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ABSTRACT
Background: The use of serious gaming in a virtual
world is a novel pedagogical approach in nursing educa-
tion. A virtual gaming simulation was implemented in a
health assessment class that focused on mental health
and interpersonal violence. The study’s purpose was to ex-
plore students’ experiences of the virtual gaming simula-
tion. Method: Three focus groups were conducted with a
convenience sample of 20 rst-year nursing students after
they completed the virtual gaming simulation. Results:
Analysis yielded ve themes: (a) Experiential Learning, (b)
The Learning Process, (c) Personal Versus Professional, (d)
Self-Ecacy, and (e) Knowledge. Conclusion: Virtual gam-
ing simulation can provide experiential learning opportu-
nities that promote engagement and allow learners to ac-
quire and apply new knowledge while practicing skills in a
safe and realistic environment. [J Nurs Educ. 2017;56(5):274-
280.]
Simulation offers a safe learning environment for nursing
students to apply knowledge, advance their skills, and re-
flect on clinical decision making while receiving imme-
diate feedback (Hayden, Smiley, Alexander, Kardong-Edgren,
& Jeffries, 2014; Nelson, 2016). Many types of simulation ex-
ist, including high fidelity, often set in a laboratory (Cant &
Cooper, 2009; McGovern, Lapum, Clune, & Schindel-Martin,
2013); however, challenges are involved, such as costs related
to creating, operating, and maintaining simulation laboratories
(Gates, Parr, & Hughen, 2012). Other nontraditional simulation
approaches in nursing education include computerized virtual
learning using Second Life® and avatar-based programs, as well
as serious gaming modalities (De Gagne, Oh, Kang, Vorder-
strasse, & Johnson, 2013; Nelson, 2016; Tiffany & Hoglund,
2016). Although these tools offer novelty and are adaptive to
student learning, a paucity of research that examines students’
experiences of virtual gaming simulation exists.
Games have been integrated into nursing curricula for many
years to motivate students and increase knowledge retention, as
well as to promote active learning, problem solving, and critical
thinking skills (Royse & Newton, 2007). More recently, com-
puterized serious gaming has been used as a way to actively
engage students and support learning (Johnston, Boyle, MacAr-
thur, & Manion, 2013). Through a virtual world, students par-
ticipate in a clinical scenario on a computer screen. The advan-
tages of online serious gaming include its vast accessibility, its
potential to provide individualized learning adaptive to student
responses, and the preservation of patient safety. Evidence has
indicated that virtual gaming can be used as a tool to promote
student engagement and advance problem-solving and deci-
sion-making capacity (Duff, Miller, & Bruce, 2016).
The current study explored student experiences of a virtual
gaming simulation (VGS) of a community home visit that was
part of a health assessment course in a collaborative undergrad-
uate nursing program across three institutional sites. The year-
long health assessment course included an in-person lecture and
a laboratory component. In addition, 3 weeks were completed
via online modalities. VGS was one of the online modalities
that students completed independently. Students were provided
in-person instructions before completing the VGS and opportu-
nities to ask questions or make comments about the activities.
All students received a .05% mark of a final course grade if
Virtual Gaming Simulation in Nursing
Education: A Focus Group Study
Margaret Verkuyl, NP-PHC, MN; Michelle Hughes, MEd, RN;
Joyce Tsui, MN, RN; Lorraine Betts, MN, RN; Oona St-Amant, PhD, RN;
and Jennifer L. Lapum, PhD, RN
Received: October 7, 2016
Accepted: January 5, 2017
Ms. Verkuyl, Ms. Hughes, and Ms. Tsui are Professors, Collaborative
Nursing Degree Program, Centennial College; Ms. Betts is Nursing Pro-
fessor, Saly Horsfall Eaton School of Nursing, George Brown College;
Dr. St-Amant is Assistant Professor, and Dr. Lapum is Associate Professor,
Daphne Cockwell School of Nursing, Ryerson University, Toronto, On-
tario, Canada.
The authors thank Ryerson University’s G. Raymond Chang School
of Continuing Education for assisting in the development of the virtual
gaming simulation. The authors also thank Interpersonal Skills Teach-
ing Centre: Live-actor Simulation Program for contributing to the virtual
gaming simulation, the Centennial College School of Community and
Health Studies for funding this study, and the nursing students who con-
tributed their time to participate in the study.
Address correspondence to Margaret Verkuyl, NP-PHC, MN, Profes-
sor, Collaborative Nursing Degree Program, Centennial College, PO Box
631, Station A, Toronto, Ontario, Canada, M1K 5E9; e-mail: MVerkuyl@
centennialcollege.ca.
doi:10.3928/01484834-20170421-04
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