Transforming standard pedagogy because of the COVID-19 pandemic: How social presence could establish and apply Watson's theory within the virtual classroom.

Social distancing requirements during the Covid-19 pandemic have made virtual teaching the only means available whereby students' health can be protected as they continue their education. Two key areas to be addressed for those seeking to teach effectively online are: establishing social presence and building from that to extend care toward learners. This paper examines practical ways in which these aims may be achieved, and will hopefully promote the debate and sharing of strategies and pedagogy between nursing educators.

INTRODUCTION

The global COVID-19 pandemic has presented challenges in delivering undergraduate nursing education, some of which refer to creating social presence and providing learners with caring support. For most nursing education institutions, including many in Hong Kong, these are completely new challenges, as online education is generally not employed in this field. Since in-person teaching has been suspended over the past several months, to protect students and prevent the spread of COVID-19, teachers are faced with practical concerns of finding ways to use virtual environments to effectively educate students so that they still feel connected to both their peers and teachers.

There is one way through which dedicated nursing educators could create a caring atmosphere with "social presence" in their online classrooms—namely, they could formulate means through which the philosophy of Watson's theory of transpersonal caring (Watson, 1996) could be applied during this unique and crucial time. This paper addresses these issues by advancing possible modifications to the delivery mode of undergraduate nursing programs. It presents existing knowledge from relevant literature and makes practical proposals for ways virtual teaching methods could be employed to assist nursing educators globally.

Need for connection

Regarding online teaching environments, social presence represents how participants feel about, perceive, and react to others in the classroom; how much they feel they can project their personality as if they were in a real-world classroom (Mayne and Wu, 2011). Feelings of isolation and the feeling that their actions are not “real” are common among online students (Cobb, 2011). Additionally, concerns they may have made errors in their online submissions increase anxiety, and students may miss feeling personally connected to their teachers and peers. Therefore, encouraging a sense of social presence is challenging for teachers, as it represents an emotional response generated by feeling cared for and needed.

In online classrooms, standard netiquette applies, representing the generally accepted guidelines for conducting oneself online when visual and tonal clues are absent. Students have a name but no facial representation; thus, many key visual guides that help us assess meaning are absent (e.g., eye contact, body language, facial expressions). Distance between teachers and students and limited communication make it difficult to establish social presence. Additionally, if students email questions, they may not receive answers right away as in a classroom.

A distinct positive correlation exists between students’ academic performance and feelings of social presence/connectedness (Joksimović et al., 2015). Contrastingly, when students do not experience the teacher's physical presence and do not feel they can socialize within online classrooms, it can decrease their study motivation and increase the likelihood of failure (Capra, 2011).

Evidence-based guidance regarding creating social presence within virtual environments remains scant in nursing literature. Teachers may consider creatively using various strategies to create social presence. One example is compensating for the lack of vocal tones and body language using punctuation, text-speak acronyms, and emoticons. Basic language that makes an individual feel cared for and part of a community is useful, for example, “Good to see you” or “Look after yourself.” A mixture of time-delayed and real-time communication may be preferable for students to create a feeling of social presence, rather than using time-delayed communication alone. Online chat rooms, discussion boards, emails, and video calling via services such as Facetime, Skype, WhatsApp, Blackboard, and Zoom can also boost social presence. Video calling can provide students with an outlet for self-expression and make them feel less isolated. Teachers can develop a feeling of trust and community for students by encouraging discussions, greeting and praising students, and offering a forum for students to express their viewpoints. From a humanistic perspective, a sense of community may be created when both students and teachers share some of their everyday stressors amid COVID-19, work collaboratively on assignments, and share encouraging quotes. This is a reciprocal process; social presence is not only created by the feeling of being welcomed and cared for, but also by the opportunities one receives to welcome, care for, and share information with others.

PEDAGOGY OF CARE

Although caring is central to professional nursing values, the wisdom and methodology that create “caring” are difficult to define (Swanson, 1991; Watson, 2002). Now is an appropriate time to apply this concept of caring with the current demands for online teaching and develop practical measures within virtual teaching environments. The theory of transpersonal caring (Watson, 1996) is founded on a value system that rejects paternalism and promotes individual autonomy, development, and freedom of choice. Interpersonal therapeutic interactions are rooted in human caring, which in turn is founded on relationships, connections, and shared subjectivity.

For nursing education, caring is a shared process that evolves through interactions between students and teachers. Transpersonal caring arises when teachers model and exemplify care. Reciprocity and shared relationships create opportunities for care through caring interactions. Thus, transpersonal caring comprises the carative factors that characterize shared caring relationships that are central to nursing education. Table 1 shows the caritas processes, and an operational interpretation in an educational context has been proposed for each. Examples were used to clarify aspects in application.

Table 1

Pedagogical examples applying the caritas processes

Caritas processes®(Watson, 2008)	Operational interpretation proposed in an educational context	Examples
Embrace altruistic values and practice loving kindness with self and others.	Students treated with kindness as individuals of value and potential. Self-care is modeled by teachers and encouraged in students.	Errors may be made in students' work, or they may misinterpret an assignment's guidelines. When this happens, humor may be appropriate to acknowledge students' humanity and learner status. Teachers may consider how they wished to be treated when they were learners. Errors may be used as learning points that can be discussed either individually or in group to move learning forward.
Instill faith and hope, and honor others.	Students are honored, respected, and encouraged to see their own potential to add kindness and value to every situation.	With certain key assignments, students can be allowed to retake tests where they have not achieved as well as hoped, provided all students are aware of the diligence and effort required from the start. Teachers may recognize previous good work. An example of typical positive teacher feedback: “You have done really well in distinguishing the concepts discussed. No one is born a perfect nurse; indeed, there is no such thing. I am pleased with your progress. Keep discussing ideas with your classmates; this is the best way to develop and grow."
Be sensitive to self and others by nurturing individual beliefsand practices.	Promoting diversity and encouraging the search for meaning within one's environment.	Students may appreciate formative tasks or non-marked exercises helping them link theory and practice. Students may be allowed to pursue their own interests when choosing discussion or research topics. Teachers must recognize that offering such assignments within rigid framework discourages creativity and de-motivates some of the best learners who want to follow their own interests.
Develop helping-trusting-caring relationships.	Each student feels a connection with the teacher that gives them the confidence to inquire and explore.	Students’ questions are encouraged. Teachers can let students know how quickly they can expect answers and what follow-up procedures are available if no answer is received.
Promote and accept positive and negative feelings; authentically listen to another's story.	Open-ended, nonjudgmental, two-way communication.	Students may feel powerless and lonely without traditional personal contact; teachers must emphasize that they want to hear about their problems and are personally invested in helping to solve them. Students sometimes see teachers as too insular and lacking openness. Teachers may learn to show genuine appreciation of what their students do or experience.
Use creative scientific problem-solving methods for caring decision making.	Using creative pedagogy and methodology tailored to each individual student's needs.	Teachers must recognize that students may have difficulty understanding guidelines and resources, even when they are clear to the teacher. Textual communication can be treated like any other, as a mutual process requiring simplicity and clarity. Welcome questioning as a valuable part of the process.
Share teaching and learning that addresses the individual needs and comprehension styles.	Flexible methodologies have been created for each individual student's specific needs.	Many tools are available, and each learner will have a favorite. These include recorded lessons, personal interactions online, videos, articles, PowerPoints, and web links. Teaching can take place through discussion boards, testing, papers, assignments, quizzes, booklets, posters, etc. Students needing extra help may be offered individual time.
Create a healing environment for the physical and spiritual self that respects human dignity.	Creating a virtual classroom environment where safety, friendliness, and freedom of expression are paramount.	Students should have a clear understanding of how the course is structured and planned. Online resources may be designed for easy navigation. It should be easy for students to find course update information. Teachers may not just provide links, but explain their purpose; care should be taken that no dead links are provided. In progressive courses with modules, additional help may be offered to any students who fall behind.
Assist with basic physical, emotional, and spiritual human needs.	Teachers view each student as a complete person, and respect and care for all students’ needs, not just their educational requirements.	There is much more to teaching than the bottom line of results. Identifying what students require, helping them to share any worries and successes, and offering help when needed is essential. Online learning can be impersonal, and teachers must always remember that learners require human contact. Like patients, learners have spiritual requirements, and teachers can address these.

REAL-WORLD CHALLENGES

Over the previous year, the worldwide COVID-19 pandemic brought face-to-face teaching to a halt, and consequently, students and teachers adopted primarily, online means of contact. From my experience concerning feedback provision during two immediate past semesters, students appreciated simple, prompt, and positive feedback that was given (timely when they need) via instant messaging software (such as Twitter and WhatsApp) as compared to emails. This shift in the primary way of teacher-to-student communication is in sharp contrast to the old days when traditional face-to-face discussions at campus were more common and relied upon by nurse educators (particularly in Hong Kong). Moreover, students reflected that the quality of teacher support received during the pandemic crucially influenced their perceived extent of how much they are cared for along the learning discourse.

As shown in the students’ evaluation of several compulsory subjects, the aforementioned feedback from teachers conferred a sense of ‘connectedness’ to the school in the pandemic. The sense of connectedness was emphasized by a vast majority of junior and senior forms of students in the Bachelor of Nursing program. Many students also added that, in the pandemic, teachers’ feedback represents more than academic or learning assistance (i.e. to help them recognize the areas for improvement after an online learning activity); to a certain degree, it represents the social presence and compassion of teachers in the virtual learning environment. One student, for example, described his conception of social presence as “the embodied care in the humanistic dialogue between teachers and learners for a better mutual understanding of learning needs.” In certain compulsory courses such as Health Assessment in which a group project (with 5 to 6 students per group) was one of the formative assessments (accounting for 25% of the total subject mark), the social distancing regulations (which prohibit face-to-face interactions) are perceived by students as an obstacle in the learning process. This is especially so when group members have extremely different ideas and opinions regarding the direction of a project. Furthermore, group projects often have an established deadline, which imposes additional time pressure on the group. Students indicated that providing feedback in the form of a video (in which the teacher can be seen) was psychologically reassuring and vital for resolving misunderstandings between group members. Likewise, students reflected that they felt much more cared for and supported if teachers incorporate more sessions of synchronous discussions in their interactions with students (i.e., using a Learning Management System). Clark et al. (2015) suggested that video-post discussions and synchronous video conferencing could improve social presence significantly compared to text-based resources. Although offering caring feedback is essential for both social presence and the teacher's role as carer, this can be particularly difficult with less-abled students, as they may perceive all feedback as negative. Teachers may attempt to mitigate criticism with praise. When an atmosphere of mutual respect has been created, and teachers model caring behavior, nursing students become aware of their capacity for caring and ways they can incorporate their personal beliefs into a care system. Caring revolves around respect and acknowledging the value of others' contributions.

For teachers, teaching during the pandemic is also challenging in that they must make themselves available to students, which may be an issue for online learning. Many students appear to expect teachers to make themselves available whenever they are needed, no matter the time of day. Teachers who are not careful may become "consumed" by online teaching; although students are able to access their course materials 24/7, they should not expect their teachers to be available the same way. Thus, I would recommended that, at the start of a course, teachers establish a mutually accepted communication pattern with their students. This will enable students to work around any pre-defined virtual consultation hours and to be familiar with the process of raising questions or concerns. Many students also expressed to me that they favored teachers adopting more personal conversational formats in the course rather than very formal and academic formats that generate a sense of distance between teachers and students. Regarding online teaching, it is important to establish synchronous as well as asynchronous consultations to facilitate students' learning. Students may feel like they are part of a learning community if instructors actively guide discourse.

During the last year, I observed students inevitably enjoying increased anonymity when they studied online; this development could have positive as well as negative aspects. In real-time video lessons, using anonymous logins can give students confidence to ask questions; however, teachers should be wary of students using this anonymity to advance inappropriate opinions or attitudes during discussions. Thus, while students are encouraged to participate in discussions, they must learn to adopt professional behavior while learning through virtual classrooms.

CONCLUSION

Interacting via computers or other devices for online learning creates considerable differences in the standard dynamics of communication. Social presence helps to create the feeling of a human presence, thus facilitating opportunities to offer care in terms of help-trust-care relationships, as described in Watson's theory is useful. In turn, this gives students the confidence and security to be able to discuss and develop their ideas. Students can be shown the value of communication, and any issues can be addressed through honest and open dialogue. Students will feel more connected and motivated if feedback balances identifying areas that need improvement and praising students’ success. Teachers should also consider the various challenges associated with learning during a pandemic. While addressing the novel teaching and learning issues resulting from this critical moment, teachers are encouraged to view the students behind the screens as real human beings, treating them with the same care and respect that they would be afforded in a real-life teaching setting.

FUNDING

This research did not receive any funding.

AUTHOR CONTRIBUTIONS

YC Yip had the idea for the article, performed the literature search, prepared the entire manuscript, reviewed the manuscript critically, and approved the final manuscript.

DECLARATION OF INTERESTS

None.