Nursing Students and Online Learning During COVID-19 Pandemic: A Scoping Review

Aim: This scoping review paper aimed to overview the published research related to nursing students and online learning during the COVID-19 pandemic over the last year 20202021. Methodology: Online Google Scholar Database was searched for articles related to nursing students and online learning during Covid 19 pandemic published between1st June 2020 to 1st June 2021. Results: Initial search with key words “nursing students” found 20300 results, finally 39 articles were selected which meet the eligibility criteria. Majority of the authors (69.23 %) have an academic affiliation, only one single author (11.2 %) with clinical affiliation and those who had both academic and clinical were (28.19 %). Only (5.12 %) study applied any theory or conceptual frame work. The Mini-Review Article George et al.; JPRI, 33(53B): 268-273, 2021; Article no.JPRI.76859 269 focuses of the studies selected were mainly (33.33 %) perception or attitude, (28.20 %) impact and satisfaction were as (20.52 %) focused on experiences and challenges faced. We could only find (5.12 %) studies those where funded. In the selection of research designs majority (46.15 %) adopted quantitative approach followed by (20.51 %) qualitative approaches and (10.25 %) mixed methods; others (23.07 %) included reports, editorials, reflective articles, opinions. About (94.8 %) studies were done without any collaboration with other disciplines only (5.12 %) studies were multidisciplinary. Conclusion: Nursing teaching faculties swiftly responded to COVID-19 by conducting researches mainly adopting quantitative approaches. Nursing researches need more collaboration and funding.


INTRODUCTION
Corona virus disease 2019 (COVID-19) is causing a slew of public health responses worldwide [1]. Closures of schools and universities are among the most visible social (physical) barriers employed to slow the spread of this contagious disease. Many Asian and European countries have implemented nationwide school closures, and some U.S. school districts and states have done so. These closures keep students from interacting with one another and minimize the number of incidents [2]. The effect of COVID-19 school closures on the healthcare workforce and net mortality in the United States. As a result of the significant disruption caused by COVID-19, the education sector is undergoing a paradigm change. Students faced various hurdles when they transitioned from face-to-face education to an online learning platform. Technology infrastructure, technology assistance, time management, learning space, family, and work were concerns [3]. Many instructors were forced to teach their classes online due to the COVID19 pandemic, which presents the potential to transform education, teacher education, and educational institutions [4]. E-Learning refers to students' learning in an online setting and the use of computer-based technology and the internet to make learning and teaching easier [5,6]. The COVID-19 pandemic prompted nursing education to use alternative platforms such as learning management systems and web conferencing to deliver traditional didactic content synchronously and asynchronously. Many nursing programs abruptly pulled students from hands-on clinical experiences at healthcare institutions, replacing these experiences with virtual and web-based simulation due to worries about COVID-19 virus exposure and the need to conserve personal protective equipment [7].
According to Polit and Beck, nurses are committed to engaging in at least one role in research. "At one end stay consumers of nursing research, who read reports of research or research summaries for relevant findings which affect their practice. At the other end of the continuum are nursing researchers who contribute in gross for the body of knowledge: nurses who dedicate themselves and actively participate in generating evidence by doing research" [8]. Nurses increasingly conduct researches to adopt evidence-based practices in their professional arena, especially in clinical settings [9].

PURPOSE
The primary purpose of this review paper is to provide an overview of the published research articles related to nursing students and online learning during the COVID-19 pandemic from June 2020 to June 2021. The following themes have guided the review: Professional affiliations, Theoretical or Conceptual Framework, Focus of research topic, Study design, Collaboration with other disciplines, Participants of the study, and Source of funding.

METHODOLOGY
A Thorough literature search was performed on Google Scholar for articles published in the English language and studies conducted between June 2020 and June 2021. The following key words were included: "Nursing students", "Online Learning"," E-Learning" "COVID-19", and "Corona Virus Diseases" The following keywords "alternate education" and "distance education" were excluded from the search due to irrelevancy. The researchers read and analyzed each article on the inclusion list as part of the evaluation procedure and completed the data extraction form. The research assistant reevaluated the included studies to validate the approach, and any differences between these evaluations were addressed through conversations and clarifications.

Overview
The initial search had 20300 results then filtered into 39 articles after a careful assessment. Fig.1 explains the search strategy and selection process adopted by the authors. In the present study, we present the themes in Professional Affiliations, Theoretical or Conceptual Framework, the focus of Research topic, Study design, Collaboration with Other Disciplines, Participants and Source of Funding.

Professional Affiliation
Hundred percent of the authors were affiliated. Majority of them were affiliated with academic institutions. About (69.23%) N=27, only one author was found clinically affiliated (11.2%) N=1, authors with both academic and clinical affiliation stood (28.19%) N=11.

Theoretical or Conceptual Framework
In the included studies, (94.88%) N= (36) didn't adopt any Theoretical or Conceptual Framework.
At the same time, (5.12%) N= (2) used theory in their studies. Here transition theory and Watson's unitary caring theory were used.

The Focus of the Research topics
The topics or themes of research topics of the selected studies focused on different aspects like (33.33%) N= (13) intended to study perception and attitude, (28.2%) N= (11) studies kept their focus on impact and satisfaction, (20.52%) N= (8) studies explored the experiences and challenges faced rest (19.4 %) N= (7) studies was a combination of topics described above.

Collaboration with Other Discipline
We found (94.8%) N= (37) of the studies included in the review no collaboration was observed with any other disciplines, only (5.12%) N= (2) studies collaborated with a multidisciplinary team.

Participants
The participants of the studies which were selected for this scoping review were Degree Nursing Students (74.35%) N= (29), Masters Nursing Students (10.25%) N=(4), Bachelor Nursing students and Masters Nursing students (15.38%) N= (6), no Diploma Nursing Students were included as participants. Other articles were editorials, reports, reflective articles, and opinions.

Source of Funding
Out of all 39 studies reported in this review (94.8%), N= (37) didn't receive any funds from any agencies, only (5.12%) N= (2)

Research Approach
In the last ten years, nursing researches have grown significantly. Nursing researches significantly impact present and future professional nursing practice, making it an essential part of the training process [10]. Each research design objective aids nurses in picking the optimum design for their research topics. The first and most crucial stage in doing scientifically sound researchwhether qualitative or quantitativeis focusing on the research topic and enlisting the best research design to answer that question [11]. Qualitative and quantitative studies are the two types of research. The word "measure" is used frequently in quantitative research, but "perception" is used frequently in qualitative research. According to Esperon (2017), quantitative research was formerly prioritized, but qualitative and mixed studies have recently gained traction. Similarly, this review supports the same result because most of the publications included in the review used a quantitative technique rather than a qualitative or mixed methodology approach. The use of diverse or multiple methods is becoming more popular, giving nursing researchers another option for addressing numerous aspects [12].

Nursing Education
Globally, providing education in an online format has witnessed multifaceted impediments. First, academician must be lucid about the contrast between what others are following-offering education in an emergency distance-learning format-and robust online education [13]. However, gross number of academic nursing institutions has embraced online education. Developing strategically significant plans about how to offer vital online programs enabled them as well [14]. The novel corona virus, formally named COVID-19 by the World Health Organization (WHO), has wreaked havoc across all academic institutions adding even more responsibility to already pressured faculty [15]. Like many other businesses, educational institutions have had to convert all classes, meetings, and other face-face encounters to a virtual environment to ensure their safety and students. This task has not been easy for those unfamiliar with the complexities of virtual learning, increasing both workload and stress during an unsettling time. These additional job demands and ongoing organizational change have required faculty to exercise their leadership abilities in unfamiliar areas [16].

Affiliation
As the theme which revolved around this scoping review was online learning, almost of all the authors were affiliated to academic institutions like the college of nursing or school of nursing, while very few had both academic and clinical affiliation and hardly one author who had only clinical association. Clinical nurses were less involved in researchers, which originated from nursing educational institutions.

Collaboration with Other Disciplines
Collaboration is the integration or linking together of different pieces of a project to accomplish a collective task so that it can effectively use one another's ideas and expertise without frequent face-to-face interaction [17]. Collaboration brings significant outcomes in research; all studies should consider the scope of it. Here only very few studies was conducted on a collaborative platform. On the other hand majority of the studies were confined to its own mother institutions or universities.

Funding
The promotion of nursing research is still challenging due to lack of internal funding for research and innovation [18]. Ideas will stay lifeless sometimes in research if it cannot be propelled by financial support. Here, there was only one study that was fully funded and another study that was partially funded .all other studies didn't receive any funds or were self-funded. Nursing research funding is still under the expectations; only 5.12% of the revised articles received funds. So, nursing research needs more support in terms of monitory basis.

CONCLUSION
The overall result showed that nurses throughout the globe swiftly responded to the sudden paradigm shift in nursing education which occurred during Covid 19 pandemic, using their research skills. Nurses of academic institutions tried and managed to find out all possible solutions in order to meet the challenges of online learning. If more collaborative research would have been happened, it would have enriched the nursing research with different perspectives on this topic. During this pandemic time, nursing teaching faculties encountered various struggles to establish a new teaching system that totally relied upon technology. We recommend more studies to bring out the challenges and struggles faced by nursing teaching faculties and prepare them for the technology-based education system.

LIMITATIONS AND RECOM-MENDATIONS
Lack of collaborative research was observed as a limitation. Doing collaborative research can bring up the scope of research and break the limits of various arenas. Clinically affiliated researchers participated less in academicoriented research subjects. Funding for the conduction of researches was another significant limitation observed. Topics like perceptions, attitudes, challenges remain the main area in the selected studies. There should be global preparation and initiative to provide hands-on training for nursing teachers to deal more effectively with changing technological advancements in nursing education. More focus should be given to nursing teachers of developing countries and underdeveloped countries.

CONSENT
It is not applicable.