Nursing faculty experiences with emergent remote teaching transitions during the COVID-19 pandemic: A qualitative systematic review

Nursing faculty experiences with emergent remote teaching transitions during the COVID-19 pandemic: A qualitative systematic review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Nursing faculty experiences with emergent remote teaching transitions during the COVID-19 pandemic: A qualitative systematic review Jee Young Joo, Kyoung-A Kim This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3865510/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The coronavirus disease 2019 (COVID 19) pandemic led to lockdowns and other social distancing measure. Nursing education programs were also disrupted and moved online. However, information and understanding of nursing faculty members’ experiences of the emergent transition from didactic to remote teaching during the COVID-19 pandemic is limited. Therefore, this qualitative systematic review aimed to synthesize qualitative studies on nursing faculty members’ experiences during the COVID-19 pandemic in the United States. Methods Eight qualitative studies published between January 2020 and the end of December 2023 in the United States were selected from five electronic databases and synthesized based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and Thomas and Harden thematic synthesis methods. This study was reviewed and registered in PROSPERO. Results Eight primary and empirical qualitative studies published between 2021 and 2023 were included. The included studies were conducted in various regions of the United States and involved nursing faculty members working in nursing programs. Based on the experiences of 230 nursing faculty members, five common themes were identified: (1) concerns about changes in traditional nursing pedagogy, (2) overwhelmingly heavy workloads, (3) acceptance of and coping with the pandemic, (4) the need for continuous and various forms of support, and (5) opportunities for the improvement of nursing programs. Conclusions These themes can be utilized by educational administrators to reidentify the challenges that nursing faculty face and to reform nursing education programs as well as nursing educational associations and institutes to improve current teaching and direct new learning methods to prepare for future pandemics. COVID-19 Experience Nurse faculty Perspective Qualitative research Qualitative synthesis Qualitative systematic review Figures Figure 1 INTRODUCTION With the rapid worldwide spread of the coronavirus disease 2019 (COVID-19) in 2020, the World Health Organization (WHO) announced a public health emergency [1]. The COVID-19 pandemic had a global impact and resulted in the deaths of many people [2]. In the United States, the Centers for Disease Control and Prevention established certain guidelines to reduce the transmission of the virus; similarly, countries worldwide had lockdowns and implemented social distancing guidelines [3]. Since early 2020, new variants have spread. In May 2023, the WHO announced that COVID-19 was no longer a global emergency. However, the WHO insists that we are still in a state of crisis and that there is a need to continue preparing for future global epidemics [4]. Background Since the announcement of lockdowns in the spring of 2020, higher education institutions, such as universities and colleges, have closed their campuses [5]. Nursing education programs were also disrupted and moved online [6]; all courses that had previously been conducted face-to-face had to be moved to remote learning abruptly, and clinical practicum courses were also moved to virtual simulations [5]. Nursing faculty members, registered nurses who are academically qualified and employed as educators [7], and nursing students enrolled in nursing programs had to adapt their teaching and learning skills without sufficient preparation or readiness [5]. In some developed countries, such as the United States, hybrid nursing programs [8], a combination of remote and face-to-face learning) began before the pandemic. Thus, nursing faculty and students in the United States might have already been slightly accustomed to remote learning. There is evidence in the literature on abrupt nursing education transitions and their impact on nursing students based on empirical studies. Additionally, several quantitative and qualitative studies have been narratively and systematically conducted to gather evidence on nursing and COVID-19 [5, 9]. However, considerably less qualitative or quantitative research has been conducted on nursing educators, including faculty members, during the COVID-19 pandemic. Globally, knowledge regarding nursing faculty members’ experiences and perceptions of emergent transitions in nursing education during the pandemic is limited. Moreover, no reviews have systematically synthesized the perspectives of nursing faculty regarding abrupt transitions in nursing education. Therefore, this study involved a literature review of qualitative evidence on COVID-19 among nursing faculty members. This study synthesized the perspectives and experiences of these faculty members to identify common issues during the pandemic. THE REVIEW Aim The aims of this qualitative systematic review were to synthesize qualitative studies of nursing faculty experiences and perspectives regarding emergent transitions to remote teaching during the COVID-19 pandemic in the United States and to identify common themes regarding emergent transitions in teaching during the pandemic. This review was limited to studies that were conducted in the United States because the United States is one of the most developed countries with regard to remote learning, as nursing educators in the country have been using remote learning as a hybrid format. Thus, this study targeted nursing faculty members who work in the United States. The two research questions are as follows: (1) What are the common experiences and perspectives of nursing faculty members in the emergent transition to online teaching during the COVID-19 pandemic? (2) What issues did nursing faculty members face during the COVID-19 pandemic? Design This study applied a qualitative systematic review method with thematic synthesis [10, 11]. This methodology is appropriate for identifying, assembling, and synthesizing common themes from empirical evidence [10, 11]. This approach is not a new methodology for nursing reviews but is relatively new for nursing faculty research. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [12] to ensure rigorous reporting. Additionally, this study was accessed and registered according to the protocols of the International Prospective Register of Systematic Reviews (PROSPERO). There were no human participants recruited for this study; thus, there was no need for institutional review board approval. Search Strategy Five electronic bibliographic databases (PubMed, CINAHL, Ovid, Web of Science, and Scopus) were searched in December 2023. The search identified qualitative studies (including mixed methods studies with qualitative data) published between January 2020 and December 2023 (including prepublications). Through combinations of keywords and medical subject headings (MeSH), the following terms were combined for searching: nursing faculty or nursing professor ; qualitative research or theme ; and COVID-19 or pandemic . Additional keyword searches were also used: nurse educator or academic nurse educator or nursing education, learning, or teaching; nursing program, or phenomenology perspective, or challenge ; and experience or perception . The pilot search was conducted in mid-November 2023 to identify an appropriate number of articles. The initial search of the five databases was subsequently conducted on December 1, 2023, and a secondary search was completed on December 15, 2023. An example of the database search strategy is presented in Additional file 1. Inclusion and Exclusion Criteria Table 1 presents the inclusion and exclusion criteria used in this review. The inclusion criteria for this study were as follows: (1) studies that targeted nursing faculty (nursing educators, including tenured, tenure-track, or clinical teaching professors or instructors) who were responsible for at least one nursing program course (either theoretical or practicum courses) in the United States during the pandemic period and who had no teaching experience before the pandemic; (2) empirical, primary studies with qualitative approaches (including mixed-methods with qualitative study results); (3) studies that highlighted the experiences and perspectives of nursing faculty who worked in United States nursing programs during the pandemic; (4) studies published in English-language and presented as articles in peer-reviewed academic journals; and (5) studies published (including prepublication) since the announcement of the COVID-19 pandemic (January 2023) to December 2023. The exclusion criteria were as follows: studies that were not conducted in the United States with nursing faculty; studies that did not meet the aim of this review; studies that focused on the perspectives of non-nursing faculty, such as public healthcare program faculty; and studies in which the nursing faculty did not teach undergraduate or graduate or any nursing programs. In this review, nursing faculty was defined as a person with academic qualified, registered nurse, and employed by a nursing program to teach and evaluate nursing students [7]. Table 1. Inclusion and exclusion criteria Inclusion criteria Exclusion criteria Studies that targeted nursing faculty members (nursing educators) who had taught undergraduate or graduate nursing students enrolled in nursing educational courses during the COVID-19 pandemic regardless of first or second waves Target populations: nursing faculty members or nursing educators who were infected with COVID-19 (including those infected with coronavirus variants) or other healthcare professions or educators; nursing faculty members (nursing educators, or nursing professors) who had not taught classes since the 2020 pandemic or who had been in research, sabbatical, or temporary absence years Studies that focused on nursing faculty members’ (or nurse educators’) experience with the nursing curriculum and teaching during the COVID-19 pandemic Nonempirical studies, any types of reviews, gray literature sources, such as editorials, policy documents, or commentaries Empirical studies, including qualitative studies or mixed methods with qualitative data Studies published or including other epidemic and pandemic outbreaks, excluding the COVID-19 crisis Primary studies conducted with data collected from the beginning (January 2020) to the end (May 5, 2023) (following the WHO declaration) of the COVID-19 pandemic in the United States Studies that were not focused on nursing educators’ theoretical courses or clinical skills, simulation laboratory, virtual practicum that related to nursing major courses Studies published from January 2020 to December 2023, including online advanced publications Studies published in languages other than English Studies published in English in peer-reviewed journals Studies that did not meet the purpose of this qualitative systematic review Selection Process and Quality Assessment Figure 1 shows the PRISMA flow diagram that illustrates the study selection process of this review. Initially, 86 articles were identified from the five databases. Using EndNote X9 (Clarivate Analytics, Philadelphia, USA), 50 duplicate articles were removed, and 36 articles remained. Of these 36 articles, 18 articles were retained, and 18 articles were excluded based on the title. Among the 18 remaining articles, ten studies were excluded after abstract review, and the final eight studies were selected for full-text review. The first author conducted the study screening process independently, and the second author reviewed the process and checked for accuracy. All eight remaining studies met these aims and met the inclusion criteria, and there was no discrepancy in the study selection process between the two authors. In a qualitative systematic review, quality appraisal is imperative for assessing methodological trustworthiness and rigor of evidence [10, 11]. Using a quality assessment tool, the Critical Appraisal Skills Program Qualitative Research Checklist (CASP) [13], the eight studies were evaluated by two authors independently. The results of the evaluation were compared and agreed with those of two other authors (see Additional file 2). Data Analysis and Synthesis A table was created to summarize the study aim, participant characteristics, study design, data collection and analysis, major themes and results. Next, data analysis and synthesis were conducted by two authors. For this process, Thomas and Harden’s [11] thematic synthesis was employed to identify meaningful codes from the qualitative data. The two authors read and reread the data to extract important codes from the selected studies. Then, similar codes were aggregated, and several descriptive themes were generated from the qualitative data. Themes were merged into comprehensive and prominent themes. Finally, higher-order common themes were generated. RESULTS Study Characteristics The eight included studies are summarized in Table 2. All eight studies had qualitative data and themes as major findings. Seven of the eight studies used a qualitative approach [14-22]; among these studies, two applied phenomenological qualitative methods [16, 18], and one used the grounded theory approach [15]. One study involved a mixed method design with qualitative responses [21]. The data from the included studies were collected between spring 2020 and April 2022, which were the first and/or second waves of the COVID-19 pandemic. The year of publication ranged from September 2021 to March 2023, and five of the eight papers were published in 2022. All eight studies were performed in regions around the United States. Hopkins et al. [17] targeted nursing faculty from one university in the southwestern United States. Due to the risk of COVID-19 transmission and the restrictions of lockdown, data were collected via personal informal semi-structured interviews. Five studies used a videoconferencing platform, and two used telephone interviews. The remaining two studies used an online survey link with open-ended questions [17, 20]. A total of 230 nursing faculty members participated in the eight studies. All of them had a registered nurse license, had an advanced degree related to nursing, and had taught theoretical or clinical nursing courses (didactic, clinical, or laboratory) either full-time or part-time at the university or college; their employment status included tenure-track, tenured, adjunct, clinical, and teaching professor positions. The targeted nursing educational programs included undergraduate and graduate (master’s or doctoral) programs, associate degree programs in nursing, and RN-to-BSN programs. The participants’ ages and work experience were not reported exactly; however, all of them started teaching before the pandemic. All participants were selected purposively, and some nursing faculty members had online teaching experience before the COVID-19 pandemic; however, none of them had fully taught online. Approximately half of the participants had no experience with online nursing programs. While there was limited information about the gender and ethnicity of the participants, it was apparent that most of the participants were female and White. The data were analyzed using thematic analysis ( n = 3), content analysis ( n = 3), grounded theory data analysis, and Barritt et al.’s five-step process (each n = 1). One study utilized an existing theoretical framework [19], and none of the included studies developed conceptual frameworks of COVID-19-related concepts based on their findings. To evaluate the quality of the included studies, the CASP 2013 tool [13] was used. The first and second authors independently scored the eight studies using the CASP 2013. Both authors compared the results of the tool, and differences were discussed. All eight included studies had appropriate methodological rigor (see Additional file 2). Main findings Through thematic synthesis, this review identified five common themes related to nursing faculty members’ perspectives and experiences of teaching during the COVID-19 pandemic: (1) concerns about changes in traditional nursing pedagogy, (2) overwhelmingly heavy workloads, (3) acceptance of and coping with the pandemic, (4) the need for continuous and various forms of support, and (5) opportunities for the improvement of nursing programs (see Table 3). Theme 1: Concerns about changes in traditional nursing pedagogy The first theme that emerged from the studies under review was that the pandemic aroused concerns among the participants about changes in traditional nursing pedagogy. The impact of the emergent transition from teaching strategies involving in-person and on-site traditional nursing education pedagogy to remote online formats during and after COVID-19 is still uncertain [19, 22]. In six studies, disruptions in traditional nursing educational teaching pedagogy were mentioned in the nursing faculty interviews [16-20, 22]. The nursing faculty participants described the challenges and worries that they faced as a result of their didactic and clinical teaching strategy changes due to the COVID-19 pandemic [19, 22]. First, since the pandemic began, nursing faculty, especially clinical teaching professors, had to manage the restriction of access to on-site clinical sites; thus, clinical education needed to be provided via virtual simulation [20]. As many nursing faculty participants mentioned, on-site clinical learning and hands-on experience are essential for nursing education, preparation as nurses, and the nursing workforce [18, 19, 22]. One participant in the study by Power et al. [20, p. 35] expressed worries about nursing students who had limited on-site clinical learning: “My biggest concern is lack of hands-on experience due to restrictions in their clinical education. Simulation activities are good, but they are not a replacement for hands-on learning.” Similarly, many participants worried about their nursing students who graduated during the pandemic and missed many clinical practicum hours in direct patient care [18, 22]. For example, one nursing faculty member stated that nursing students who did not have much experience as front-line staff during the pandemic would never be nurses in hospital settings. Another concern that nursing faculty members commonly reported was a lack of interpersonal relationships with students and little opportunity to interact with actual patients in remote learning [16-19, 22]. Participants reported that online didactic education was able to provide theoretical knowledge that allowed them to succeed academically; however, the ability to translate such knowledge into actual patient care was limited [20-22]. In a study by Power et al. [20, p. 35], a nursing faculty member said that nursing students can be prepared “theoretically” but not “clinically”. Additionally, some nursing faculty reported that they missed connections with their students [16]. For example, one faculty member stated, “I just really miss the live interaction with the students…you just can’t have the same interactions with the students over Zoom” (p. 77). Moreover, some remote nursing learning courses were not conducted in real time, which is synchronous, but rather were recorded; thus, both faculty and students lost opportunities for live Q&A sessions [17, 19]. Theme 2: Overwhelmingly heavy workloads Overwhelmingly heavy workloads was the second theme that emerged. Nursing faculty demonstrated significant stress and exhaustion due to an increase in their workload as educators compared to their work before the pandemic. [15-19, 21, 22]. First, nursing faculty members had to emergently transition their courses from didactic to online nursing curricula in only one or two weeks in spring 2020 without clear notice from universities and without sufficient training [16, 19, 22]. Moreover, they needed to change teaching strategies, exams, assignments, or supplementary files to an online format [16, 19, 22]. The spring of 2020 and the summer of 2020 constituted the initial the wave of the COVID-19 pandemic, and the first semester required emergently closing campuses and starting online. Many participants reported that even though some had experienced online teaching before the pandemic in the United States, they had no experience with full-time online teaching or virtual practicums; thus, they had to spend more hours preparing materials in an online format, which they were not accustomed to [15, 16, 18]. One participant in the study by Iheduru-Anderson and Foley [18] said, “The workload was above and beyond. We were literally on the computer with students from 9:00 am to 9:00 pm. And it was brutal” (p. 3). In Gazza [16], one clinical professor expressed an extremely increased workload: “For two weeks, it was utter chaos, and it was maddening and I couldn’t get off [my computer]…I was online all day long” (p. 76). Some studies also reported that nursing faculty members’ burnout was caused by the additional workload associated with COVID-19 (5). In addition to transferring their nursing course resources into an online format, nursing faculty also had to make their students “learner mindset” [19. 21]. Some students were not ready to learn in different learning environments, such as at home instead of on campus; thus, nursing faculty members were required to facilitate, engage in, and pay attention to the students as participants in online classes or clinicals [17-19, 22]. One faculty member mentioned that “...keeping them (students) motivated… can be a little bit exhausting…” [22, p. 479]. Typically, nursing faculty members has already experienced normal stress from their teaching, maintaining their clinical expertise, and qualifying for tenure requirements [21]. However, nursing faculty worked more hours because of the significantly increased workload related to developing the course in an online format and motivating their students to study online during the COVID-19 pandemic [21]. In one study, participants expressed this as “technology burnout” [18, p. 2]. Theme 3: Acceptance of and coping with the pandemic The third theme, acceptance of and coping with the pandemic, emerged from seven studies under review. The studies demonstrated that nursing faculty understood the serious, emergent, and critical events of the COVID-19 pandemic and accepted an alternative way of teaching, i.e., remote or virtual full-time teaching [16-22]. Moreover, they coped with their transitions in teaching strategies [18, 19]. Even though it is not easy for nursing faculty to prepare all related elements for virtual clinical teaching, many participants reported that they could meet the aim of their course objectives [17]. One clinical nursing faculty member noted that “it enabled achievement of the key academic objective of DNP residency for students. Students were able to obtain further input from a variety of faculty and peers regarding their capstone project” [17, p. 29]. In addition to accepting the emergent transition, participants also tried to flexibly cope with this situation for themselves [18, 19, 21]. For example, one participant of McKay et al. [19] stated, “It's kind-of like we have to do this right now and everybody is panicking, and nobody knows what’s going to happen and, you know nurses are good at being flexible, so I was able to manage that” [19, p. 3]. Some nursing faculty members reported feeling that they were in chaos preparing for an emergent transition to remote teaching in Spring 2020, which was the first semester of lockdown due to the pandemic; however, as the pandemic continued into fall 2020, they became accustomed to remote teaching and coping with alternative teaching strategies [16, 20, 22]. Theme 4: The need for continuous and various forms of support The fourth theme, the need for continuous and various forms of support, was identified from five studies. Nursing faculty participants in five studies reported that they needed continuous support at various levels [15, 16, 18-20]. Participants demonstrated that technical assistance that can help faculty members apply new technologies in nursing courses, national or state-level professional nursing organizations, and psychological support are required [15, 16, 18-20]. First, they demonstrated that they need continuous support from technology experts for technical assistance [15, 18, 19]. Some participants had utilized remote learning as a part of hybrid courses before the pandemic; nonetheless, this was the first time that they had transitioned to full-time remote teaching and virtual simulations [16, 18]. Some faculty members were accustomed to internet video teaching skills; however, some of them had challenges [16]. Moreover, some faculty members lacked internet access; furthermore, some faculty members worried about time needed to learn new technologies and apply them to their courses [16, 19]. Additionally, studies reported that faculty needed ‘helpers’ who could educate and train them, such as educational associations or professional nursing organizations, at the state or national levels [15,18]. These kinds of helpers could provide updated new modules for remote learning and continuous education via online video conferencing during the pandemic [15]. At the beginning of the pandemic restrictions, several institutional and nursing organizations prepared webinars for nursing faculty on how to survive the abrupt teaching transition and how to teach with contingent infections [15, 16, 20]. For instance, faculty mentioned the Association of College and University Educators (ACUE) training, which helped them learn how to perform online teaching and utilize this training course [15]. In addition, participants reported that they required emotional and psychological support [18, 19]. Due to the pandemic, lockdown, and transition to different teaching environments, many participants had no opportunity to communicate or interact with students or their colleagues face to face, which made them feel lonely and isolated [19]. Thus, participants stated that emotional support was pivotal for nursing faculty at the administrative level [18, 19]. Theme 5: Opportunity for the improvement of nursing educational programs In all eight studies reviewed, participants expressed that an emergent transition to remote learning due to the pandemic represented a good opportunity to develop themselves as nursing educators, to learn future teaching delivery methods and to follow and prepare for the movement of teaching delivery methods [15-22]. Finally, they had the opportunity to innovate traditional nursing teaching strategies by renewing, redesigning, modifying, and reevaluating as the pandemic continued and as the future required it while still maintaining the course objectives and outcomes [15-22]. According to many nursing faculty members involved in these studies, the pandemic was an opportunity for growth as a nursing educator [15, 16, 18, 19]. With the emergent transition from didactic to remote teaching and from on-the-ground to virtual simulations, nursing faculty showed tremendous, quick development of new teaching tools. One participant used a simile to describe their efforts: “…necessity is the mother of invention” [18, p. 9]. Similarly, a nursing faculty member commented, “I learned a lot of new things. I had never heard about Google forms before this crisis, but I learned very quickly. I used it to create evolving case studies to augment the clinical learning for the students” [18, p. 9]. One associate professor stated that abrupt changes to remote teaching had made them reflect on the objectives of programs and had the chance to support students. These kinds of efforts were beneficial to faculty, nursing students, nursing programs, and universities [16]. Even though nursing faculty were very stressed due to the pandemic and the accompanying heavy workloads, they said that the pandemic presented an opportunity to improve their programs and promote professional development in the future [15, 16]. Several studies have reported that moving from an on-the-ground clinical practicum to virtual simulations is a new opportunity and is beneficial for both faculty and students [18, 22]. While virtual simulations were being performed, faculty and students were able to flexibly conduct clinical labs and adapt their abilities to access nursing skills in unique ways [22]. In a study by Power et al. (p. 35), one nursing faculty member stated, “We all know there can be a lot of waiting around for a faculty member [in clinical], but in simulation, that did not happen.” In Christoffers et al. [15], one nursing faculty member mentioned, “I think that [COVID-19 caused] a lot of growth., you know, talk about doing impossible things. I see the good stuff that came out of that for a lot of people that I work with and maybe myself too, that there’s things that probably [we] needed to work on anyway, and it just pushed it forward” [15, p. 112]. Thus, even during the crisis, nursing faculty members had been using the pandemic situation to develop themselves as well as nursing programs. DISCUSSION This review aimed to synthesize the findings of eight qualitative studies to identify nursing faculty members’ perceptions and experiences during the emergent transition to remote teaching during the COVID-19 pandemic in the United States. There have been several COVID-19-related studies in nursing; however, studies on nursing faculty members’ experiences are limited. Additionally, this is the first qualitative systematic review to explore nursing faculty members’ responses since the beginning of the COVID-19 pandemic. Thus, this review addresses the valuable contributions of nursing faculty to nursing students’ education during this crisis. Across the eight included studies, five common themes emerged regarding nursing faculty’s perceptions and experiences when teaching nursing students via remote teaching during the COVID-19 pandemic in the United States: (1) concerns about changes in traditional nursing pedagogy, (2) overwhelmingly heavy workloads, (3) acceptance of and coping with the pandemic, (4) the need for continuous and various forms of support, and (5) opportunities for the improvement of nursing education programs. First, this review revealed that nursing faculty members experienced difficulties related to abrupt changes in traditional nursing pedagogy without sufficient preparation during the pandemic. In addition, nursing faculty members were worried about academic progress and the effectiveness of remote learning [18, 20, 22]. In the included studies, many nursing faculty members reported that their theoretical and clinical courses were disrupted [15, 18]. There are limitations to remote teaching in nursing programs, which traditionally emphasize hands-on experience and face-to-face care in clinical settings [15, 18]. Additionally, nursing students are required to learn and practice face-to-face communication and interactions with patients during clinical practicums [18]. These results are congruent with the findings of previous studies that reviewed nursing students’ perspectives on learning during the pandemic. According to a scoping review by Joo [5], nursing students also worried about their academic progress during the pandemic. Likewise, learning about these basic and essential skills, such as hands-on experience and communication, was lacking among nursing students enrolled during the pandemic [16, 22]. Thus, the participants were worried about their students’ learning outcomes. In other countries, such as Australia and Korea, qualitative studies have reported that nursing faculty members demonstrated uncertainty about the impact of alternative teaching and training during the pandemic [23. 24]. Similarly, a quantitative study compared the outcomes of final exam scores, grades, and assignments among nursing students in the fall of 2019 and spring of 2020 [25]. To reveal the rigorous and clear impact of full-time remote and virtual learning, additional studies measuring and comparing learning outcomes before and during online learning are needed. Moreover, many faculty members felt overwhelmed by heavy workloads and felt more frustrated, stressed, and exhausted than they were before the pandemic. Regardless of whether faculty members had previously experienced remote learning, it was challenging for them to transition abruptly to full-time teaching via remote learning and virtual simulation. In particular, when the pandemic started in the Spring Semester of 2020, faculty members did not have enough time to prepare for remote teaching; instead, they had to transition their teaching in only one or two weeks with limited help from IT services or apparent directions from institutes or principles [15]. A quantitative study reported that nursing faculty members worked significantly more hours during than before the pandemic [26]. They had to switch tasks, such as examinations, group assignments, or communication methods, between students and other instructors [16, 18]. The experiences of nursing faculty members, nursing students, and nurses who abruptly faced the pandemic might be common to all nursing-related people [5, 9]. The problems experienced by nursing faculty members during the pandemic were related to frustration and low satisfaction as nursing faculty members. Some participants in the included studies expressed low satisfaction due to heavy workloads and long working hours in preparing, facilitating, and evaluating students online [16]. A survey study reported that nursing faculty members’ job satisfaction was significantly lower during than before the pandemic [26]. There is evidence of the importance of job satisfaction; thus, it needs to be prioritized. The third and fourth themes, acceptance of and coping with the pandemic and the need for continuous and varied forms of support, focused on nursing faculty members’ willingness to teach pedagogically and meet the quality expectations for nursing education. Even with the challenges brought about by the pandemic, faculty members tried to accept these emergent transitions in teaching and did their best to meet the goals of the courses for which they took responsibility [17-19]. While adapting to the pandemic, nursing faculty members requested sufficient and continuous support from nursing education administrators, IT services, and institutions. In addition, this review revealed that nursing faculty need continuous education regarding online tutoring and educational pedagogies at the national level (e.g., ACUE) (4). Moreover, owing to the emergent experiences of the pandemic, many nursing facilities have been subjected to traumatic stress and burnout [18, 26]; thus, these kinds of psychological support are also needed for nursing faculty members. The last theme, opportunities for the improvement of nursing education programs, was highlighted in all included studies. Several other studies have reported that the pandemic was devastating to nursing education, causing people to worry about academic progress and being nurses who graduated from a nursing program [5]. This could lead to new opportunities and possibilities to research remote teaching services for future learning pedagogy beyond traditional learning methodologies [5, 19] and professional advancement for nursing faculty members. It is time to reassess traditional approaches to nursing education and evaluate the effectiveness of courses to determine the helpful elements for novice nurses [18, 27]. Limitations This study had several limitations. First, the included studies did not clearly identify the characteristics of the participants or the nursing faculty. In the eight included studies, we could not obtain sufficient information about participants’ ages, sex, ethnicity, years of teaching experience, remote and virtual simulation teaching experience, or ability to access the Internet. Some of the participants in the included studies had experience in remote teaching. None of the included studies considered the participants’ computer skills. Second, this study only reviewed studies conducted with nursing faculty in the United States. Thus, the themes highlighted in this review may not apply to other countries. The United States had already implemented hybrid nursing programs before the pandemic; however, some countries only recently started remote learning because of the pandemic. There may be different aspects from those in other developed or undeveloped countries. This is why the studies reviewed were limited to those conducted in the United States. Therefore, the results of this review may not be generalizable to other countries. Third, due to the limited number of qualitative studies comparing nursing faculty members’ experiences during the pandemic with those of nurses or nursing students, the studies included nursing faculty members’ perspectives on the transition teaching of theoretical and clinical courses. There might be a different perspective from didactic to remote and from on-ground to virtual transitions. Recommendations and Implications for Nursing Despite the above limitations, the themes extracted from this review were common among the included studies. The themes included broad aspects of emergent transitions in teaching in the United States. The results of this review can be utilized to improve remote teaching and develop new pedagogies for nursing education for nursing faculty members and students. Nursing and educational associations should continuously provide guidance and support, even after the pandemic. Preparing for future crises is also recommended. In the United States, the American Association of Colleges of Nurses released guidelines for nursing schools to deliver didactic and clinical content virtually in March 2020 (Farber 2022), and the Center for Reading and Learning Association provided training for nursing faculty members (Hawkins 2022). Likewise, continuous support at the institutional and national levels is recommended for nursing faculty members to overcome the difficulties brought about by the pandemic and any unexpected future crises. Nursing research is also required to identify the impact of remote learning on student outcomes. Additionally, evaluating the effectiveness of and identifying the benefits or barriers associated with new learning pedagogies is vital. In addition, economic, physical, and psychological support are recommended for nursing faculty members to develop their teaching methods. Thus, additional empirical research and institutional and political support are needed to overcome the current difficulties of remote learning and prepare for future pandemics. CONCLUSIONS This review is the first qualitative synthesis to identify common themes from nursing faculty members’ perspectives and experiences with education during the COVID-19 pandemic. Nursing faculty members, nurse leaders, and nursing colleges can utilize the findings of this qualitative systematic review to determine the importance of the current status of remote teaching and provide support to nursing faculty during current and future pandemics. Additionally, the barriers and facilitators of nursing education identified in this review can be used to develop nursing programs and new pedagogies for future nursing education. Furthermore, this review contributes evidence on nursing faculty members’ teaching experiences during the pandemic. While this review was limited to the United States, there are few qualitative studies on nursing faculty members during the pandemic (Australia and South Korea), and few quantitative studies have been conducted that have targeted nursing faculty members. However, further studies with qualitative and quantitative evidence are needed on this topic. Abbreviations WHO World Health Organization COVID-19 Coronavirus disease PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses MeSH Medical subject headings CASP Critical Appraisal Skills Program Qualitative Research Checklist Declarations Ethics approval and consent to participate Not applicable to this study. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Funding Title page References Timeline: WHO’s COVID-19 response [Internet]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline Watson R, Hayter M. The COVID‐19 epidemic of manuscripts. J Adv Nurs. 2020 Jun 12;76(10):2454–5. Available from: https://doi.org/10.1111/jan.14437 Ebrahim SH, Ahmed QA, Gozzer E, Schlagenhauf P, Memish ZA. Covid-19 and community mitigation strategies in a pandemic. The BMJ. 2020 Mar 17;m1066. Available from: https://doi.org/10.1136/bmj.m1066 Geddes L. COVID-19 is no longer a Public Health Emergency of International Concern. Does this mean the pandemic is over? VaccinesWork. 2023 [cited 2024 Jan 12]. Available from: https://www.gavi.org/vaccineswork/covid-19-no-longer-public-health-emergency-international-concern-does-mean-pandemic?gclid=CjwKCAiA7t6sBhAiEiwAsaieYvmw0R4LjOkgloZcxj_buLedXcSODK6Ps8Qiw_ZRjzxOgixWFvAJRBoCGesQAvD_BwE Joo JY. Abrupt transition to remote learning in nursing students during the COVID-19 pandemic. J Nurs Educ. 2023 Nov 14;1–8. Available from: https://doi.org/10.3928/01484834-20231031-01 Romli MH, Foong CC, Hong WH, Subramaniam PL, Yunus FW. Restructuring education activities for full online learning: findings from a qualitative study with Malaysian nursing students during Covid-19 pandemic. BMC Med Educ. 2022 Jul 11;22(1). Available from: https://doi.org/10.1186/s12909-022-03587-1 ACEN Accreditation Manual – Glossary – Accreditation Commission for Education in Nursing. Available from: https://www.acenursing.org/acen-accreditation-manual-glossary/#:~:text=Faculty%2C%20Nursing%20%E2%80%93%20Nurses%20who%20teach,Administrator%20and%20Nursing%20Program%20Coordinator. De Castro AB, Shapleigh E, Bruck AM, Salazar MK. Developing blended online and classroom strategies to deliver an occupational Health nursing overview course in a Multi-State region in the United States. Workplace Health Saf [Internet]. 2015 Mar 1;63(3):121–6. Available from: https://doi.org/10.1177/2165079915576919 Joo JY, Liu MF. Nurses’ barriers to caring for patients with COVID‐19: a qualitative systematic review. Int Nurs Rev. 2021 Jan 8;68(2):202–13. Available from: https://doi.org/10.1111/inr.12648 Butler AE, Hall H, Copnell B. A guide to writing a Qualitative Systematic Review Protocol to Enhance Evidence‐Based Practice in Nursing and Health Care. Worldviews on Evid Based Nurs. 2016 Jan 20;13(3):241–9. Available from: https://doi.org/10.1111/wvn.12134 Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008 Jul 10;8(1). Available from: https://doi.org/10.1186/1471-2288-8-45 Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann T, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. The BMJ. 2021 Mar 29;n71. Available from: https://doi.org/10.1136/bmj.n71 CASP Checklists - Critical Appraisal Skills Programme [Internet]. CASP - Critical Appraisal Skills Programme. Available from: https://casp-uk.net/casp-tools-checklists/ Walker J. Systematic reviews in the social sciences: A practical guide ‐ by Petticrew, M. and Roberts, H. Sociol Health Illn. 2007 Mar 1;29(2):318–9. Available from: https://doi.org/10.1111/j.1467-9566.2007.498_4.x Christoffers C. Practical implications of online learning with nurses during coronavirus disease 2019. Nurs Clin North Am. 2023;58:107–19 Gazza EA. The experience of being a Full-Time Academic Nurse educator during the COVID-19 pandemic. Nurs Educ Perspect. 2022;43:74–9. Hopkins E, Spadaro KC, Hoh NZ, Singh A, Doas M. Nursing faculty experiences transitioning to a virtual DNP residency during COVID-19. J Dr Nurs Pract. 2022;15:26–31. Iheduru-Anderson K, Foley JA. Transitioning to full online teaching during COVID-19 crisis: The associate degree nurse faculty experience. Glob Qual Nurs Res. 2021;8:233339362110575. McKay M, Pariseault CA, Whitehouse CR, Smith TL, Ross JG. The experience of baccalaureate clinical nursing faculty transitioning to emergency remote clinical teaching during the COVID-19 pandemic: Lessons for the future. Nurs Educ Today. 2022;111:105309. Powers K, Pate K, Montegrico J, Pagel J. Faculty perceptions of the impact of the COVID-19 pandemic on new graduate nurses’ transition to practice: A qualitative study. J Prof Nurs. 2022;43:33–41. Sacco TL, Kelly MM. Nursing faculty experiences during the COVID-19 pandemic response. Nurs Educ Perspect. 2021;42:285–90. Sessions LC, Ness M, Mark H. Exploring the experiences of nursing faculty during the coronavirus (COVID-19) pandemic—A qualitative descriptive study. Teach Learn Nurs. 2022;17:477–81. Choi S-Y, Jin S, Kim J. Laboratory and clinical teaching experience of nursing professors in the COVID-19 pandemic era: Now and the future. Front Public Health. 2022;10: 961443. Available from: https://doi: 10.3389/fpubh.2022.961443. eCollection 2022.. Ridgway L, McKenna L, Hokke S, Hackworth N, Nicholson JM. Maternal and Child Health Nursing education before and during COVID-19: An exploratory descriptive study. J Prof Nurs. 2022 Jul 1;41:100–7. Available from: https://doi.org/10.1016/j.profnurs.2022.04.007 Cygan H, Bejster M, Tribbia C, Vondracek H. Impact of COVID‐19 on public health nursing student learning outcomes. Public Health Nurs. 2021 Oct 6;39(2):481–7. Available from: https://doi.org/10.1111/phn.12978 Farber J, Payton C, Dorney P, Colancecco E. Work-life balance and professional quality of life among nurse faculty during the COVID-19 pandemic. J Prof Nurs [Internet]. 2023 May 1;46:92–101. Available from: https://doi.org/10.1016/j.profnurs.2023.03.005 Hopkins E, Wasco JJ, Spadaro KC, Fisher M, Walter L, Piotrowski M. Crisis response to COVID-19: Elements for a successful virtual event transition. J Nurs Educ Prac [Internet]. 2020 Nov 19;11(3):36. Available from: https://doi.org/10.5430/jnep.v11n3p36 Tables Table 2 and 3 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files 202401Additionalfile1Exampleofsearchingstrategy.docx 202401Additionalfile2Qualityassessment.docx 20240111PRISMA2020checklistQSRBMC.docx 20240111TablesFacultyQSRBMC.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3865510","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":267690258,"identity":"a425fb78-6fd2-4bc2-896d-a7bf76973539","order_by":0,"name":"Jee Young Joo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA40lEQVRIiWNgGAWjYBACxgYEg/EBkObhI0ULswFICxspNrJJgElCypjbm49JfGy7Y9cMZFR+zbGTYWNgfvjoBj6H9RxLk5zZ9iy5Eci4LbstGegwNmPjHHxaZuSYSfO2HU4GMW5LbmMGauFhk8arZf77b3AtxZLb6onQMgOoAKjFDqSF8eO2w0Ro6Ukztpxx7nAC0FPJ0ozbjvOwMRPwi2H74Yc3PpQdtjdsbz748ee2ant+9uaHj/FqaWBgAUVH4sYGYIjzgISY8SgHAXmgkg9A2l4e5MofBFSPglEwCkbByAQALa9IhHKLxSsAAAAASUVORK5CYII=","orcid":"","institution":"Gachon University, Korea","correspondingAuthor":true,"prefix":"","firstName":"Jee","middleName":"Young","lastName":"Joo","suffix":""},{"id":267690260,"identity":"c1b764ff-0390-43aa-a273-1c4675f35fcf","order_by":1,"name":"Kyoung-A Kim","email":"","orcid":"","institution":"Suwon Women’s University","correspondingAuthor":false,"prefix":"","firstName":"Kyoung-A","middleName":"","lastName":"Kim","suffix":""}],"badges":[],"createdAt":"2024-01-15 05:44:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3865510/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3865510/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49848269,"identity":"deccb4e1-d9b2-437c-9f90-083a6ef1d2e0","added_by":"auto","created_at":"2024-01-19 04:14:57","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":68487,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA 2020 flow\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3865510/v1/14bdc28712f41daacd8cd9a8.png"},{"id":57592380,"identity":"25ccb05f-8872-47f9-9a1b-0359fbd7120c","added_by":"auto","created_at":"2024-06-03 05:50:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":525493,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3865510/v1/af51ba9d-eb49-4ebf-b60b-98295296335d.pdf"},{"id":49848545,"identity":"d72c9a6e-b49c-4b65-8d85-d83702accab5","added_by":"auto","created_at":"2024-01-19 04:22:57","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":21741,"visible":true,"origin":"","legend":"","description":"","filename":"202401Additionalfile1Exampleofsearchingstrategy.docx","url":"https://assets-eu.researchsquare.com/files/rs-3865510/v1/beae2abe40336c6d1e3c168a.docx"},{"id":49848272,"identity":"aaa19f08-df97-43ce-bab1-aea8df3fb4f4","added_by":"auto","created_at":"2024-01-19 04:14:57","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":24874,"visible":true,"origin":"","legend":"","description":"","filename":"202401Additionalfile2Qualityassessment.docx","url":"https://assets-eu.researchsquare.com/files/rs-3865510/v1/9b168083b7700ad164fee5d8.docx"},{"id":49848273,"identity":"dd5f42b7-c3c3-4bc5-a35c-df697af1d14e","added_by":"auto","created_at":"2024-01-19 04:14:58","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":33965,"visible":true,"origin":"","legend":"","description":"","filename":"20240111PRISMA2020checklistQSRBMC.docx","url":"https://assets-eu.researchsquare.com/files/rs-3865510/v1/5a8152a77a91bf7a2eb8b87f.docx"},{"id":49848270,"identity":"61573763-3016-4b74-98ed-8e8dc1550486","added_by":"auto","created_at":"2024-01-19 04:14:57","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":70670,"visible":true,"origin":"","legend":"","description":"","filename":"20240111TablesFacultyQSRBMC.docx","url":"https://assets-eu.researchsquare.com/files/rs-3865510/v1/5c314f83cfc1541590c45647.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Nursing faculty experiences with emergent remote teaching transitions during the COVID-19 pandemic: A qualitative systematic review","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eWith the rapid\u0026nbsp;worldwide spread of the coronavirus disease 2019 (COVID-19)\u0026nbsp;in 2020, the World Health Organization (WHO) announced a public health emergency [1]. The COVID-19 pandemic had a global impact and resulted in the deaths of many people [2]. In the United States, the Centers for Disease Control and Prevention\u0026nbsp;established certain guidelines to reduce the transmission of the virus; similarly, countries worldwide had lockdowns and implemented social distancing guidelines [3]. Since early 2020, new variants have spread. In May 2023, the WHO announced that COVID-19 was no longer a global emergency. However, the WHO insists that we are still in a state of crisis and that there is a need to continue preparing for future global epidemics [4].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSince the announcement of lockdowns in the spring of 2020, higher education institutions,\u0026nbsp;such as universities and colleges, have\u0026nbsp;closed their campuses [5]. Nursing education programs were also disrupted and moved\u0026nbsp;online\u0026nbsp;[6]; all courses that had previously been conducted face-to-face had to be moved to remote learning abruptly, and clinical practicum courses were also moved to virtual simulations [5]. Nursing faculty members, registered nurses who are academically qualified and employed as educators [7], and nursing students enrolled in nursing programs had to adapt their teaching and learning skills without sufficient preparation or readiness [5]. In some developed countries, such as the United States, hybrid nursing programs [8], a combination of remote and face-to-face learning) began before the pandemic. Thus, nursing faculty and students in the United States might have already been slightly accustomed to remote learning.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere is evidence in the literature on abrupt nursing education transitions and their impact on nursing students based on empirical studies. Additionally, several quantitative and qualitative studies have been narratively and systematically conducted to gather evidence on nursing and COVID-19 [5, 9]. However, considerably less qualitative or quantitative research has been conducted on nursing educators, including faculty members, during the COVID-19 pandemic. Globally, knowledge regarding nursing faculty members\u0026rsquo; experiences and perceptions of emergent transitions in nursing education during the pandemic is limited. Moreover, no reviews have systematically synthesized the perspectives of nursing faculty regarding abrupt transitions in nursing education. Therefore, this study involved a literature review of qualitative evidence on COVID-19 among nursing faculty members. This study synthesized the perspectives and experiences of these faculty members to identify common issues during the pandemic.\u003c/p\u003e"},{"header":"THE REVIEW","content":"\u003ch2\u003eAim\u003c/h2\u003e\n\u003cp\u003eThe aims of this qualitative systematic review were to synthesize qualitative studies of nursing faculty experiences and perspectives regarding emergent transitions to remote teaching during the COVID-19 pandemic in the United States and to identify common themes regarding emergent transitions in teaching during the pandemic. This review was limited to studies that were conducted in the United States because the United States is one of the most developed countries with regard to remote learning, as nursing educators in the country have been using remote learning as a hybrid format. Thus, this study targeted nursing faculty members who work in the United States.\u003c/p\u003e\n\u003cp\u003eThe two research questions are as follows: (1) What are the common experiences and perspectives of nursing faculty members in the emergent transition to online teaching during the COVID-19 pandemic? (2) What issues did nursing faculty members face during the COVID-19 pandemic?\u003c/p\u003e\n\u003ch2\u003eDesign\u003c/h2\u003e\n\u003cp\u003eThis study applied a qualitative systematic review method with thematic synthesis [10, 11]. This methodology is appropriate for identifying, assembling, and synthesizing common themes from empirical evidence [10, 11]. This approach is not a new methodology for nursing reviews but is relatively new for nursing faculty research. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [12]\u0026nbsp;to ensure rigorous reporting. Additionally, this study was accessed and registered according to the protocols of the International Prospective Register of Systematic Reviews (PROSPERO). There were no human participants recruited for this study; thus, there was no need for institutional review board approval.\u003c/p\u003e\n\u003ch2\u003eSearch Strategy\u003c/h2\u003e\n\u003cp\u003eFive electronic bibliographic databases (PubMed, CINAHL, Ovid, Web of Science, and Scopus) were searched in December 2023. The search identified qualitative studies (including mixed methods studies with qualitative data) published between January 2020 and December 2023 (including prepublications). Through combinations of keywords and medical subject headings (MeSH), the following terms were combined for searching: \u003cem\u003enursing faculty\u0026nbsp;\u003c/em\u003eor \u003cem\u003enursing professor\u003c/em\u003e; \u003cem\u003equalitative research or theme\u003c/em\u003e; and \u003cem\u003eCOVID-19\u003c/em\u003e or \u003cem\u003epandemic\u003c/em\u003e. Additional keyword searches were also used: \u003cem\u003enurse educator\u0026nbsp;\u003c/em\u003eor\u003cem\u003e\u0026nbsp;academic nurse educator or nursing education,\u003c/em\u003e \u003cem\u003elearning, or teaching; nursing program,\u003c/em\u003e or \u003cem\u003ephenomenology perspective, or challenge\u003c/em\u003e; and \u003cem\u003eexperience\u0026nbsp;\u003c/em\u003eor\u003cem\u003e\u0026nbsp;perception\u003c/em\u003e. The pilot search was conducted in mid-November 2023 to identify an appropriate number of articles. The initial search of the five databases was subsequently conducted on December 1, 2023, and a secondary search was completed on December 15, 2023. An example of the database search strategy is presented in Additional file 1.\u003c/p\u003e\n\u003ch2\u003eInclusion and Exclusion Criteria\u003c/h2\u003e\n\u003cp\u003eTable 1 presents the inclusion and exclusion criteria used in this review. The inclusion criteria for this study were as follows: (1) studies that targeted nursing faculty (nursing educators, including tenured, tenure-track, or clinical teaching professors or instructors) who were responsible for at least one nursing program course (either theoretical or practicum courses) in the United States during the pandemic period and who had no teaching experience before the pandemic; (2) empirical, primary studies with qualitative approaches (including mixed-methods with qualitative study results); (3) studies that highlighted the experiences and perspectives of nursing faculty who worked in United States nursing programs during the pandemic; (4) studies published in English-language and presented as articles in peer-reviewed academic journals; and (5) studies published (including prepublication) since the announcement of the COVID-19 pandemic (January 2023) to December 2023.\u003c/p\u003e\n\u003cp\u003eThe exclusion criteria were as follows: studies that were not conducted in the United States with nursing faculty; studies that did not meet the aim of this review; studies that focused on the perspectives of non-nursing faculty, such as public healthcare program faculty; and studies in which the nursing faculty did not teach undergraduate or graduate or any nursing programs. In this review, nursing faculty was defined as a person with academic qualified, registered nurse, and employed by a nursing program to teach and evaluate nursing students [7].\u003c/p\u003e\n\u003cp\u003eTable 1. Inclusion and exclusion criteria\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusion criteria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eStudies that targeted nursing faculty members (nursing educators) who had taught undergraduate or graduate nursing students enrolled in nursing educational courses during the COVID-19 pandemic regardless of first or second waves\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eTarget populations: nursing faculty members or nursing educators who were infected with COVID-19 (including those infected with coronavirus variants) or other healthcare professions or educators; nursing faculty members (nursing educators, or nursing professors) who had not taught classes since the 2020 pandemic or who had been in research, sabbatical, or temporary absence years\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eStudies that focused on nursing faculty members\u0026rsquo; (or nurse educators\u0026rsquo;) experience with the nursing curriculum and teaching during the COVID-19 pandemic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eNonempirical studies, any types of reviews, gray literature sources, such as editorials, policy documents, or commentaries\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eEmpirical studies, including qualitative studies or mixed methods with qualitative data\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eStudies published or including other epidemic and pandemic outbreaks, excluding the COVID-19 crisis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary studies conducted with data collected from the beginning (January 2020) to the end (May 5, 2023) (following the WHO declaration) of the COVID-19 pandemic in the United States\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eStudies that were not focused on nursing educators\u0026rsquo; theoretical courses or clinical skills, simulation laboratory, virtual practicum that related to nursing major courses\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eStudies published from January 2020 to December 2023, including online advanced publications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eStudies published in languages other than English\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eStudies published in English in peer-reviewed journals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp\u003eStudies that did not meet the purpose of this qualitative systematic review\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2\u003eSelection Process and Quality Assessment\u003c/h2\u003e\n\u003cp\u003eFigure 1 shows the PRISMA flow diagram that illustrates the study selection process of this review. Initially, 86 articles were identified from the five databases. Using EndNote X9 (Clarivate Analytics, Philadelphia, USA), 50 duplicate articles were removed, and\u0026nbsp;36 articles remained. Of these 36 articles, 18 articles were retained, and 18 articles were excluded based on the title. Among the 18 remaining articles, ten studies were excluded after abstract review, and the final eight studies were selected for full-text review. The first author conducted the study screening process independently, and the second author reviewed the process and checked for accuracy. All eight remaining studies met these aims and met the inclusion criteria, and there was no discrepancy in the study selection process between the two authors.\u003c/p\u003e\n\u003cp\u003eIn a qualitative systematic review, quality appraisal is imperative for assessing methodological trustworthiness and rigor of evidence [10, 11]. Using a quality assessment tool, the Critical Appraisal Skills Program Qualitative Research Checklist (CASP) [13], the eight studies were evaluated by two authors independently. The results of the evaluation were compared and agreed with those of two other authors (see Additional file 2).\u003c/p\u003e\n\u003ch2\u003eData Analysis and Synthesis\u003c/h2\u003e\n\u003cp\u003eA table was created to summarize the study aim, participant characteristics, study design, data collection and analysis, major themes and results. Next, data analysis and synthesis were conducted by two authors. For this process, Thomas and Harden\u0026rsquo;s [11] thematic synthesis was employed to identify meaningful codes from the qualitative data.\u003c/p\u003e\n\u003cp\u003eThe two authors read and reread the data to extract important codes from the selected studies. Then, similar codes were aggregated, and several descriptive themes were generated from the qualitative data. Themes were merged into comprehensive and prominent themes. Finally, higher-order common themes were generated.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003ch2\u003eStudy Characteristics\u003c/h2\u003e\n\u003cp\u003eThe eight included studies are summarized in Table 2. All eight studies had qualitative data and themes as major findings. Seven of the eight studies used a qualitative approach [14-22]; among these studies, two applied phenomenological qualitative methods [16, 18], and one used the grounded theory approach [15]. One study involved a mixed method design with qualitative responses [21]. \u003c/p\u003e\n\u003cp\u003eThe data from the included studies were collected between spring 2020 and April 2022, which were the first and/or second waves of the COVID-19 pandemic. The year of publication ranged from September 2021 to March 2023, and five of the eight papers were published in 2022. All eight studies were performed in regions around the United States. Hopkins et al. [17] targeted nursing faculty from one university in the southwestern United States. Due to the risk of COVID-19 transmission and the restrictions of lockdown, data were collected via personal informal semi-structured interviews. Five studies used a videoconferencing platform, and two used telephone interviews. The remaining two studies used an online survey link with open-ended questions [17, 20].\u003c/p\u003e\n\u003cp\u003eA total of 230 nursing faculty members participated in the eight studies. All of them had a registered nurse license, had an advanced degree related to nursing, and had taught theoretical or clinical nursing courses (didactic, clinical, or laboratory) either full-time or part-time at the university or college; their employment status included tenure-track, tenured, adjunct, clinical, and teaching professor positions. The targeted nursing educational programs included undergraduate and graduate (master\u0026rsquo;s or doctoral) programs, associate degree programs in nursing, and RN-to-BSN programs. The participants\u0026rsquo; ages and work experience were not reported exactly; however, all of them started teaching before the pandemic. All participants were selected purposively, and some nursing faculty members had online teaching experience before the COVID-19 pandemic; however, none of them had fully taught online. Approximately half of the participants had no experience with online nursing programs. While there was limited information about the gender and ethnicity of the participants, it was apparent that most of the participants were female and White.\u003c/p\u003e\n\u003cp\u003eThe data were analyzed using thematic analysis (\u003cem\u003en\u003c/em\u003e = 3), content analysis (\u003cem\u003en\u003c/em\u003e = 3), grounded theory data analysis, and Barritt et al.\u0026rsquo;s five-step process (each \u003cem\u003en\u003c/em\u003e = 1). One study utilized an existing theoretical framework [19], and none of the included studies developed conceptual frameworks of COVID-19-related concepts based on their findings.\u003c/p\u003e\n\u003cp\u003eTo evaluate the quality of the included studies, the CASP 2013 tool [13] was used. The first and second authors independently scored the eight studies using the CASP 2013. Both authors compared the results of the tool, and differences were discussed. All eight included studies had appropriate methodological rigor (see Additional file 2).\u003c/p\u003e\n\u003ch2\u003eMain findings\u003c/h2\u003e\n\u003cp\u003eThrough thematic synthesis, this review identified five common themes related to nursing faculty members\u0026rsquo; perspectives and experiences of teaching during the COVID-19 pandemic: (1) concerns about changes in traditional nursing pedagogy, (2) overwhelmingly heavy workloads, (3) acceptance of and coping with the pandemic, (4) the need for continuous and various forms of support, and (5) opportunities for the improvement of nursing programs (see Table 3).\u003c/p\u003e\n\u003ch3\u003eTheme 1: Concerns about changes in traditional nursing pedagogy\u003c/h3\u003e\n\u003cp\u003eThe first theme that emerged from the studies under review was that the pandemic aroused concerns among the participants about changes in traditional nursing pedagogy. The impact of the emergent transition from teaching strategies involving in-person and on-site traditional nursing education pedagogy to remote online formats during and after COVID-19 is still uncertain [19, 22]. In six studies, disruptions in traditional nursing educational teaching pedagogy were mentioned in the nursing faculty interviews [16-20, 22]. The nursing faculty participants described the challenges and worries that they faced as a result of their didactic and clinical teaching strategy changes due to the COVID-19 pandemic [19, 22].\u003c/p\u003e\n\u003cp\u003eFirst, since the pandemic began, nursing faculty, especially clinical teaching professors, had to manage the restriction of access to on-site clinical sites; thus, clinical education needed to be provided via virtual simulation [20]. As many nursing faculty participants mentioned, on-site clinical learning and hands-on experience are essential for nursing education, preparation as nurses, and the nursing workforce [18, 19, 22]. One participant in the study by Power et al. [20, p. 35] expressed worries about nursing students who had limited on-site clinical learning: \u0026ldquo;My biggest concern is lack of hands-on experience due to restrictions in their clinical education. Simulation activities are good, but they are not a replacement for hands-on learning.\u0026rdquo; Similarly, many participants worried about their nursing students who graduated during the pandemic and missed many clinical practicum hours in direct patient care [18, 22]. For example, one nursing faculty member stated that nursing students who did not have much experience as front-line staff during the pandemic would never be nurses in hospital settings.\u003c/p\u003e\n\u003cp\u003eAnother concern that nursing faculty members commonly reported was a lack of interpersonal relationships with students and little opportunity to interact with actual patients in remote learning [16-19, 22]. Participants reported that online didactic education was able to provide theoretical knowledge that allowed them to succeed academically; however, the ability to translate such knowledge into actual patient care was limited [20-22]. In a study by Power et al. [20, p. 35], a nursing faculty member said that nursing students can be prepared \u0026ldquo;theoretically\u0026rdquo; but not \u0026ldquo;clinically\u0026rdquo;. Additionally, some nursing faculty reported that they missed connections with their students [16]. For example, one faculty member stated, \u0026ldquo;I just really miss the live interaction with the students\u0026hellip;you just can\u0026rsquo;t have the same interactions with the students over Zoom\u0026rdquo; (p. 77). Moreover, some remote nursing learning courses were not conducted in real time, which is synchronous, but rather were recorded; thus, both faculty and students lost opportunities for live Q\u0026amp;A sessions [17, 19].\u003c/p\u003e\n\u003ch3\u003eTheme 2: Overwhelmingly heavy workloads\u003c/h3\u003e\n\u003cp\u003eOverwhelmingly heavy workloads was the second theme that emerged. Nursing faculty demonstrated significant stress and exhaustion due to an increase in their workload as educators compared to their work before the pandemic. [15-19, 21, 22]. First, nursing faculty members had to emergently transition their courses from didactic to online nursing curricula in only one or two weeks in spring 2020 without clear notice from universities and without sufficient training [16, 19, 22]. Moreover, they needed to change teaching strategies, exams, assignments, or supplementary files to an online format [16, 19, 22]. The spring of 2020 and the summer of 2020 constituted the initial the wave of the COVID-19 pandemic, and the first semester required emergently closing campuses and starting online. Many participants reported that even though some had experienced online teaching before the pandemic in the United States, they had no experience with full-time online teaching or virtual practicums; thus, they had to spend more hours preparing materials in an online format, which they were not accustomed to [15, 16, 18]. One participant in the study by Iheduru-Anderson and Foley [18] said, \u0026ldquo;The workload was above and beyond. We were literally on the computer with students from 9:00 am to 9:00 pm. And it was brutal\u0026rdquo; (p. 3). In Gazza [16], one clinical professor expressed an extremely increased workload: \u0026ldquo;For two weeks, it was utter chaos, and it was maddening and I couldn\u0026rsquo;t get off [my computer]\u0026hellip;I was online all day long\u0026rdquo; (p. 76).\u003c/p\u003e\n\u003cp\u003eSome studies also reported that nursing faculty members\u0026rsquo; burnout was caused by the additional workload associated with COVID-19 (5). In addition to transferring their nursing course resources into an online format, nursing faculty also had to make their students \u0026ldquo;learner mindset\u0026rdquo; [19. 21]. Some students were not ready to learn in different learning environments, such as at home instead of on campus; thus, nursing faculty members were required to facilitate, engage in, and pay attention to the students as participants in online classes or clinicals [17-19, 22]. One faculty member mentioned that \u0026ldquo;...keeping them (students) motivated\u0026hellip; can be a little bit exhausting\u0026hellip;\u0026rdquo; [22, p. 479].\u003c/p\u003e\n\u003cp\u003eTypically, nursing faculty members has already experienced normal stress from their teaching, maintaining their clinical expertise, and qualifying for tenure requirements [21]. However, nursing faculty worked more hours because of the significantly increased workload related to developing the course in an online format and motivating their students to study online during the COVID-19 pandemic [21]. In one study, participants expressed this as \u0026ldquo;technology burnout\u0026rdquo; [18, p. 2].\u003c/p\u003e\n\u003ch3\u003eTheme 3: Acceptance of and coping with the pandemic\u003c/h3\u003e\n\u003cp\u003eThe third theme, acceptance of and coping with the pandemic, emerged from seven studies under review. The studies demonstrated that nursing faculty understood the serious, emergent, and critical events of the COVID-19 pandemic and accepted an alternative way of teaching, i.e., remote or virtual full-time teaching [16-22]. Moreover, they coped with their transitions in teaching strategies [18, 19].\u003c/p\u003e\n\u003cp\u003eEven though it is not easy for nursing faculty to prepare all related elements for virtual clinical teaching, many participants reported that they could meet the aim of their course objectives [17]. One clinical nursing faculty member noted that \u0026ldquo;it enabled achievement of the key academic objective of DNP residency for students. Students were able to obtain further input from a variety of faculty and peers regarding their capstone project\u0026rdquo; [17, p. 29].\u003c/p\u003e\n\u003cp\u003eIn addition to accepting the emergent transition, participants also tried to flexibly cope with this situation for themselves [18, 19, 21]. For example, one participant of McKay et al. [19] stated, \u0026ldquo;It\u0026apos;s kind-of like we have to do this right now and everybody is panicking, and nobody knows what\u0026rsquo;s going to happen and, you know nurses are good at being flexible, so I was able to manage that\u0026rdquo; [19, p. 3].\u003c/p\u003e\n\u003cp\u003eSome nursing faculty members reported feeling that they were in chaos preparing for an emergent transition to remote teaching in Spring 2020, which was the first semester of lockdown due to the pandemic; however, as the pandemic continued into fall 2020, they became accustomed to remote teaching and coping with alternative teaching strategies [16, 20, 22].\u003c/p\u003e\n\u003ch3\u003eTheme 4: The need for continuous and various forms of support\u003c/h3\u003e\n\u003cp\u003eThe fourth theme, the need for continuous and various forms of support, was identified from five studies. Nursing faculty participants in five studies reported that they needed continuous support at various levels [15, 16, 18-20]. Participants demonstrated that technical assistance that can help faculty members apply new technologies in nursing courses, national or state-level professional nursing organizations, and psychological support are required [15, 16, 18-20].\u003c/p\u003e\n\u003cp\u003eFirst, they demonstrated that they need continuous support from technology experts for technical assistance [15, 18, 19]. Some participants had utilized remote learning as a part of hybrid courses before the pandemic; nonetheless, this was the first time that they had transitioned to full-time remote teaching and virtual simulations [16, 18]. Some faculty members were accustomed to internet video teaching skills; however, some of them had challenges [16]. Moreover, some faculty members lacked internet access; furthermore, some faculty members worried about time needed to learn new technologies and apply them to their courses [16, 19].\u003c/p\u003e\n\u003cp\u003eAdditionally, studies reported that faculty needed \u0026lsquo;helpers\u0026rsquo; who could educate and train them, such as educational associations or professional nursing organizations, at the state or national levels [15,18]. These kinds of helpers could provide updated new modules for remote learning and continuous education via online video conferencing during the pandemic [15]. At the beginning of the pandemic restrictions, several institutional and nursing organizations prepared webinars for nursing faculty on how to survive the abrupt teaching transition and how to teach with contingent infections [15, 16, 20]. For instance, faculty mentioned the Association of College and University Educators (ACUE) training, which helped them learn how to perform online teaching and utilize this training course [15].\u003c/p\u003e\n\u003cp\u003eIn addition, participants reported that they required emotional and psychological support [18, 19]. Due to the pandemic, lockdown, and transition to different teaching environments, many participants had no opportunity to communicate or interact with students or their colleagues face to face, which made them feel lonely and isolated [19]. Thus, participants stated that emotional support was pivotal for nursing faculty at the administrative level [18, 19].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 5: Opportunity for the improvement of nursing educational programs\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn all eight studies reviewed, participants expressed that an emergent transition to remote learning due to the pandemic represented a good opportunity to develop themselves as nursing educators, to learn future teaching delivery methods and to follow and prepare for the movement of teaching delivery methods [15-22]. Finally, they had the opportunity to innovate traditional nursing teaching strategies by renewing, redesigning, modifying, and reevaluating as the pandemic continued and as the future required it while still maintaining the course objectives and outcomes [15-22].\u003c/p\u003e\n\u003cp\u003eAccording to many nursing faculty members involved in these studies, the pandemic was an opportunity for growth as a nursing educator [15, 16, 18, 19]. With the emergent transition from didactic to remote teaching and from on-the-ground to virtual simulations, nursing faculty showed tremendous, quick development of new teaching tools. One participant used a simile to describe their efforts: \u0026ldquo;\u0026hellip;necessity is the mother of invention\u0026rdquo; [18, p. 9]. Similarly, a nursing faculty member commented, \u0026ldquo;I learned a lot of new things. I had never heard about Google forms before this crisis, but I learned very quickly. I used it to create evolving case studies to augment the clinical learning for the students\u0026rdquo; [18, p. 9]. One associate professor stated that abrupt changes to remote teaching had made them reflect on the objectives of programs and had the chance to support students. These kinds of efforts were beneficial to faculty, nursing students, nursing programs, and universities [16]. Even though nursing faculty were very stressed due to the pandemic and the accompanying heavy workloads, they said that the pandemic presented an opportunity to improve their programs and promote professional development in the future [15, 16].\u003c/p\u003e\n\u003cp\u003eSeveral studies have reported that moving from an on-the-ground clinical practicum to virtual simulations is a new opportunity and is beneficial for both faculty and students [18, 22]. While virtual simulations were being performed, faculty and students were able to flexibly conduct clinical labs and adapt their abilities to access nursing skills in unique ways [22]. In a study by Power et al. (p. 35), one nursing faculty member stated, \u0026ldquo;We all know there can be a lot of waiting around for a faculty member [in clinical], but in simulation, that did not happen.\u0026rdquo; In Christoffers et al. [15], one nursing faculty member mentioned, \u0026ldquo;I think that [COVID-19 caused] a lot of growth., you know, talk about doing impossible things. I see the good stuff that came out of that for a lot of people that I work with and maybe myself too, that there\u0026rsquo;s things that probably [we] needed to work on anyway, and it just pushed it forward\u0026rdquo; [15, p. 112]. Thus, even during the crisis, nursing faculty members had been using the pandemic situation to develop themselves as well as nursing programs.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis review aimed to synthesize the findings of eight qualitative studies to identify nursing faculty members\u0026rsquo; perceptions and experiences during the emergent transition to remote teaching during the COVID-19 pandemic in the United States. There have been several COVID-19-related studies in nursing; however, studies on nursing faculty members\u0026rsquo; experiences are limited. Additionally, this is the first qualitative systematic review to explore nursing faculty members\u0026rsquo; responses since\u0026nbsp;the beginning of the COVID-19 pandemic. Thus, this review\u0026nbsp;addresses the valuable contributions\u0026nbsp;of nursing faculty\u0026nbsp;to nursing students\u0026rsquo; education during this crisis.\u003c/p\u003e\n\u003cp\u003eAcross the eight included studies, five common themes emerged regarding nursing faculty\u0026rsquo;s\u0026nbsp;perceptions and experiences when teaching nursing students via remote teaching during the COVID-19 pandemic in the United States: (1) concerns about changes in traditional nursing pedagogy, (2) overwhelmingly heavy workloads, (3) acceptance of and coping with the pandemic, (4)\u0026nbsp;the\u0026nbsp;need for continuous and various forms of support, and (5) opportunities for the improvement of nursing education\u0026nbsp;programs.\u003c/p\u003e\n\u003cp\u003eFirst, this review revealed that nursing faculty members experienced difficulties related to abrupt changes in traditional nursing pedagogy without sufficient preparation during the pandemic. In addition, nursing faculty members were worried about academic progress and the effectiveness of remote learning [18, 20, 22]. In the included studies, many nursing faculty members reported that their theoretical and clinical courses were disrupted [15, 18]. There are limitations to remote teaching in nursing programs, which traditionally emphasize hands-on experience and face-to-face care in clinical settings [15, 18]. Additionally, nursing students are required to learn and practice face-to-face communication and interactions with patients during clinical practicums [18]. These results are congruent with the findings of previous studies\u0026nbsp;that reviewed nursing students\u0026rsquo; perspectives on learning during the pandemic. According to a scoping review by Joo [5], nursing students also worried about their academic progress during\u0026nbsp;the pandemic. Likewise, learning about these basic and essential skills, such as hands-on experience and communication, was lacking among nursing students enrolled during the pandemic [16, 22]. Thus, the participants were worried about their students\u0026rsquo; learning outcomes. In other countries, such as Australia and Korea, qualitative studies have reported that nursing faculty members demonstrated uncertainty about the impact of alternative teaching and training during the pandemic [23. 24]. Similarly, a quantitative study compared the outcomes of final exam scores, grades, and assignments among nursing students in\u0026nbsp;the fall of 2019\u0026nbsp;and spring\u0026nbsp;of 2020 [25]. To reveal the rigorous\u0026nbsp;and clear impact of full-time remote and virtual learning, additional studies measuring and comparing learning outcomes before and during online learning are needed.\u003c/p\u003e\n\u003cp\u003eMoreover, many faculty members felt overwhelmed by heavy workloads and felt more frustrated, stressed, and exhausted than\u0026nbsp;they were before the pandemic.\u0026nbsp;Regardless of whether faculty members had previously experienced remote learning, it was challenging for them to transition\u0026nbsp;abruptly to\u0026nbsp;full-time teaching via remote learning and virtual simulation. In particular, when the pandemic started in the Spring Semester of 2020, faculty members did not have enough time to prepare for remote teaching; instead, they had to transition their teaching in only one or two weeks with limited help from IT services or apparent directions from institutes or principles [15]. A quantitative study reported that nursing faculty members worked significantly more hours during than before the pandemic [26]. They had to switch tasks, such as examinations, group assignments, or communication methods,\u0026nbsp;between students and other instructors [16, 18]. The experiences of nursing faculty members, nursing students, and nurses who abruptly faced the pandemic might be common to all nursing-related people [5, 9].\u003c/p\u003e\n\u003cp\u003eThe problems experienced by nursing faculty members during the pandemic were related to frustration and low satisfaction as nursing faculty members. Some participants in the included studies expressed low satisfaction due to heavy workloads and long working hours\u0026nbsp;in preparing, facilitating, and evaluating students online [16]. A survey\u0026nbsp;study reported that nursing faculty members\u0026rsquo; job satisfaction was significantly lower during than before the pandemic [26]. There\u0026nbsp;is evidence of the importance of job satisfaction; thus, it needs to be prioritized.\u003c/p\u003e\n\u003cp\u003eThe third and fourth themes, acceptance of and coping with the pandemic and the need for continuous and varied forms of support, focused on nursing faculty members\u0026rsquo; willingness to teach pedagogically and meet the quality expectations for nursing education. Even with the challenges brought about by the pandemic, faculty members tried to accept these emergent transitions in teaching and did their best to meet the goals of\u0026nbsp;the courses\u0026nbsp;for which they took responsibility [17-19]. While adapting to the pandemic, nursing faculty members requested sufficient and continuous support from nursing education administrators, IT services, and institutions. In addition, this review revealed that nursing faculty need continuous education regarding online tutoring and educational pedagogies at the national level (e.g., ACUE) (4). Moreover, owing to the emergent experiences of the pandemic, many nursing facilities have been subjected to traumatic stress and burnout [18, 26]; thus, these kinds of psychological support are also needed for nursing faculty members.\u003c/p\u003e\n\u003cp\u003eThe last theme, opportunities for the improvement of nursing education programs,\u0026nbsp;was highlighted in all\u0026nbsp;included studies. Several other studies have reported that the pandemic was devastating to nursing education, causing people to worry about academic progress and being nurses who graduated\u0026nbsp;from a nursing program [5]. This could lead to new opportunities and possibilities to research remote teaching services for future learning pedagogy beyond traditional learning methodologies [5, 19] and professional advancement for nursing faculty members. It is time to reassess traditional approaches to nursing education and evaluate the effectiveness of courses to determine the helpful elements for novice nurses [18, 27].\u003c/p\u003e\n\u003ch2\u003eLimitations\u003c/h2\u003e\n\u003cp\u003eThis study had several limitations. First, the included studies did not clearly identify the characteristics of the participants or\u0026nbsp;the nursing faculty. In the eight included\u0026nbsp;studies, we could not obtain sufficient information about participants\u0026rsquo; ages, sex, ethnicity, years of teaching experience, remote and virtual simulation teaching experience, or ability to access the Internet. Some of the participants in the included studies had experience in remote teaching. None of the included studies considered\u0026nbsp;the participants\u0026rsquo;\u0026nbsp;computer skills.\u003c/p\u003e\n\u003cp\u003eSecond, this study\u0026nbsp;only reviewed\u0026nbsp;studies conducted with nursing faculty in the United States. Thus, the themes highlighted in this review may not apply to other countries. The United States had already implemented hybrid nursing programs before the pandemic; however, some countries only recently started remote learning because of the pandemic. There may be different aspects from those in other developed or undeveloped countries. This is why the studies reviewed were limited to those conducted in the United States. Therefore, the results of this review may not be generalizable to other countries.\u003c/p\u003e\n\u003cp\u003eThird, due to the limited number of qualitative studies comparing nursing faculty members\u0026rsquo; experiences\u0026nbsp;during the pandemic\u0026nbsp;with those of nurses or nursing students, the studies included nursing faculty members\u0026rsquo; perspectives on the transition teaching of theoretical and clinical courses. There might be a different perspective from didactic to remote and from on-ground to virtual transitions.\u003c/p\u003e\n\u003ch2\u003eRecommendations and Implications for Nursing\u003c/h2\u003e\n\u003cp\u003eDespite the above limitations, the themes extracted from this review were common among the included studies. The themes included broad aspects of emergent transitions in teaching in the United States. The results of this review can be utilized to improve remote teaching and develop new pedagogies for nursing education for nursing faculty members and students.\u003c/p\u003e\n\u003cp\u003eNursing and educational associations should continuously provide guidance and support, even after the pandemic. Preparing for future crises is\u0026nbsp;also recommended. In the United States, the American Association of Colleges of Nurses released\u0026nbsp;guidelines for nursing schools to deliver didactic and clinical content virtually in March 2020 (Farber 2022), and the Center for Reading and Learning Association provided training for nursing faculty members (Hawkins 2022). Likewise, continuous support at the institutional and national levels is recommended for nursing faculty members to overcome the difficulties brought about by the pandemic and any unexpected future crises.\u003c/p\u003e\n\u003cp\u003eNursing research is also required to identify the impact of remote learning on student outcomes. Additionally, evaluating the effectiveness of and identifying the benefits or barriers associated with new learning pedagogies is vital. In addition, economic, physical, and psychological support are recommended for nursing faculty members to develop their teaching methods. Thus, additional empirical research and institutional and political support are needed to overcome the current difficulties of remote learning and prepare for future pandemics.\u003c/p\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eThis review is the first qualitative synthesis to identify common themes from nursing faculty members\u0026rsquo; perspectives and experiences with education during the COVID-19 pandemic. Nursing faculty members, nurse leaders, and nursing colleges can utilize the findings of this qualitative systematic review to determine the importance of the current\u0026nbsp;status of remote teaching\u0026nbsp;and provide support to nursing faculty during current and future pandemics. Additionally, the barriers and facilitators of nursing education identified in this review can be used to develop nursing programs and new pedagogies for future nursing education.\u003c/p\u003e\n\u003cp\u003eFurthermore, this review contributes evidence on nursing faculty members\u0026rsquo; teaching experiences during the pandemic. While this review was limited to the United States, there are few qualitative studies on nursing faculty members during the pandemic (Australia and South Korea), and few quantitative studies have been conducted that have targeted nursing faculty members. However, further studies with qualitative and quantitative evidence are needed on this topic.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.63242375601926%\" valign=\"top\"\u003e\n \u003cp\u003eWHO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.36757624398074%\" valign=\"top\"\u003e\n \u003cp\u003eWorld Health Organization\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.63242375601926%\" valign=\"top\"\u003e\n \u003cp\u003eCOVID-19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.36757624398074%\" valign=\"top\"\u003e\n \u003cp\u003eCoronavirus disease\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.63242375601926%\" valign=\"top\"\u003e\n \u003cp\u003ePRISMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.36757624398074%\" valign=\"top\"\u003e\n \u003cp\u003ePreferred Reporting Items for Systematic Reviews and Meta-Analyses\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.63242375601926%\" valign=\"top\"\u003e\n \u003cp\u003eMeSH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.36757624398074%\" valign=\"top\"\u003e\n \u003cp\u003eMedical subject headings\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.63242375601926%\" valign=\"top\"\u003e\n \u003cp\u003eCASP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.36757624398074%\" valign=\"top\"\u003e\n \u003cp\u003eCritical Appraisal Skills Program Qualitative Research Checklist\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable to this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTitle page\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eTimeline: WHO\u0026rsquo;s COVID-19 response [Internet]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline\u003c/li\u003e\n\u003cli\u003eWatson R, Hayter M. The COVID‐19 epidemic of manuscripts. J Adv Nurs. 2020 Jun 12;76(10):2454\u0026ndash;5. Available from: https://doi.org/10.1111/jan.14437\u003c/li\u003e\n\u003cli\u003eEbrahim SH, Ahmed QA, Gozzer E, Schlagenhauf P, Memish ZA. Covid-19 and community mitigation strategies in a pandemic. The BMJ. 2020 Mar 17;m1066. Available from: https://doi.org/10.1136/bmj.m1066\u003c/li\u003e\n\u003cli\u003eGeddes L. COVID-19 is no longer a Public Health Emergency of International Concern. Does this mean the pandemic is over? VaccinesWork. 2023 [cited 2024 Jan 12]. Available from: https://www.gavi.org/vaccineswork/covid-19-no-longer-public-health-emergency-international-concern-does-mean-pandemic?gclid=CjwKCAiA7t6sBhAiEiwAsaieYvmw0R4LjOkgloZcxj_buLedXcSODK6Ps8Qiw_ZRjzxOgixWFvAJRBoCGesQAvD_BwE\u003c/li\u003e\n\u003cli\u003eJoo JY. Abrupt transition to remote learning in nursing students during the COVID-19 pandemic. J Nurs Educ. 2023 Nov 14;1\u0026ndash;8. Available from: https://doi.org/10.3928/01484834-20231031-01\u003c/li\u003e\n\u003cli\u003eRomli MH, Foong CC, Hong WH, Subramaniam PL, Yunus FW. Restructuring education activities for full online learning: findings from a qualitative study with Malaysian nursing students during Covid-19 pandemic. BMC Med Educ. 2022 Jul 11;22(1). Available from: https://doi.org/10.1186/s12909-022-03587-1\u003c/li\u003e\n\u003cli\u003eACEN Accreditation Manual \u0026ndash; Glossary \u0026ndash; Accreditation Commission for Education in Nursing. Available from: https://www.acenursing.org/acen-accreditation-manual-glossary/#:~:text=Faculty%2C%20Nursing%20%E2%80%93%20Nurses%20who%20teach,Administrator%20and%20Nursing%20Program%20Coordinator.\u003c/li\u003e\n\u003cli\u003eDe Castro AB, Shapleigh E, Bruck AM, Salazar MK. Developing blended online and classroom strategies to deliver an occupational Health nursing overview course in a Multi-State region in the United States. Workplace Health Saf [Internet]. 2015 Mar 1;63(3):121\u0026ndash;6. Available from: https://doi.org/10.1177/2165079915576919\u003c/li\u003e\n\u003cli\u003eJoo JY, Liu MF. Nurses\u0026rsquo; barriers to caring for patients with COVID‐19: a qualitative systematic review. Int Nurs Rev. 2021 Jan 8;68(2):202\u0026ndash;13. Available from: https://doi.org/10.1111/inr.12648\u003c/li\u003e\n\u003cli\u003eButler AE, Hall H, Copnell B. A guide to writing a Qualitative Systematic Review Protocol to Enhance Evidence‐Based Practice in Nursing and Health Care. Worldviews on Evid Based Nurs. 2016 Jan 20;13(3):241\u0026ndash;9. Available from: https://doi.org/10.1111/wvn.12134\u003c/li\u003e\n\u003cli\u003eThomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008 Jul 10;8(1). Available from: https://doi.org/10.1186/1471-2288-8-45\u003c/li\u003e\n\u003cli\u003ePage MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann T, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. The BMJ. 2021 Mar 29;n71. Available from: https://doi.org/10.1136/bmj.n71\u003c/li\u003e\n\u003cli\u003eCASP Checklists - Critical Appraisal Skills Programme [Internet]. CASP - Critical Appraisal Skills Programme. Available from: https://casp-uk.net/casp-tools-checklists/\u003c/li\u003e\n\u003cli\u003eWalker J. Systematic reviews in the social sciences: A practical guide ‐ by Petticrew, M. and Roberts, H. Sociol Health Illn. 2007 Mar 1;29(2):318\u0026ndash;9. Available from: https://doi.org/10.1111/j.1467-9566.2007.498_4.x\u003c/li\u003e\n\u003cli\u003eChristoffers C. Practical implications of online learning with nurses during coronavirus disease 2019. Nurs Clin North Am. 2023;58:107\u0026ndash;19\u003c/li\u003e\n\u003cli\u003eGazza EA. The experience of being a Full-Time Academic Nurse educator during the COVID-19 pandemic. Nurs Educ Perspect. 2022;43:74\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eHopkins E, Spadaro KC, Hoh NZ, Singh A, Doas M. Nursing faculty experiences transitioning to a virtual DNP residency during COVID-19. J Dr Nurs Pract. 2022;15:26\u0026ndash;31.\u003c/li\u003e\n\u003cli\u003eIheduru-Anderson K, Foley JA. Transitioning to full online teaching during COVID-19 crisis: The associate degree nurse faculty experience. Glob Qual Nurs Res. 2021;8:233339362110575.\u003c/li\u003e\n\u003cli\u003eMcKay M, Pariseault CA, Whitehouse CR, Smith TL, Ross JG. The experience of baccalaureate clinical nursing faculty transitioning to emergency remote clinical teaching during the COVID-19 pandemic: Lessons for the future. Nurs Educ Today. 2022;111:105309.\u003c/li\u003e\n\u003cli\u003ePowers K, Pate K, Montegrico J, Pagel J. Faculty perceptions of the impact of the COVID-19 pandemic on new graduate nurses\u0026rsquo; transition to practice: A qualitative study. J Prof Nurs. 2022;43:33\u0026ndash;41.\u003c/li\u003e\n\u003cli\u003eSacco TL, Kelly MM. Nursing faculty experiences during the COVID-19 pandemic response. Nurs Educ Perspect. 2021;42:285\u0026ndash;90.\u003c/li\u003e\n\u003cli\u003eSessions LC, Ness M, Mark H. Exploring the experiences of nursing faculty during the coronavirus (COVID-19) pandemic\u0026mdash;A qualitative descriptive study. Teach Learn Nurs. 2022;17:477\u0026ndash;81.\u003c/li\u003e\n\u003cli\u003eChoi S-Y, Jin S, Kim J. Laboratory and clinical teaching experience of nursing professors in the COVID-19 pandemic era: Now and the future. Front Public Health. 2022;10: 961443. Available from: https://doi: 10.3389/fpubh.2022.961443. eCollection 2022..\u003c/li\u003e\n\u003cli\u003eRidgway L, McKenna L, Hokke S, Hackworth N, Nicholson JM. Maternal and Child Health Nursing education before and during COVID-19: An exploratory descriptive study. J Prof Nurs. 2022 Jul 1;41:100\u0026ndash;7. Available from: https://doi.org/10.1016/j.profnurs.2022.04.007\u003c/li\u003e\n\u003cli\u003eCygan H, Bejster M, Tribbia C, Vondracek H. Impact of COVID‐19 on public health nursing student learning outcomes. Public Health Nurs. 2021 Oct 6;39(2):481\u0026ndash;7. Available from: https://doi.org/10.1111/phn.12978\u003c/li\u003e\n\u003cli\u003eFarber J, Payton C, Dorney P, Colancecco E. Work-life balance and professional quality of life among nurse faculty during the COVID-19 pandemic. J Prof Nurs [Internet]. 2023 May 1;46:92\u0026ndash;101. Available from: https://doi.org/10.1016/j.profnurs.2023.03.005\u003c/li\u003e\n\u003cli\u003eHopkins E, Wasco JJ, Spadaro KC, Fisher M, Walter L, Piotrowski M. Crisis response to COVID-19: Elements for a successful virtual event transition. J Nurs Educ Prac [Internet]. 2020 Nov 19;11(3):36. Available from: https://doi.org/10.5430/jnep.v11n3p36\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 2 and 3 are available in the Supplementary Files section.\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"COVID-19, Experience, Nurse faculty, Perspective, Qualitative research, Qualitative synthesis, Qualitative systematic review","lastPublishedDoi":"10.21203/rs.3.rs-3865510/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3865510/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe coronavirus disease 2019 (COVID 19) pandemic led to lockdowns and other social distancing measure. Nursing education programs were also disrupted and moved online. However, information and understanding of nursing faculty members\u0026rsquo; experiences of the emergent transition from didactic to remote teaching during the COVID-19 pandemic is limited. Therefore, this qualitative systematic review aimed to synthesize qualitative studies on nursing faculty members\u0026rsquo; experiences during the COVID-19 pandemic in the United States.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eEight qualitative studies published between January 2020 and the end of December 2023 in the United States were selected from five electronic databases and synthesized based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and Thomas and Harden thematic synthesis methods. This study was reviewed and registered in PROSPERO.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eEight primary and empirical qualitative studies published between 2021 and 2023 were included. The included studies were conducted in various regions of the United States and involved nursing faculty members working in nursing programs. Based on the experiences of 230 nursing faculty members, five common themes were identified: (1) concerns about changes in traditional nursing pedagogy, (2) overwhelmingly heavy workloads, (3) acceptance of and coping with the pandemic, (4) the need for continuous and various forms of support, and (5) opportunities for the improvement of nursing programs.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThese themes can be utilized by educational administrators to reidentify the challenges that nursing faculty face and to reform nursing education programs as well as nursing educational associations and institutes to improve current teaching and direct new learning methods to prepare for future pandemics.\u003c/p\u003e","manuscriptTitle":"Nursing faculty experiences with emergent remote teaching transitions during the COVID-19 pandemic: A qualitative systematic review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-19 04:14:53","doi":"10.21203/rs.3.rs-3865510/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"589688d8-e23b-4fa3-a175-4b64ada103a4","owner":[],"postedDate":"January 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-06-03T05:42:23+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-19 04:14:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3865510","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3865510","identity":"rs-3865510","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}