Columbia College had 60 nursing students graduate this past April including the 2020 BSN class pictured above.

By Anna Brugmann – courtesy of the Columbia Daily Tribune

When Stan Checketts arrives at the emergency room, the 52-year-old man complains of a distended, painful abdomen and dehydration. He says he thought he might have the flu, but came to the ER when his abdominal pain worsened.

A student nurse is assigned his case. Except neither the student nor Checketts is in a local hospital. Both Boone Hospital Center and MU Health Care suspended clinical hours for students amid precautions against COVID-19.

In fact, Checketts isn’t even a real person.

He’s a character on a virtual clinical platform Columbia College turned to when faced with how to train nursing students amid COVID-19 precautions.

“I mean, of course, it’s not the ideal situation that we want to be in,” Columbia College student Olivia Lang said. She is on track to graduate with her associate’s degree in nursing in December.

“Of course we want to be actually in the hospital, but I like them,” she said of the virtual programs. “I think it’s still cool that we get to get some of the clinical experience and go through with the virtual experience and give them (the characters) the medicine they need.”

For now, the program, vSim, is a temporary solution to help students, especially graduating seniors, continue and finish their education.

“It’s a stopgap, but I would say we’re so impressed with it and the students love it so much I can definitely see us using something like to supplement classes in the future,” said Tina Dalrymple, director of nursing and health sciences.

No one is advocating for shifting clinical practice to the virtual space entirely. Even Dalrymple is anxious to see her students return to hospitals.

But as COVID-19 leads hospitals to reevaluate who is allowed in facilities and when, virtual learning may take on a more central role in the education of future nurses.

The sudden shift has pointed out certain advantages for students, particularly nontraditional learners, who can possibly save on child care or other expenses of attending on-campus classes

Monica Smith, chief of nursing at Boone Hospital Center, said nursing’s new image, as a heroic frontline worker, could attract more young people to the profession. Virtual learning could keep them there.

“I think that’s a potential pro, because you don’t have to have seats in a nursing school,” Smith said. “Currently we have a national nursing shortage. We have it now and we’re going to have it in the future … If we can become more innovative, we may be able to bring more students into the profession.”

It would also allow schools and hospitals to train all those nurses without depleting their personal protective equipment to do it.

“And honestly that may not be sustainable until we really get a grasp on how many patients we are going to be seeing and how long this is really going to occur,” she said.

Boone will bring student nurses back in June. Half of their clinical hours will be performed virtually or

in a lab setting.

Lang will resume in-hospital hours June 22 at MU Health Care. Although she’s grateful for the opportunity to return to the hospital setting, she’s nervous her skills might be less sharp due to the time away.

Columbia College is taking students through a skills refresher before they return to the facilities.

As virtual training is refined, the way in-person clinical instruction is handled will be refined, said Mark Wakefield, associate chief medical officer for MU Health Care.

Smaller groups of students, taking turns doing in-person rounds with patients, could be more common, he said. Online work could focus on clinical tasks like charting and reading and writing medical orders.

Still, every advantage always comes back to the same disadvantage.

“It’s a hands-on, humanistic career,” Wakefield said. “I think we’ll have to be deliberate about how we ensure our learners have an experience that will help them be the best they can be taking care of patients down the road.”