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Using Virtual Interactive Digital Simulator to Enhance Simulation Experiences for Undergraduate Nursing Students
Abstract
It is increasingly difficult to find quality clinical placements that allow nursing students to work with high acuity patients. To address this need, simulation is recommended; however, human patient simulation is costly from a human and resource perspective. In a search for alternatives, we offered a simulation experience using a virtual interactive digital simulator and evaluated student outcomes. This emerging technology, although not intended to replace human patient simulation, shows promise in enabling easier, more self-directed access to simulation for students.
... Dentre as diferentes estratégias de simulação, destaca-se as simulações virtuais no ensino da enfermagem. As simulações virtuais inserem o aluno em uma realidade e vêm sendo utilizadas em simulações cirúrgicas, havendo a necessidade de computação gráfica para replicar um procedimento (BRANDÃO; COLLARES; MARIN, 2014). Dos simuladores destacados por McLaughlin, Fitch e Gordon (2008), os do tipo paciente virtual parecem ser os que melhor se adaptam à realidade educacional, tendo em vista que, para serem utilizados, necessitam somente de um computador ou telefone celular, com acesso à internet. ...
... Sua escolha é então realizada e é fornecida uma resposta apropriada, permitindo que os alunos continuem com sua avaliação ou plano de tratamento ou reavaliam suas decisões e mudam de direção na maneira como prestam assistência. Os alunos podem escolher um banco de cenários criados pelo desenvolvedor da ferramenta, como pacientes com problemas respiratórios, e podem definir a duração do cenário (BETTS et al., 2020). ...
A simulação tem o potencial para desenvolver conhecimentos, habilidades e atitudes que auxiliem na formação de um profissional crítico e reflexivo, inserindo o estudante em diferentes contextos assistenciais. O objetivo geral desta pesquisa foi analisar as percepções dos estudantes de enfermagem quanto à resolução do caso clínico pelo simulador virtual. Trata-se de um estudo com abordagem qualitativa, com 40 estudantes de enfermagem de uma universidade do Sul do Brasil, por meio de entrevista. A análise de conteúdo permitiu identificar cinco subcategorias temáticas, dois subtemas e um tema. A experiência foi considerada mais proveitosa quando comparada com a forma que, atualmente, o conteúdo é ministrado em sala de aula, e emergiram dificuldades quanto à interface do simulador virtual e na realização do processo de enfermagem. A simulação virtual pode contribuir para a análise e a interpretação do estudo de caso, possibilitando o exercício do raciocínio clínico e da tomada de decisão.
... The simulations were available online, making the orientation package more sustainable than using mannikins, which Diaz et al. [17] found successful but which required a physical staff presence to engage students with the simulation. Mannikin simulations have also been found to be costly [32]. Our approach made the learning package cheaper, more accessible, and able to be completed anywhere and at the student's convenience. ...
Background:
Nursing students and nurse preceptors indicate that a comprehensive orientation is vital to successful work-integrated learning placements in Prison Health Services. The aim of this study was to implement and evaluate a Prison Health Service orientation package that included innovative asynchronous online video simulations with branched decision-making and feedback opportunities to stimulate learning and improve students' feelings of preparedness for a placement in this setting.
Methods:
A cross-sectional pre and post design was used to evaluate the resource. Students were given access to the package and invited to complete a pre-placement survey evaluating the resource and their feelings of preparedness for placement. Following placement, they re-evaluated the resource in terms of how well it prepared them for the placement and how well prepared they felt. Third year Australian undergraduate nursing students from one university who completed a Prison Health Service work-integrated learning placement in 2018, 2021, and 2022 were invited to participate. Placements were unavailable in 2019 and 2020. Independent t-tests were used to determine differences in scale means and level of preparedness between pre- and post-survey responses.
Results:
Twenty-three of 40 (57.5%) eligible nursing students completed the pre-placement survey and 13 (32.5%) completed the post placement survey. All respondents to the pre-placement survey indicated that they felt satisfactorily, well, or very well prepared after completing the orientation package prior to their clinical placement. Students were significantly more likely to consider themselves well prepared by the package after they had attended placement (p < .001). All students post placement indicated that overall, the simulation resources and the specific simulation scenario about personal boundaries and management of manipulative behaviours was useful for their placement. The majority of students would recommend the orientation package to other students. Suggestions for improvement included streamlining the resource to reduce the time to complete it.
Conclusions:
Asynchronous online simulation with the capacity for branched decision making and feedback along with a comprehensive online orientation package were perceived as useful to prepare undergraduate students for placement in the Prison Health Service work-integrated learning setting.
... The simulations were available online, making the orientation package more sustainable than using mannikins, which Diaz et al. (17) found successful but which required a physical staff presence to engage students with the simulation. Mannikin simulations have also been found to be costly (32). Our approach made the learning package cheaper, more accessible, and able to be completed anywhere and at the student's convenience. ...
Background
Nursing students and nurse preceptors indicate that a comprehensive orientation is vital to successful work-integrated learning placements in Prison Health Services. The aim of this study was to implement and evaluate a Prison Health Service orientation package that included innovative asynchronous online video simulations with branched decision-making and feedback opportunities to stimulate learning and improve students’ feelings of preparedness for a placement in this setting.
Methods
A cross-sectional pre and post design was used to evaluate the resource. Students were given access to the package and invited to complete a pre-placement survey evaluating the resource and their feelings of preparedness for placement. Following placement, they re-evaluated the resource in terms of how well it prepared them for the placement and how well prepared they felt. Third year Australian undergraduate nursing students from one university who completed a Prison Health Service work-integrated learning placement in 2018, 2021, and 2022 were invited to participate. Placements were unavailable in 2019 and 2020. Independent t-tests were used to determine differences in scale means and level of preparedness between pre- and post-survey responses.
Results
Twenty-three of 40 (57.5%) eligible nursing students completed the pre-placement survey and 13 (32.5%) completed the post placement survey. All respondents to the pre-placement survey indicated that they felt satisfactorily, well, or very well prepared after completing the orientation package prior to their clinical placement. Students were significantly more likely to consider themselves well prepared by the package after they had attended placement (p < .001). All students post placement indicated that overall, the simulation resources and the specific simulation scenario about personal boundaries and management of manipulative behaviours was useful for their placement. The majority of students would recommend the orientation package to other students. Suggestions for improvement included streamlining the resource to reduce the time to complete it.
Conclusions
Asynchronous online simulation with the capacity for branched decision making and feedback along with a comprehensive online orientation package were perceived as useful to prepare undergraduate students for placement in the Prison Health Service work-integrated learning setting.
... As such, researchers have undertaken examinations to determine the extent to which simulations of varying levels of fidelity impact desired learning outcomes [4]. However, there is a need for continued examination about how we can comprehend and leverage the value simulations offer in advancing clinical nursing education [5], [6]. ...
Simulations are widely adopted in undergraduate nursing education because they offer low-risk, experiential ways to expose pre-licensure students to clinical environments, and to situate the development of requisite knowledge and skills for patient care. Virtual reality (VR) simulations present novel opportunities for clinical education. Research in this area is burgeoning around questions related to perception about VR modality, adoption of the technology, and educational outcomes VR simulations can help facilitate. In this paper, we demonstrate the application of epistemic network analysis (ENA), a quantitative ethnography (QE) technique, to model how one nursing educator facilitated clinical judgment, and nurtured quality and safety education for nurses’ competencies through the use of the Simulation Leaning System with Virtual Reality (SLS with VR). We modeled the discourse obtained from three simulation sessions in October and November 2020, all involving a fundamentals scenario requiring second-year nursing students to practice basic assessment and care management. Our work aims to advance research in healthcare education, particularly nursing education, using immersive learning environments by way of applying theory-backed learning analytic techniques.
Soft skills training is considered important for employees to be successful at work. Several companies are offering immersive virtual soft skills training with head-mounted displays. The main contribution of this paper is to provide an overview of the research literature within the field of using immersive virtual soft skills learning and training of employees. The results of this preliminary scoping review show that there is a lack of research literature and empirical studies within this topic.
The 7th International Conference of the Immersive Learning Research Network (iLRN 2021) is an innovative and interactive virtual gathering for a strengthening global network of researchers and practitioners collaborating to develop the scientific, technical, and applied potential of immersive learning. It is the premier scholarly event focusing on advances in the use of virtual reality (VR), augmented reality (AR), mixed reality (MR), and other extended reality (XR) technologies to support learners across the full span of learning—from K-12 through higher-education to workbased, informal, and lifelong learning contexts.
Following the success of iLRN 2020, our first fully online and in-VR conference, this year’s
conference was once again based on the iLRN Virtual Campus, powered by ©Virbela, but with a range of activities taking place on various other XR simulation, gaming, and other platforms.
Scholars and professionals working from informal and formal education settings as well as those representing diverse industry sectors are invited to participate in the conference, where they may share their research findings, experiences, and insights; network and establish partnerships to envision and shape the future of XR and immersive technologies for learning; and contribute to the emerging scholarly knowledge base on how these technologies can be used to create experiences that educate, engage, and excite learners.
Background
Simulation-based nursing education is an increasingly popular pedagogical approach. It provides students with opportunities to practice their clinical and decision-making skills through various real-life situational experiences. However, simulation approaches fall along a continuum ranging from low-fidelity to high-fidelity simulation. The purpose of this study was to determine the effect size of simulation-based educational interventions in nursing and compare effect sizes according to the fidelity level of the simulators through a meta-analysis.
Method
This study explores the quantitative evidence published in the electronic databases EBSCO, Medline, ScienceDirect, ERIC, RISS, and the National Assembly Library of Korea database. Using a search strategy including the search terms “nursing,” “simulation,” “human patient,” and “simulator,” we identified 2279 potentially relevant articles. Forty studies met the inclusion criteria and were retained in the analysis.
Results
This meta-analysis showed that simulation-based nursing education was effective in various learning domains, with a pooled random-effects standardized mean difference of 0.70. Subgroup analysis revealed that effect sizes were larger for high-fidelity simulation (0.86), medium-fidelity simulation (1.03), and standardized patients (0.86) than they were for low-fidelity and hybrid simulations. In terms of cognitive outcomes, the effect size was the largest for high-fidelity simulation (0.50). Regarding affective outcome, high-fidelity simulation (0.80) and standardized patients (0.73) had the largest effect sizes.
Conclusions
These results suggest that simulation-based nursing educational interventions have strong educational effects, with particularly large effects in the psychomotor domain. Since the effect is not proportional to fidelity level, it is important to use a variety of educational interventions to meet all of the educational goals.
Beginning nursing students typically report anxiety, low self-confidence, and difficulty transferring theoretical knowledge to the clinical setting prior to their first clinical experience. To address these issues, first-semester faculty in a prelicensure, undergraduate nursing program created a collaborative simulation experience (CSE). Implementation prior to the first clinical day provided real-life exposure to patient care, enhanced the transfer of knowledge, decreased anxiety, promoted self-confidence, and allowed faculty to identify students' strengths and weaknesses. Clinical faculty reported enhanced student performance following participation.
Introduction:
The purposes of this study were to (1) compare learning outcomes between students who participated in mannequin-based simulation activities and students who participated in virtual simulation activities and (2) describe a cost-utility analysis comparing the two types of simulation activities in terms of costs and multiple measures of effectiveness.
Methods:
Nursing student participants were randomly assigned to one of two experimental groups to complete either a mannequin-based or virtual simulation activity. The simulation scenario was the same for both groups and involved the care of a hospitalized patient experiencing a chronic obstructive pulmonary disease exacerbation. Participants completed presimulation and postsimulation assessments reflecting qualitative and quantitative measures of learning. A random sample of participants from each group completed a postsimulation performance assessment during which they interacted one on one with a standardized patient.
Results:
Eighty-four nursing students were enrolled in the study and completed the simulation activities. There were no significant differences in quantitative measures of learning or performance between participants in the mannequin-based and virtual simulation groups. Participants' qualitative responses to postintervention written reflections and questions yielded additional data for describing learning from the two interventions. In the cost-utility analysis, the virtual simulation activity had a more favorable cost-utility ratio of US $1.08 versus the mannequin-based simulation activity's US $3.62.
Conclusions:
Healthcare educators striving to make evidence-based decisions about how to best employ simulation pedagogy may consider these findings about the cost utility of various simulation modalities. However, additional research is needed.
Background
The introduction of simulation has produced significant improvements in nursing education. The technological evolution gives way to new opportunities through new pedagogical strategies. Some limitations found in high-fidelity simulators can be overcome by clinical virtual simulation (CVS). However, little is known about students' perceived ease, usefulness, and intention to use this new pedagogical strategy applied to nursing education. The aim of this study is to assess the ease, usefulness, and intention of pregraduate nursing students to use a clinical virtual simulator.
Method
An exploratory, descriptive, and cross-sectional study was conducted using a quantitative approach. A nonprobabilistic sample of 426 pregraduate students was recruited from a Portuguese nursing school. The data were collected through a questionnaire (10-point Likert scale) based on the Technology Acceptance Model.
Results
The results showed an average of perceived ease to use the simulator of 8.99 (SD ± 1) and a perceived usefulness and intention of 9.60 (SD ± 0.55) to use the clinical virtual simulator in pregraduate nursing education. Results also showed an average of 9.55 (SD ± 0.73) for relevance and an average of 9.71 points (SD ± 0.59) for the facilitator role of CVS in nursing education.
Conclusion(s)
The pregraduate nursing students revealed perceived ease, usefulness, and intention to use CVS as an important complementary strategy for their nursing education programmes.
Background:
The costs involved with technology-enhanced simulation remain unknown. Appraising the value of simulation-based medical education (SBME) requires complete accounting and reporting of cost. We sought to summarize the quantity and quality of studies that contain an economic analysis of SBME for the training of health professions learners.
Methods:
We performed a systematic search of MEDLINE, EMBASE, CINAHL, ERIC, PsychINFO, Scopus, key journals, and previous review bibliographies through May 2011. Articles reporting original research in any language evaluating the cost of simulation, in comparison with nonstimulation instruction or another simulation intervention, for training practicing and student physicians, nurses, and other health professionals were selected. Reviewers working in duplicate evaluated study quality and abstracted information on learners, instructional design, cost elements, and outcomes.
Results:
From a pool of 10,903 articles we identified 967 comparative studies. Of these, 59 studies (6.1%) reported any cost elements and 15 (1.6%) provided information on cost compared with another instructional approach. We identified 11 cost components reported, most often the cost of the simulator (n = 42 studies; 71%) and training materials (n = 21; 36%). Ten potential cost components were never reported. The median number of cost components reported per study was 2 (range, 1-9). Only 12 studies (20%) reported cost in the Results section; most reported it in the Discussion (n = 34; 58%).
Conclusion:
Cost reporting in SBME research is infrequent and incomplete. We propose a comprehensive model for accounting and reporting costs in SBME.
Cost: The missing outcome in simulation-based medical education research: A systematic review
- B Zendejas
- A T Want
- R Brydges
- S J Hamstra
- D A Cook
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missing outcome in simulation-based medical education research: A systematic
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