**1. Introduction**

The emergence and effect of the SARS-CoV-2 coronavirus transformed educational approaches, as clinical settings were no longer available for internship, and nursing schools had to replace and reshape clinical scenarios [1] by reinventing strategies and adjusting teaching, learning, and assessment methods in nursing education [2,3].

It created unprecedented opportunities for nursing education as it required creative teaching techniques to promote students' clinical learning, ensuring that the necessary learning outcomes and professional competencies were achieved [4,5].

The traditional clinical practice and face-to-face experiences were replaced by technological environments, for both students and faculty, with screen-based simulation [4], remote or virtual simulated learning experiences using commercial products or telehealth [6], and technology-enhanced storyboard techniques [7]. Moreover, nursing schools were unprepared for remote instruction transition during the COVID-19 pandemic, which challenged their curricula [5].

The discipline of nursing focuses on human reactions to health disease occurrences and life processes, where face-to-face nursing care is vital [8]. Thus, training students who will be qualified nurses caring for people involves developing specific skills, reflecting on role-playing discussions, exchanging clinical experiences, professional and multidiscipline relationships, and critical thinking [8].

The pandemic raised numerous challenges in teaching nursing students, specifically in the clinical context. This new reality allowed [9] students to achieve the required clinical hours and therefore complete their degrees if they were senior students. On the other hand,

**Citation:** Lobão, C.; Coelho, A.; Parola, V.; Neves, H.; Sousa, J.P.; Gonçalves, R. Changes in Clinical Training for Nursing Students during the COVID-19 Pandemic: A Scoping Review. *Nurs. Rep.* **2023**, *13*, 378–388. https://doi.org/10.3390/ nursrep13010035

Academic Editors: Niall Higgins, Sonia Udod and Richard Gray

Received: 22 December 2022 Revised: 20 February 2023 Accepted: 22 February 2023 Published: 1 March 2023

**Copyright:** © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

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young nursing students had their clinical placements delayed due to rapid changes in the clinical environment. Conversely, lock-in policies forced junior students to discontinue or delay clinical education [9]. What alternatives were offered to these students?

According to JBI methodology and the previously published review protocol [10], we conducted a scoping review to map the changes in clinical training for undergraduate nursing students during the COVID-19 pandemic.

Moreover, it would be relevant to do this mapping at any level of education. The focus on undergraduate students is because the fundamentals of nursing are acquired in this period. During training, when undergraduate students receive the information and abilities that set nurses apart from laypeople as professional healthcare providers, it is a crucial time in the professional development of nursing students [11]. If it is compromised, the repercussions will manifest from the base of the nursing profession.

This review aims to understand how faculties adapted curricula to face the problem of inaccessibility to clinical settings and how academics developed programs to target clinical teaching, learning, and assessment strategies for nursing students in similar contexts. This map identified relevant topics on nursing education strategies to improve nursing students' knowledge development and helped identify potential research gaps. This mapping will support, in the near future, comparison studies between changes in teaching before and after the pandemic, and comparison studies between changes implemented temporarily and those which "came to stay".

An initial search of MEDLINE (PubMed), the J.B.I. Evidence Synthesis, the Cochrane Database of Systematic Reviews, PROSPERO, and Open Science Framework (O.S.F.) revealed that, currently, there are no scoping reviews or systematic reviews (published or in progress) about this subject [12–14].

This scoping review was developed to answer the following questions:


#### **2. Materials and Methods**

The JBI latest guidance methodology guided this scoping review [12–14], and was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines [15]. This review protocol has been previously published [10].
