were zero telehealth sites, but there were four by May.”

After this experience, Moen is convinced telehealth is here to stay. Parents are thankful to connect with Moen and her students without bringing their children into the clinic, and it has helped patients engage with the technology. Moen believes her students will have a leg up on other job candidates and several have been asked about their telehealth experience during interviews — the first time that’s happened.

“St. Kate’s is small, and faculty has a lot to say about how things are done because the administration trusts us to do the right thing. It’s like owning your own business,” Moen said. “I feel really confident our students found value in clinicals. We suffered through the pandemic, but persevered. It’s the St. Kate’s way; when a door is closed, find the window. And it worked.”

By Tom Brandes