Author ORCID Identifier

Elizabeth Moxley:

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Nurse Education Today


Background: To maintain curricular integrity in response to COVID-19, nurse educators are increasingly required to transition from traditional (face-to-face) to virtual pedagogy. Objectives: The purpose of this analysis was to compare the HESI scores based on a traditional pedagogy with the HESI scores following implementation of virtual pedagogy during Spring 2020. Methods: Student (n = 115; 81% female; mean age = 25.71 years) HESI scores were compared after each eightweek session using the Mann Whitney U test, permutation test and Wilcoxon rank test. Logistic regression was used to identify students achieving at least 850. Chi-square test was used to determine the relationship between pedagogy and students meeting 850 HESI scores. Fall 2019 Exit HESI scores were also compared with Spring 2020 Exit HESI scores. Results: Students from diverse backgrounds (53.9% White; 27.8% Hispanic; 10.4% Asian; 5.2% Black; 1% Unknown) increased (p = 0.022) MHESI scores following virtual pedagogy in Fundamentals, although no difference was found in Maternity (p = 0.311), Psychiatric (p = 0.129) or Medical Surgical Nursing (p = 0.692). Wilcoxon rank test revealed significant differences in MHESI scores in same cohort of students between traditional (Psychiatric) and virtual strategies (Medical-Surgical) (p < 0.01); and traditional (Medical-Surgical) and virtual (Psychiatric) strategies (p = 0.023). White students’ MHESI scores were higher than Asian students’, as revealed by Logistic regression with no differences based on gender. Spring 2020 and Fall 2019 Exit HESI scores were comparable (p = 0.499). Chi-square analysis revealed no relationship between pedagogy and achieving at least 850 on HESI (χ2 = 0.027, p = 0.871). Conclusions: Based on the exit HESI scores, virtual pedagogy was as effective as traditional pedagogy for maintaining student competency in a community college associate degree nursing program. Future analyses of the effectiveness of virtual pedagogy in meeting curricular outcomes is warranted, regardless of exit degree option.

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©2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license The version of record can be found at

Original Citation

Moxley, E., Saravanan, A., Habtezgi, D., Dixon, L., Miller, J., & Waller, M. (2021). Virtual pedagogical strategies and HESI student outcomes in response to COVID-19. Nurse Education Today, 104, 1-7.


School of Nursing





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