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Best Practices for Healthcare Training During the COVID-19 Pandemic

Nursing was already a profession that faced engagement and satisfaction challenges—then came COVID-19. It’s no surprise that the pandemic has served to exacerbate problems that already existed among clinicians. In 2019, Medscape surveyed 5,600 RNs and nurse managers about their career satisfaction. 21% of those who responded were dissatisfied with their careers. As many as a quarter wanted to pursue a new path within nursing, and 18% planned to retire earlier than expected. Nearly 10% indicated they wanted to leave the nursing profession altogether and to pursue other employment.

A Challenged Workforce

Those were the conditions before COVID-19 became a problem. The pandemic has had an even bigger impact on the working nurse population, in terms of early retirements, furloughs, stress, burnout, and even the virus itself. Dealing with the pandemic already occupies a significant cognitive space for many nurses, whether in terms of the demands of COVID-19 care or the mental burden and stress generated by the pandemic. Especially now, providing too much education can be overwhelming for many clinicians. In addition, think about how the pandemic has changed nursing. Primary nursing was the rule in many organizations, but team nursing is more applicable for many COVID patients. In addition, social distancing and the use of personal protective equipment (PPE) has affected peer support, which is crucial for nursing morale.

Nursing Has Changed to Deal with COVID-19

In terms of care, nurses are spending less time with patients—there are more demands on their time as well as the need to limit nurses’ exposure to infected patients. At the same time, many patients are alone, without family members or a significant other, giving the nurse a much more important role for every patient. Without visitors, patients are lonely, and nurses are filling in the blanks. This situation puts the mental health and resilience of nurses even more at risk. Although healthcare organizations and larger groups are making mental health resources available, many are still not being used adequately.

Training Is More Important Than Ever

There also is a widening gap between nurses with less experience and patient whose conditions are far more complex. To close this gap, organizations need to teach novice nurses more effectively, change onboarding, and transition them to competency more quickly. Likewise, healthcare organizations have to retrain and redistribute experienced nurses across the organization so to where they're needed. New nurses hired during the pandemic have missed clinical rotations, lost some of their didactic education, as well as their peer groups, which are a large source of support. They haven't had time to learn new clinical skills, develop critical thinking, practice prioritization, and work on interpersonal communication.

An important question for healthcare organizations to answer is what is important now.  If cognitive space is limited, learning cannot be just a matter of crossing off an assignment. Education must be purposeful, functional, and help nurses provide better care. Educators should determine what can be put on hold for the moment and focus on what is truly essential. Once that is understood, the best practices below should be applied to training, whether virtual in person, virtual e-learning, or live instructor led.

Best Practices for Virtual Live Training

  • Master the educational platform being used.
  • Use chat to keep people engaged, use the chat function and mention the names of people asking questions. Address the entire cohort of people learning by asking questions.
  • Consider gaming options.
  • If the platform you're using allows breakout rooms, encourage that, especially for longer training sessions. And if you're doing so, set specific expectations, facilitate these small gatherings and encourage chat collaboration and annotation.


Best Practices for Virtual e-Learning

  • Make the training content interactive and engaging.
  • Limit the concentrated time someone learning spends in front of a screen.
  • Avoid converting instructor-led training to a watchable video.
  • Use a blended learning approach with videos, debriefings, etc.
  • Encourage preceptors to ask trainees about what they've learned and how to apply it.
  • Provide time for reflection and application of learning.
  • Encourage also some peer to peer knowledge sharing.
  • Connect every specific element of e-learning to its impact on providing better patient care.


Best Practices for Instructor-Led Training

  • Make sure training is safe and incorporates appropriate social distance.
  • Masks are mandatory, and handouts need to be digital.
  • Where skill labs have to be done, practice safety.
  • Avoid passing any materials.
  • Make sure all equipment is cleaned adequately between uses. Consider a self-directed approach to any skills labs based on an honor system.
  • Determine whether skills labs are truly necessary and whether they can be done on the unit, while caring for patients.


Anything that's going on with training simultaneous to the COVID-19 pandemic means that we're learning as we go. What's valid today may not be valid months from now, and certainly not next year. An appropriate question and an appropriate response to training is mainly to do what's important for treating patients now. Be conscious of not overloading trainees with too much information given the cognitive overload that characterizes these times. Make sure learners understand why any training is important and connect it back to what's in it for them and how it can improve outcomes for patients.

This blog post is based on the HealthStream Webinar, Healthcare Trends and Best Practices for Learning During a Pandemic, presented by Julie Miller, Clinical Practice Specialist, American Association of Critical Care Nurses (AACN).

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