[Development of Clinical Practice in Adult Nursing (Chronic Care) During the COVID-19 Pandemic - Building and Implementing an Online Training Program].

The Department of Nursing, School of Health Sciences, University of Occupational and Environmental Health provides the specialized course "Clinical Practice in Adult Nursing (Chronic Care)" as a compulsory subject for third- and fourth-year students to acquire the basic skills required in nursing practice for adult patients with chronic diseases. Students are trained in hospital wards and in outpatient medical departments/admission support units for a total of 3 weeks to communicate directly with patients with chronic diseases, and to deepen their learning about the specialty of chronic nursing care. The COVID-19 pandemic forced the Department of Nursing to hold prompt discussions and determine an appropriate method to provide clinical training under this situation. It decided to cancel the conventional face-to-face training program, which was scheduled to start in May 2020, and to implement an online training program instead. Remote training was provided using the online conferencing system Zoom. The online training program was designed to realize simultaneous bidirectional training. To prepare for the training, simulated cases and simulated medical records were created. Faculty members played the roles of "simulated patients", "clinical supervisors", and "faculty members", while adopting elaborate approaches to help students develop nursing practice in real time. As a result, students were able to participate in training with a real feeling, even in an online environment, as they communicated with simulated patients daily, similarly to the case of clinical training. They also realized the limitations of learning without using the five physial senses and providing patient support with appropriate timing, revealing challenges specific to online training.