Faculty and students adapt to shift to virtual learning

 Dr Shefaly Shorey checking the matriculation card of a student as the latter comes online for her assessment.

Since February 2020, to help prevent the spread of COVID-19 virus, many face-to-face classes at the National University of Singapore have been suspended and moved online.

At the NUS Alice Lee Centre for Nursing Studies, an unprecedented shift in how instruction is delivered has also taken place. Classroom tutorials are now replaced by interactive Zoom sessions with breakout rooms allowing smaller groups of students to collaborate virtually. Even hands-on sessions such as lab classes have not been spared. In their place, students join virtual simulation sessions or practice nursing skills from their homes, aided by online videos and multimedia resources and supported by tutors who engage them remotely.

“The sudden switch from face-to-face classes to an online format is a big change for all of us, and our faculty have been doing their best to move to online options that facilitate interaction and a sense of community,” said Professor Emily Ang, Head of NUS Nursing.

A few months ago, Assistant Professor Dr Shefaly Shorey shifted the tutorials for her course, “Communication and Cultural Diversity” online, using Zoom to hold virtual discussions and practice sessions with standardised patients. The solution didn’t address assessment, which traditionally required candidates and standardised patients to come together in a physical consultation room to interact with one another.   

“Effective communication is a core nursing skill that we impart, and I wanted to give my students the best learning experience possible to mitigate any feelings of being sidelined in their learning as a result of physical distancing,” she explained.

Instead of getting her students to write a reflective essay, she decided to transition the in-person assessment to an online format that would allow each candidate to interact with a standardised patient “live” while being assessed by a tutor. The exam was conducted via Zoom on 24 March and 25 March, with the 257 students, their standardised patients and the school’s assessors dispersed across homes and offices in Singapore and even Malaysia. 

Standardised patient Andrew Chan shows a candidate his wrist tag as the latter’s assessment began.

“We had to make this transition very quickly, and this was a highly stressful experience,” said Dr Shorey.

“It was a huge challenge to test fairly what students have learnt, while coordinating with everyone – students, assessors and standardised patients – in different locations with variable Internet connectivity. The technology options require a well-functioning infrastructure, and everything from laptops to cameras to Wi-Fi needs to work for students, assessors and standardised patients. We are very grateful to NUS IT staff who worked very hard to get us up and running,” added Dr Shorey.

Due to the high-tech setup, other challenges included teaching instructors and standardised patients unfamiliar with Zoom. “We had to run a few mock assessments and exercises but it was all worth it,” she added. She attributed good team communication – even if it was virtual – as a key success factor in the design and execution of the online assessment. “We were entering a territory that none of us has ever explored before. My assessors, admin team and I were trying out different things and sharing ideas and learning points on the fly!” Dr Shorey recalled.

Tutor Lubna Shah assesses the performance of a student who is taking the exam from Malaysia, as a result of Malaysia’s border closure.

An online assessment can replicate almost all of the best features of even a very interactive physical session, say students and assessors. Tutor Lubna Shah found the overall assessing experience equally satisfying. “I think this is a really novel way of conducting assessments. It’s technologically advanced and allows students to take the assessment from wherever they are,” she said.

Year 1 Nursing student Claudia Tan appreciated the real-time, virtual environment of the assessment. “I think it is a unique and interesting experience as it was my first time doing it. There wasn’t much difference in face-to-face and online interviews because the communication aspect was still there.”

Ms Shah noted that one of the options for educators looking to develop dynamic, interactive classes and assessments online is to simulate real-life settings as much as possible. “For instance, we had the standardised patients wear wrist tags and students don their scrubs. The only barrier is just the screen, and everything else feels quite life-like,” she added.

Assessor Dr Zakir Hussain smoothly completes the second day of assessing the examination.

Few, however, seem to want online tutorials or assessments to be the new norm in the communication course. “For communication skills, it is good to see in-person interaction between the patient and student as there would be a lot of hand gestures, body language and the occasional physical touch from a nurse to reassure a patient especially in the hospital setting. This kind of human touch is lost here,” said Senior Lecturer Dr Zakir Hussain, adding that in crisis situations such as these, tech-based assessments are the way to go.

Said Andrew Chan, one of the standardised patients: “At the end of the day, I prefer to talk to the doctor or nurse face-to-face. It’s that personal connection I am looking for when she can read my non-verbal cues and emotions I am feeling and I can be sure she understands and relates to what I am talking about.”

Claudia agreed: “The patient and nurse connection, I felt, was more difficult to establish online than in a face-to-face interview.”

“The innovative online assessment was the need of the day and it was a huge success in assessing students’ verbal communication skills. However, technology cannot replace the human touch and personalised nursing care that can only be displayed by being physically around your patients,” Dr Shorey concluded.