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Ota Y, Aikawa G, Nishimura A, Kawashima T, Imanaka R, Sakuramoto H. Effects of educational methods using extended reality on pre-registration nursing students' knowledge, skill, confidence, and satisfaction: A systematic review and meta-analysis. NURSE EDUCATION TODAY 2024; 141:106313. [PMID: 39042984 DOI: 10.1016/j.nedt.2024.106313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 06/11/2024] [Accepted: 07/11/2024] [Indexed: 07/25/2024]
Abstract
AIMS This study examined whether educational methods utilizing extended reality (XR) improve pre-registration nursing students' knowledge, skills, confidence, and satisfaction compared with traditional methods. DESIGN We conducted a systematic review and meta-analysis of the effectiveness of XR in nursing education based on the Cochrane methodology. DATA SOURCES Randomized controlled trials (RCTs) were searched in MEDLINE, CINAHL, ERIC, Web of Science, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi from inception of each database to March 21, 2024. REVIEW METHODS Two authors independently screened study titles and abstracts to identify potentially relevant studies. Subsequently, two reviewers independently assessed the eligibility of the studies based on full-text reviews and extracted the data. They calculated the pooled effect estimates associated with pre-registration nursing students' knowledge and skills, confidence, and satisfaction using a random-effects meta-analytic model. RESULTS Among the 1615 records identified, 128 studies were identified. Following full-text evaluation, 38 studies were included in the systematic review. The meta-analysis included 34 studies. XR had significant positive effects on knowledge (N = 1926, standard mean difference [SMD] = 0.55, 95 % confidence interval [CI]: 0.34 to 0.77), skills (N = 904, SMD = 1.00, 95 % CI: 0.46 to 1.54), and satisfaction (N = 574, SMD = 1.19, 95 % CI: 0.09 to 2.30). In particular, immersive virtual reality (VR) had significant positive effects on knowledge (N = 707, SMD = 0.60, 95%CI: 0.36 to 0.83), skills (N = 302, SMD = 1.60, 95%CI: 0.70 to 2.50), and satisfaction (N = 406; SMD = 1.63, 95%CI: 0.04 to 3.22). CONCLUSIONS XR may be a viable teaching strategy for improving knowledge, skills, and satisfaction acquisition. In particular, immersive VR improves knowledge, skills, and satisfaction. XR could not be a direct replacement for traditional methods but can complement pre-registration nursing students' traditional education methods.
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Affiliation(s)
- Yuma Ota
- Faculty of Healthcare, Division of Nursing, Tokyo Healthcare University, Japan.
| | - Gen Aikawa
- College of Nursing, Kanto Gakuin University, Japan
| | - Ayako Nishimura
- Faculty of Healthcare, Division of Nursing, Tokyo Healthcare University, Japan
| | | | - Ryota Imanaka
- Department of Nursing, Kyorin University Hospital, Japan
| | - Hideaki Sakuramoto
- Department of Critical Care and Disaster Nursing, Japanese Red Cross Kyushu International College of Nursing, Japan
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Rayamajhi S, Machin A, Breen C, Gebreheat G, Paterson R. Quality and impact of pharmacology digital simulation education on pre-registration healthcare students: A systematic literature review. NURSE EDUCATION TODAY 2024; 140:106295. [PMID: 38959780 DOI: 10.1016/j.nedt.2024.106295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 06/04/2024] [Accepted: 06/23/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVE This review aimed to assess the quality and nature of the literature related to digital simulation-based pharmacology education. Specifically, we sought to understand the influence of simulations on the knowledge, satisfaction, and confidence of pre-registration nurses and other healthcare students participating in such educational programs. DESIGN Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. This study was registered in the Prospective Register of Systematic Reviews (PROSPERO, reg no: CRD42023437570). DATA SOURCES PubMed, MEDLINE, APA PsycInfo, ProQuest, Web of Science, ScienceDirect, and CINHAL databases were searched. REVIEW METHODS The review focused on the quantitative findings from the studies published from 2016 to 2023. Only the studies that assessed the impact of digital simulation-based pharmacology education on pre-registration healthcare students' knowledge, satisfaction, and confidence were selected for review. Data were synthesized using a narrative approach. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included articles. This was followed by a narrative synthesis to consolidate the themes. RESULT Out of 1587 articles,16 met the inclusion criteria. A wide variety of digital technologies have been utilised, such as virtual simulation, computer simulation (2D/3D), mixed reality, and augmented reality, with the majority using virtual simulation. All studies implemented single-user simulations. The themes emerging from the narrative synthesis suggest that a digital simulation-based pharmacology course is an effective tool for enhancing students' knowledge, confidence, and satisfaction in learning pharmacological concepts. Furthermore, simulation-based teaching with a blended approach was found to be beneficial. However, the integration of the polypharmacy concept and the intra and interprofessional approach to teaching and learning was not evident in these studies. CONCLUSION This systematic literature review provides evidence of the potential of digital simulation-based education in pharmacology teaching among healthcare pre-registration students. In future studies, the integration of polypharmacy content with an intra and interprofessional teaching-learning approach is recommended.
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Kim Y, Park HY. Effects of virtual reality training on clinical skill performance in nursing students: A systematic review, meta-analysis and meta-regression. Int J Nurs Pract 2024:e13284. [PMID: 39107136 DOI: 10.1111/ijn.13284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 06/10/2024] [Accepted: 06/30/2024] [Indexed: 08/09/2024]
Abstract
AIMS This review examined the impact of virtual reality (VR) training on nursing students' clinical skill performance and identified essential features of VR training. BACKGROUND VR provides immersive content, simulating real-life scenarios and preventing errors in clinical settings. DESIGN This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. DATA SOURCES Studies were obtained from Ovid-EMBASE, MEDLINE, CINAHL and PubMed. REVIEW METHODS Studies related to VR training published from 1 January 2000 to 8 May 2024 were included. Comprehensive Meta-Analysis 4.0 software was used for meta-analysis and random effects meta-regression. The overall effect was assessed with Hedges' g and Z-statistics (p < 0.05). Heterogeneity was measured using I-squared (I2) statistics. RESULTS Among the 31 476 studies, 11 randomized controlled trial studies were included. Meta-analysis demonstrated a significant improvement in clinical skill performance, with a medium to large effect (g = 0.61) in the VR group (Z = 3.80, p < 0.001). Subgroup analyses highlighted higher nursing skills in the VR training topic. Meta-regression revealed that the VR training topic (β = 1.23, p < 0.001) and method of VR training (β = -0.53, p = 0.05) were significant covariates influencing clinical skill performance. CONCLUSION VR training improves nursing students' clinical skill performance, addressing shortcomings in the clinical practicum.
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Affiliation(s)
- Yoojin Kim
- National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - Ha-Young Park
- College of Nursing, Kyungbok University, Namyangju, Republic of Korea
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Aydın Doğan R, Yazıcı S. Use and Effectiveness of Innovative Virtual Reality Application in Teaching Fetal Development: A Randomized Controlled Trial. Comput Inform Nurs 2024; 42:515-521. [PMID: 38453431 DOI: 10.1097/cin.0000000000001036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Virtual reality-based training is effective. It is increasingly used by multiple disciplines to develop observation and critical skills, including engineering, education, arts, and health. This study was conducted to determine the effectiveness of the application created with Fetal Development Application Created by Virtual Reality Technology, which was developed to teach fetal development. The study was conducted in a single-blind, randomized fashion. Undergraduate midwifery students who took normal pregnancy lessons and learned fetal development were included. Eighty-four students were included in the experimental (n = 42) and control (n = 42) groups. Before the training, a personal information form and a pretest were applied to both groups. After the pretest, the experimental group received Fetal Development Application Created by Virtual Reality Technology, and the control group received 2 hours of theory training. Posttest was applied to both groups 6 weeks after the application. Preintervention scores were similar for the two groups. The posttest score of the experimental group was statistically significant compared with that of the control group ( P < .05). The mean cognitive load score of the experimental group was 1.09 ± 0.29, and the application did not create a cognitive load. The innovative application of Fetal Development Application Created by Virtual Reality Technology is an effective and applicable method in teaching fetal development in midwifery education.
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Affiliation(s)
- Reyhan Aydın Doğan
- Author Affiliations : Faculty of Health Sciences, Department of Midwifery, Karabuk University (Dr Aydın Doğan); and Faculty of Health Sciences, Department of Nursing, Istanbul Health and Technology University (Prof Dr Yazıcı), Istanbul, Turkey
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Huai P, Li Y, Wang X, Zhang L, Liu N, Yang H. The effectiveness of virtual reality technology in student nurse education: A systematic review and meta-analysis. NURSE EDUCATION TODAY 2024; 138:106189. [PMID: 38603830 DOI: 10.1016/j.nedt.2024.106189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/13/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
AIM The purpose of this study was to analyze the effectiveness of virtual reality technology in nursing education. BACKGROUND Virtual reality technology is regarded as one of the advanced and significant instructional tools in contemporary education. However, its effectiveness in nursing education remains a subject of debate, and there is currently limited comprehensive research discussing the impact of varying degrees of virtual technology on the educational effectiveness of nursing students. DESIGN Systematic review and meta-analysis. METHODS The present systematic review and meta-analysis were applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The PubMed, Embase, CINAHL, ProQuest, Cochrane Library, Web of Science, and Scopus were searched for relevant articles in the English language. The methodologies of the studies evaluated were assessed using Cochrane Risk of Bias2 (ROB 2) tool and Joanna Briggs Institute (JBI) assessment tool. We took the learning satisfaction, knowledge, and skill performance of nursing students as the primary outcomes, and nursing students' self-efficacy, learning motivation, cognitive load, clinical reasoning, and communication ability were assessment as secondary outcomes. The meta-analysis was performed using R 4.3.2 software according to PRISMA guidelines. Heterogeneity was assessed by I2 and P statistics. Standardized mean difference (SMD) and 95 % confidence intervals (CIs) were used as effective indicators. RESULTS Twenty-six studies were reviewed, which involved 1815 nursing students. The results showed that virtual reality teaching, especially immersive virtual reality, was effective in improving nursing students' learning satisfaction (SMD: 0.82, 95%CI: 0.53-1.11, P < 0.001), knowledge (SMD: 0.56, 95%CI: 0.34-0.77, P < 0.001), skill performance (SMD: 1.13, 95 % CI: 0.68-1.57, P < 0.001), and self-efficacy (SMD: 0.64, 95%CI: 0.21,1.07, P < 0.001) compared to traditional teaching methods. However, the effects of virtual reality technology on nursing students' motivation, cognitive load, clinical reasoning, and communication ability were not significant and require further research. CONCLUSIONS The results of this study show that virtual reality technology has a positive impact on nursing students. Nonetheless, it is crucial not to underestimate the effectiveness of traditional education methods, and future research could analyze the impact of different populations on nursing education while improving virtual reality technology, to more comprehensively explore how to improve the quality of nursing education. Moreover, it is imperative to emphasize the integration of virtual education interventions with real-world experiences promptly. This integration is essential for bridging the gap between the virtual learning environment and real-life scenarios effectively. REGISTRATION NUMBER CRD42023420497 (https://www.crd.york.ac.uk/PROSPERO/#recordDetails).
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Affiliation(s)
- Panpan Huai
- School of Nursing, Shanxi Medical University, Shanxi Province, China
| | - Yao Li
- School of Nursing, Shanxi Medical University, Shanxi Province, China
| | - Xiaomeng Wang
- School of Nursing, Peking University, Beijing, China
| | - Linghui Zhang
- School of Nursing, Shanxi Medical University, Shanxi Province, China
| | - Nan Liu
- School of Nursing, Shanxi Medical University, Shanxi Province, China
| | - Hui Yang
- Department of Nursing, First Hospital of Shanxi Medical University, Shanxi Province, China.
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Rose D, Espin S, Purdy N, Cahuas D, Mack K, Fazzari A, Sudhai S. Evaluating Virtual Simulation to Augment Undergraduate Nurses' Clinical Practice. J Nurs Educ 2024; 63:470-477. [PMID: 38979731 DOI: 10.3928/01484834-20240505-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
BACKGROUND Due to the lack of clinical placements during the pandemic, virtual simulation was used to augment student practice experiences. METHOD Using Kirkpatrick's evaluation model, a program evaluation study using a mixed-methods design was implemented to assess student and faculty satisfaction and usefulness of virtual simulation, the effectiveness of meeting learning needs, and the effects of the virtual simulation resource on the development of clinical judgment (n = 70). RESULTS Virtual simulation was rated as moderately useful with an overall mean of 1.7 (SD = 0.66, range 1 to 3). Only 21% to 49% of the students found online simulation either met or well met the various areas of learning needs. Qualitative data highlighted the benefits of this strategy as well as implementation factors that affected students' experience. CONCLUSION Virtual simulation can be used in clinical courses to augment learning when implemented in a way that addresses students' needs. [J Nurs Educ. 2024;63(7):470-477.].
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Medel D, Reguant M, Cemeli T, Jiménez Herrera M, Campoy C, Bonet A, Sanromà-Ortíz M, Roca J. Analysis of Knowledge and Satisfaction in Virtual Clinical Simulation among Nursing Students: A Mixed Study. NURSING REPORTS 2024; 14:1067-1078. [PMID: 38804414 PMCID: PMC11130862 DOI: 10.3390/nursrep14020081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Virtual simulation offers a powerful educational tool with considerable, albeit underexplored potential. This technology immerses students in lifelike digital scenarios, fostering the acquisition of knowledge and skills necessary for their future careers. This study aimed to assess knowledge acquisition and satisfaction outcomes among students using a virtual simulation teaching approach. The specific objectives were (1) to compare pre-and posttest knowledge acquisition, (2) to investigate the influence of prior professional experience on knowledge, and (3) to explore satisfaction levels with virtual simulation. One hundred and fifty-nine nursing students participated in a virtual simulation-based clinical intervention, entailing the resolution of a virtual adult patient hospitalized with respiratory pathology. Sociodemographic data and prior professional experience were collected, and knowledge was evaluated through pre-to-post tests. Satisfaction levels were assessed using open-ended questions. Quantitative data were analyzed using descriptive statistics, Wilcoxon, Mann-Whitney U, and Cohen's tests, while qualitative data underwent keyword-in-context analysis. Significant differences were noted between pre- and posttest knowledge levels, with prior experience showing no significant impact on knowledge acquisition. Participants reported high levels of satisfaction. Lexicometric analysis identified four clusters of words related to the key terms "simulation", "learn", "activity", and "knowledge". Virtual clinical simulation effectively enhances knowledge acquisition and fosters satisfaction, with students recognizing the positive impact of this approach on their learning. Consequently, virtual simulation contributes to the training of competent health professionals.
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Affiliation(s)
- Daniel Medel
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, 25199 Lleida, Spain; (D.M.); (C.C.); (A.B.); (M.S.-O.)
| | - Mercedes Reguant
- Department of Research Methods and Diagnosis in Education, University of Barcelona, 08007 Barcelona, Spain;
| | - Tània Cemeli
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, 25199 Lleida, Spain; (D.M.); (C.C.); (A.B.); (M.S.-O.)
| | | | - Carme Campoy
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, 25199 Lleida, Spain; (D.M.); (C.C.); (A.B.); (M.S.-O.)
| | - Aida Bonet
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, 25199 Lleida, Spain; (D.M.); (C.C.); (A.B.); (M.S.-O.)
| | - Montserrat Sanromà-Ortíz
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, 25199 Lleida, Spain; (D.M.); (C.C.); (A.B.); (M.S.-O.)
| | - Judith Roca
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 2 Montserrat Roig, 25199 Lleida, Spain; (D.M.); (C.C.); (A.B.); (M.S.-O.)
- Health Education, Nursing, Sustainability and Innovation Research Group (GREISI), 25199 Lleida, Spain
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Han F, Jin S. Evaluation of the combination of virtual simulation and in-person simulation among undergraduate nursing students: A mixed methods study. Nurse Educ Pract 2024; 75:103899. [PMID: 38277799 DOI: 10.1016/j.nepr.2024.103899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/28/2023] [Accepted: 01/12/2024] [Indexed: 01/28/2024]
Abstract
AIM This study aimed to evaluate the combination of virtual simulation and in-person simulation among undergraduate nursing students. BACKGROUND At present, in-person simulation is the main form of simulation in China. With the development of computer technology, computer-based virtual simulation is gradually applied in simulation and has shown unique advantages. However, simulation format that combines virtual simulation with in-person simulation is rare in China. DESIGN This was a mixed methods study, which applied a QUAN→qual sequential explanatory approach. METHODS In the quantitative phase, a non-randomized controlled trial (NRCT) was employed among 93 junior nursing students from nursing school of a university in China. Students from parallel classes 1, 2 and 3 (45 students) were selected as experimental group, while students from parallel classes 4, 5 and 6 (48 students) were selected as control group. The control group completed the in-person simulation, while the experimental group was required to complete both virtual simulation and in-person simulation. The students' performance in in-person simulation was evaluated by the teachers according to a demonstrating checklist. After simulation, Students were invited to answer the Students' Satisfaction and Self-confidence in Learning Scale (SSS), Educational Practices in Simulation Scale (EPSS) and Clinical Learning Environment Comparison Survey (CLECS). A descriptive qualitative study was conducted in qualitative phase. Ten students were recruited by a purposive sampling method from the experimental group and were interviewed by the researcher. A semi-structured interview method was used to conduct in-depth interviews with them. RESULTS The mean score of the students' performance in the experimental group was higher than that in the control group (63.00 vs 57.67). There were no significant differences in learning satisfaction, self-confidence and simulated practice score (except cooperation dimension) between the two groups (P>0.05). For experimental group, the total CLECS score in in-person simulation was higher than that in virtual simulation, which was 84.98±12.50 and 72.58±13.04 respectively and the difference was statistically significant (t=5.270, p<0.001). Ten students were interviewed in the qualitative phase. Through the interview, we have learned that students believed that virtual simulation combined with in-person simulation is helpful to enhance their knowledge, improve their learning confidence and help them develop non-technical skills (i.e., decision-making and critical thinking). CONCLUSION In-person simulation is the preferred form of simulation and virtual simulation is a beneficial supplement to in-person simulation. The combination of the two is suggested to be introduced into the simulation curriculum for undergraduate nursing students.
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Affiliation(s)
- Fengping Han
- Laboratory Center, School of Nursing, Peking University, Beijing, China
| | - Sanli Jin
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, Beijing, China.
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Kiegaldie D, Shaw L. Virtual reality simulation for nursing education: effectiveness and feasibility. BMC Nurs 2023; 22:488. [PMID: 38114940 PMCID: PMC10729454 DOI: 10.1186/s12912-023-01639-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023] Open
Abstract
Virtual Reality simulation (VRS) is an innovative and emerging technology that has the potential to offer increased numbers of pre-registration students authentic learning experiences compared to traditional simulation- based education (SBE) with simulated participants. The aim was to evaluate learner outcomes of SBE compared to 4 fully immersive VRS scenarios, for vocational and higher education nursing students at a training and further education institute in Melbourne, Australia. A mixed methods quasi-experimental design study was conducted over two semesters from 2019 to 2020. Participants were 675 pre-registration nursing students. The intervention group (VRS n = 393) received 4 three-dimensional, immersive VRS modules. The control group (SBE n = 282) received 4 face-to-face large group immersive simulations. In the VRS group 95% of students actively participated, compared to SBE (on average 15%). Knowledge test scores were initially significantly greater (p < 0.01) for VRS versus SBE students, but not maintained post clinical placement. Intervention students found VRS to be realistic and prepared them for clinical practice. Some technical difficulties were identified with VRS. VRS was found to be more cost effective than SBE. VRS fostered critical thinking and provided an efficient and sustainable platform for learning about complex clinical situations.
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Affiliation(s)
- Debra Kiegaldie
- Eastern Health Clinical School, Monash University, Victoria, 3128, Australia
| | - Louise Shaw
- Centre for Digital Transformation of Health, University of Melbourne, Grattan Street, Parkville, Vic, 3010, Australia.
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Heyn LG, Brembo EA, Byermoen KR, Cruaud C, Eide H, Flo J, Nordsteien A, Overgaard G, Egilsdottir HÖ. Exploring facilitation in virtual simulation in nursing education: A scoping review. PEC INNOVATION 2023; 3:100233. [PMID: 38033419 PMCID: PMC10687044 DOI: 10.1016/j.pecinn.2023.100233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/10/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023]
Abstract
Objective To systematically map existing research regarding the reflective feedback in virtual simulation in undergraduate nursing education. Methods A scoping review was conducted based on the Arksey and O'Malley framework and the PRISMA-ScR. Results We included 41 studies from 15 different countries. The simulation interventions allowed for interaction between the student and the virtual patient, the software, faculty, peers, or a combination of two or more of these. Students valued reflective feedback during and after the simulation. Conclusions Our review emphasizes the importance of a human in the loop. Feedback before, during, and after the simulation is possible in virtual simulation where the facilitator can pause the virtual scenario and stimulate reflections during the simulation to obtain deep learning. Virtual simulation provides opportunities to give feedback from the software, such as cues or direct feedback. Innovation There is a lack of focus on the feedback process and there is a need to revitalize the role of facilitators in a virtual simulation to determine their relative contribution in this process. Several studies reported the usefulness or the effect of virtual simulation on learning processes, but most lacked emphasis on investigating the significance of including a human in the loop.
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Affiliation(s)
- Lena Günterberg Heyn
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Espen Andreas Brembo
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Kirsten Røland Byermoen
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Caroline Cruaud
- Unit for Digitalisation and Education, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Hilde Eide
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Jill Flo
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Anita Nordsteien
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Grith Overgaard
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
| | - Hugrun Ösp Egilsdottir
- Center for Health and Technology, University of South-Eastern Norway, Campus Drammen, Grønland 58, 3045 Drammen, Norway
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Uslu-Sahan F, Bilgin A, Ozdemir L. Effectiveness of Virtual Reality Simulation Among BSN Students: A Meta-analysis of Randomized Controlled Trials. Comput Inform Nurs 2023; 41:921-929. [PMID: 37607725 DOI: 10.1097/cin.0000000000001059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
This study aimed to evaluate the effect of virtual reality simulation in nursing education in five domains: knowledge, skill performance, self-confidence, self-efficacy, and satisfaction. Randomized controlled trials were obtained from the databases SCOPUS, Web of Science, PubMed, and EBSCO from inception until September 2021. The standardized mean differences with 95% confidence intervals were determined for the main variables, and heterogeneity was analyzed using the I2 test. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Checklist was used. Meta-analysis was performed using the Stata 15.0 software. Among the 2074 records identified, 18 trials were included. The meta-analysis of these trials indicated that virtual reality simulation caused a significant improvement in knowledge with a moderate effect, skill performance with a moderate effect, and satisfaction with a moderate effect compared with the control group. However, virtual reality simulation did not significantly influence self-confidence and self-efficiency. The findings of this study suggested that virtual reality simulation might significantly benefit knowledge, skill performance, and satisfaction but not self-confidence and self-efficiency. Further well-designed randomized controlled trials with a larger sample size are recommended to confirm these findings.
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Affiliation(s)
- Fatma Uslu-Sahan
- Author Affiliations: Departments of Obstetrics and Gynecologic Nursing (Dr Uslu-Sahan) and Internal Medicine Nursing (Dr Ozdemir), Faculty of Nursing, Hacettepe University, Ankara; and Department of Nursing, Faculty of Health Sciences, Sakarya University of Applied Sciences (Dr Bilgin), Turkey
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Shorey S, Ang ENK, Ng ED, Yap J, Lau LST, Chui CK, Chan YH. Evaluation of a Theory-Based Virtual Counseling Application in Nursing Education. Comput Inform Nurs 2023; 41:385-393. [PMID: 36728150 DOI: 10.1097/cin.0000000000000999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Effective communication skills in nursing are necessary for high-quality nursing care, but given the decline in nursing students' attitudes and their low self-confidence in effective communication with patients, a participatory and experiential training method is needed. Therefore, a virtual counseling application was developed using artificial intelligence and a three-dimensional avatar to facilitate learning of communication skills. This study aimed to evaluate the effectiveness of this theory-based virtual intervention on nursing students' learning attitudes, communication self-efficacy, and clinical performance. A longitudinal quasi-experimental study was conducted. Ninety-three undergraduate nursing students received virtual patient trainings with four clinical scenarios over 2 years. Data were analyzed using McNemar test and analysis of variance. Virtual patient training improved students' learning attitudes toward communication skills for scenarios involving the pregnant woman (20.4%, P = .03) and depressed patient (17.1%, P = .01) and enhanced perceived self-efficacy for scenarios involving the pregnant woman (22.6%, P = .002) and stressed nursing student (18.3%, P = .002). Students received lower clinical communication scores for pediatric, obstetric, and medical practicums compared with a previous cohort who received no training. Overall, this virtual counseling application can provide a valuable and cost-effective communication learning resource for the nursing curriculum.
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Affiliation(s)
- Shefaly Shorey
- Author Affiliations: Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore (Ms Ng and Drs Shorey, Ang, and Lau); National University Health System, Singapore (Drs Shorey and Ang); Application, Architecture and Technology, National University of Singapore Information Technology (Mr Yap); and Control & Mechatronics, Department of Mechanical Engineering (Dr Chui), and Biostatistics Unit, Yong Loo Lin School of Medicine (Dr Chan), National University of Singapore
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Tamilselvan C, Chua SM, Chew HSJ, Devi MK. Experiences of simulation-based learning among undergraduate nursing students: A systematic review and meta-synthesis. NURSE EDUCATION TODAY 2023; 121:105711. [PMID: 36634505 DOI: 10.1016/j.nedt.2023.105711] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES We aimed to examine the experiences of simulation-based learning (SBL) among undergraduate nursing students. DESIGN We conducted a systematic review and meta-synthesis on the experiences among undergraduate nursing studies who received SBL. DATA SOURCES We searched through six databases namely PubMed, CINAHL, Scopus, Web of Science, Embase, ProQuest, for qualitative studies published from January 2011 to January 2022. REVIEW METHODS A meta-synthesis was conducted according to the three-stage framework outlined by Thomas and Harden (2008). Critical appraisal was performed using the Critical Appraisal Skills Program (CASP) checklist. A standardised data extraction form was developed with reference from JBI Qualitative Assessment and Review Instrument Data Extraction Tools for Qualitative Research (JBI-QARI) checklist for data extraction. RESULTS Fifteen studies were included, and four themes emerged from the synthesis: (1) acquiring knowledge and skills through SBL; (2) positive experiences of using high-fidelity simulation (HFS) and virtual reality simulation (VRS) methods; (3) challenges encountered while using SBL methods and (4) drawing parallels between simulation and real clinical settings. CONCLUSION SBL allowed undergraduate nursing students to gain knowledge, acquire skills and have a positive SBL experiences. However, the provision of innovative strategies and resources for nursing students to overcome SBL-based challenges are still needed.
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Affiliation(s)
| | | | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - M Kamala Devi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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An H, Park S, Lee J. Clinical Field and Alternative Clinical Practice Experience in a Pandemic Situation of Nursing Students Who Have Experienced Clinical Practice before COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13372. [PMID: 36293953 PMCID: PMC9603083 DOI: 10.3390/ijerph192013372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to understand the experiences of nursing students who experienced clinical practice before the outbreak of COVID-19 on clinical field practice and alternative clinical practice adopted during the COVID-19 pandemic. A phenomenological study was conducted on 14 graduates who experienced clinical field practice and alternative clinical practice during a pandemic. Data were collected using individual in-depth interviews that were semi-structured. Data were analyzed according to Colaizzi's procedure. As a result of data analysis, five themes and 17 sub-themes were selected. The five themes were: alienation during the process of clinical practice change, regret caused by alternative clinical practice, alternative clinical practice as a supplementary measure, difficulties due to COVID-19, non-replaceable clinical field practice. It is necessary to consider using alternative clinical practices to complement the clinical setting and improve the quality of clinical practice in the post-corona era. To this end, it is necessary to supplement the disadvantages of alternative clinical practice, such as reduced concentration and lack of sense of presence, by applying integrated education using Edutech.
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Affiliation(s)
- Hyeran An
- Department of Nursing, College of Nursing, Daegu Catholic University, Daegu 42472, Korea
| | - Sunnam Park
- Department of Nursing, Seoul Women’s College of Nursing, Seoul 03617, Korea
| | - Jongeun Lee
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju-si 28644, Korea
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15
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Yeo JY, Jang MS. Nursing students' self-directed learning experiences in web-based virtual simulation: A qualitative study. Jpn J Nurs Sci 2022; 20:e12514. [PMID: 36191904 DOI: 10.1111/jjns.12514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 08/07/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Since the start of the COVID-19 pandemic, virtual reality simulation, including web-based simulation, has increased in nursing education. This study explored nursing students' self-directed problem-solving in web-based virtual simulation experiences. METHOD Convenience sampling yielded 16 Korean senior nursing students who had experienced clinical practice in the last semester. Data were collected from August 2020 to January 2021 through in-depth Zoom video interviews and organized using NVivo version 12.0. Thematic analysis was applied to analyze the data. RESULTS The following four themes were identified from nursing students' learning experiences during the web-based virtual simulations: "self-awareness of a lack of nursing competency in virtual reality," "applying new learning strategies learned from failure," "voluntary learning behavior," and "cognitive shift toward a holistic understanding." Web-based virtual simulations activated various cognitive and metacognitive factors of self-directed learning, and the system's prompt feedback and students' reflections facilitated learning effects. Nursing students corrected their cognitive errors while learning from their failures and mistakes and gained a holistic view of nursing practice. CONCLUSION In this study, web-based self-directed learning activated the metacognition of nursing students in a virtuous cycle. The virtual environment with no actual harm to the patient has become a space for learners to experience a sense of confidence, achievement, and satisfaction. Web-based virtual simulation can be an effective teaching method to improve nursing students' self-directed learning abilities and nursing competency.
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Affiliation(s)
- Ji-Young Yeo
- Hanyang University College of Nursing, Seoul, South Korea
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16
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Cant R, Ryan C. An Educator's Anthology of Virtual Simulation Applications for Nursing Curricula: A Mapping Review. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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17
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Sim JJM, Rusli KDB, Seah B, Levett-Jones T, Lau Y, Liaw SY. Virtual Simulation to Enhance Clinical Reasoning in Nursing: A Systematic Review and Meta-analysis. Clin Simul Nurs 2022; 69:26-39. [PMID: 35754937 PMCID: PMC9212904 DOI: 10.1016/j.ecns.2022.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background The COVID-19 pandemic has given rise to more virtual simulation training. This study aimed to review the effectiveness of virtual simulations and their design features in developing clinical reasoning skills among nurses and nursing students. Method A systematic search in CINAHL, PubMed, Cochrane Library, Embase, ProQuest, PsycINFO, and Scopus was conducted. The PRISMA guidelines, Cochrane's risk of bias, and GRADE was used to assess the articles. Meta-analyses and random-effects meta-regression were performed. Results The search retrieved 11,105 articles, and 12 randomized controlled trials (RCTs) were included. Meta-analysis demonstrated a significant improvement in clinical reasoning based on applied knowledge and clinical performance among learners in the virtual simulation group compared with the control group. Meta-regression did not identify any significant covariates. Subgroup analyses revealed that virtual simulations with patient management contents, using multiple scenarios with nonimmersive experiences, conducted more than 30-minutes and postscenario feedback were more effective. Conclusions Virtual simulations can improve clinical reasoning skill. This study may inform nurse educators on how virtual simulation should be designed to optimize the development of clinical reasoning.
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Affiliation(s)
- Jia Jia Marcia Sim
- Nursing Department, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Khairul Dzakirin Bin Rusli
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Betsy Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tracy Levett-Jones
- School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Australia
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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18
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Joung J, Kang KI. Can Virtual Simulation Replace Clinical Practical Training for Psychiatric Nursing? Issues Ment Health Nurs 2022; 43:706-711. [PMID: 35380910 DOI: 10.1080/01612840.2022.2055684] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In Korea, virtual simulation is currently replacing clinical practical training for psychiatric nursing due to the COVID-19 pandemic. This study aimed to explore the virtual simulation experiences of nursing students through focus-group interviews. Three categories were derived: 'glad that the patients were not real people', 'bridge between the text world and the real world', and 'supplementations needed for virtual simulation to replace clinical practice'. Although virtual simulation helped acquire knowledge and skills related to psychiatric nursing practice in a safe environment, there were limitations to replacing clinical practice. To overcome this, a diverse approach between students and professors is required.
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Affiliation(s)
- Jaewon Joung
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Republic of Korea
| | - Kyung Im Kang
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
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Chen Y, Li Z, Zou X, Yang Q, Guan B, Ming WK. Nursing Students' Perceptions of Using Virtual Patients to Prepare for Clinical Practice. J Nurs Educ 2022; 61:398-402. [PMID: 35858137 DOI: 10.3928/01484834-20220613-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Educators are called on to provide opportunities for students to practice and integrate skills and knowledge to ensure preparation for the complexities of today's health care environment. This study explored nursing students' perceptions of using virtual patients to prepare for clinical practice. METHOD This study used an exploratory qualitative design. Four focus group interviews were conducted with 25 third-year nursing students. Data were collected and analyzed using thematic content analysis. RESULTS Four main themes and eight subthemes emerged. Main themes included personal engagement, learning environment, organizational factors, and improvement needed. Subthemes included being a computer game player, becoming confident in clinical practice, convenient to practice, an authentic stressful learning environment, organization, better to be combined with mannequin-based simulation, technology difficulties, and aural factors. CONCLUSION Although some perceived disadvantages were identified, the use of virtual patients could be an effective strategy to improve nursing students' preparation for clinical preparation. [J Nurs Educ. 2022;61(7):398-402.].
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20
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Sharoff L. Student's Perception of vSim for Nursing® using the Simulation Effectiveness Tool-Modified. Clin Simul Nurs 2022; 68:1-8. [PMID: 36718189 PMCID: PMC9876738 DOI: 10.1016/j.ecns.2022.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background Due to the COVID-19 pandemic, our nursing program utilized virtual simulation learning experiences to replace clinical hours. This pilot project used both quantitative and qualitative research methods to explore undergraduate pre-licensure (n = 99) and accelerated second-degree students (n = 19) student's perceived effectiveness of using vSim for Nursing® as a clinical replacement with a second aim that explored their preparedness for the virtual simulation experience. Method Efficacy was evaluated using the Simulation Effectiveness Tool-Modified (SET-M). Results Mean scores indicated that students strongly agreed on the efficacy of vSim for learning, with all items ranging from 50% to 79.7%. Majority of students strongly agreed that their preparation was highly effective, ranging 67.8% to 77.1%. Qualitative findings from the open-ended feedback supports findings to the effectiveness of virtual simulation, with one of the major themes that emerged was the presence of the clinical nurse educator. Conclusion Students perceived vSim for Nursing® to be an effective tool for clinical practice replacement and felt prepared to meet the learning outcomes. Debriefing remains an essential component to any mode of simulation.
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Mestre A, Muster M, El Adib AR, Ösp Egilsdottir H, Byermoen KR, Padilha M, Aguilar T, Tabagari N, Betts L, Sales L, Garcia P, Ling L, Café H, Binnie A, Marreiros A. The impact of small-group virtual patient simulator training on perceptions of individual learning process and curricular integration: a multicentre cohort study of nursing and medical students. BMC MEDICAL EDUCATION 2022; 22:375. [PMID: 35578233 PMCID: PMC9109952 DOI: 10.1186/s12909-022-03426-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has precipitated rapid changes in medical education to protect students and patients from the risk of infection. Virtual Patient Simulators (VPS) provide a simulated clinical environment in which students can interview and examine a patient, order tests and exams, prioritize interventions, and observe response to therapy, all with minimal risk to themselves and their patients. Like high-fidelity simulators (HFS), VPS are a tool to improve curricular integration. Unlike HFS, VPS require limited infrastructure investment and can be used in low-resource settings. Few studies have examined the impact of VPS training on clinical education. This international, multicenter cohort study was designed to assess the impact of small-group VPS training on individual learning process and curricular integration from the perspective of nursing and medical students. METHODS We conducted a multi-centre, international cohort study of nursing and medical students. Baseline perceptions of individual learning process and curricular integration were assessed using a 27-item pre-session questionnaire. Students subsequently participated in small-group VPS training sessions lead by a clinical tutor and then completed a 32-item post-session questionnaire, including 25 paired items. Pre- and post-session responses were compared to determine the impact of the small-group VPS experience. RESULTS Participants included 617 nursing and medical students from 11 institutions in 8 countries. At baseline, nursing students reported greater curricular integration and more clinical and simulation experience than did medical students. After exposure to small-group VPS training, participants reported significant improvements in 5/6 items relating to individual learning process and 7/7 items relating to curricular integration. The impact of the VPS experience was similar amongst nursing and medical students. CONCLUSIONS In this multi-centre study, perceptions of individual learning process and curricular integration improved after exposure to small-group VPS training. Nursing and medical students showed similar impact. Small-group VPS training is an accessible, low-risk educational strategy that can improve student perceptions of individual learning process and curricular integration.
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Affiliation(s)
- André Mestre
- Faculty of Medicine and Biomedical Sciences, University of Algarve, Campus de Gambelas, Ed. 2 - Norte, 8005-139, Faro, Portugal
| | - Marek Muster
- Institute of Health Sciences, Medical College of University of Rzeszow, University of Rzeszow, Rzeszow, Poland
| | | | - Hugrun Ösp Egilsdottir
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Kirsten Røland Byermoen
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Miguel Padilha
- Porto Nursing School, CINTESIS-Tech4edusim, Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Thania Aguilar
- Central American Technological University (UNITEC), Tegucigalpa, Honduras
| | - Nino Tabagari
- AIETI Medical School, David Tvildiani Medical University, Tbilisi, Georgia
| | - Lorraine Betts
- Sally Horsfall Eaton School of Nursing, Waterfront Campus, George Brown College, Toronto, ON, Canada
| | - Leila Sales
- Red Cross Higher School of Health, Lisbon, Portugal
| | - Pedro Garcia
- Faculty of Medical Sciences, Nova Medical School, Lisbon, Portugal
| | - Luo Ling
- Guangxi Medical College, Nanning, Guangxi, China
| | - Hugo Café
- Faculty of Medicine and Biomedical Sciences, University of Algarve, Campus de Gambelas, Ed. 2 - Norte, 8005-139, Faro, Portugal
| | - Alexandra Binnie
- Faculty of Medicine and Biomedical Sciences, University of Algarve, Campus de Gambelas, Ed. 2 - Norte, 8005-139, Faro, Portugal.
- ABC-RI, Algarve Biomedical Center Research Institute, Faro, Portugal.
- William Osler Health System, Brampton, ON, Canada.
| | - Ana Marreiros
- Faculty of Medicine and Biomedical Sciences, University of Algarve, Campus de Gambelas, Ed. 2 - Norte, 8005-139, Faro, Portugal
- ABC-RI, Algarve Biomedical Center Research Institute, Faro, Portugal
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Akman Ö, Yildirim D, Sarikaya A, Ozturk C. Evaluation of Nursing Students’ Peripheral Intravenous Catheter (Insertion/Placement) Attempts with Simulator. CYPRUS JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4274/cjms.2021.2285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cant R, Cooper S, Ryan C. Using virtual simulation to teach evidence-based practice in nursing curricula: A rapid review. Worldviews Evid Based Nurs 2022; 19:415-422. [PMID: 35261156 DOI: 10.1111/wvn.12572] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/08/2021] [Accepted: 09/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Virtual simulation is an interactive teaching and learning strategy used in undergraduate nursing student education, especially since the onset of the COVID-19 pandemic. Few published studies have reviewed the impact of virtual simulation as a strategy for teaching nursing students the elements of evidence-based practice. AIM To describe types of virtual simulation that are relevant to nursing student education and examine how these modalities are applied to teach elements of evidence-based practice. METHODS A rapid review of literature was conducted to discern the use and impact of virtual simulation. Thirty-seven studies published between 2017 and May 2021 that addressed nursing students' educational outcomes were reviewed and summarized as a narrative analysis. RESULTS Virtual simulation and virtual reality simulation engage learners in role-plays via a computer screen or hand-held phone. Various levels of realism and immersion were apparent across different modalities and with the utilization of educational games. Most studies related to the teaching of best practice evidence-based clinical nursing topics. Twenty primary studies reported objective measures of students' improvement such as knowledge, performance, better documentation, or communication accuracy. Sixteen studies that measured knowledge identified significant knowledge gains. All studies endorsed virtual simulation as a teaching method. LINKING EVIDENCE TO ACTION Virtual simulation approaches offer an innovative and feasible option for teaching nursing students. Such approaches should be included in undergraduate nursing curricula. While it is apparent that evidence-based practice guidelines inform the design of the virtual simulation scenarios, the effectiveness of the modality for teaching specific elements of evidence-based practice to nursing students is not yet confirmed. Nursing curricula need to include ways of teaching nursing students to search for and critically appraise trustworthy sources of knowledge for clinical practice.
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Affiliation(s)
- Robyn Cant
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Simon Cooper
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Colleen Ryan
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
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Lei YY, Zhu L, Sa YTR, Cui XS. Effects of high-fidelity simulation teaching on nursing students' knowledge, professional skills and clinical ability: A meta-analysis and systematic review. Nurse Educ Pract 2022; 60:103306. [PMID: 35202957 DOI: 10.1016/j.nepr.2022.103306] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This meta-analysis was designed to systematically determine the effect of high-fidelity simulation teaching on nursing students' knowledge level, professional skill level and clinical ability. BACKGROUND High-fidelity simulation is an increasingly popular pedagogical approach in nursing education. It provides students with opportunity to practice in a variety of simulations before entering clinical practice through a variety of real-life situational experiences and many institutions and educators have embraced this method for enhancing access to clinical skills. However, evidence for the effectiveness of the method in nursing teaching remains scarce. DESIGN A meta-analysis and systematic review. METHODS The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane library, Web of Science, CNKI (China National Knowledge Infrastructure) and Wangfang. The search encompassed the establishment of these databases up until November 2021. Two reviewers separately entered the data into Review Manager Software 5.3. RESULTS A total of 15 studies were included in this study. High-fidelity simulation significantly increased nursing students' knowledge acquisition (SMD = 1. 37, 94%CI:0. 73-2. 00,P <0. 0001), enhanced nursing students'professional skills (SMD = 0. 90, 95%CI:0. 36-1. 44,P = 0. 0001). In terms of clinical practice ability outcomes, high-fidelity simulation significantly improved the levels of critical thinking ability (SMD = 0. 58, 95%CI:0. 09-1. 07,P <0. 00001), Clinical judgement ability (SMD = 1. 34, 95%CI:0. 38-2. 31,P=0. 006) and communication skills (SMD = 2. 62, 95%CI:1. 84-3. 40,P <0. 001) of nursing students. CONCLUSIONS We found that high-fidelity simulation have strong educational effects in nursing education, helping nursing students to increase knowledge acquisition, enhance professional skills and cultivate their clinical practice ability (critical thinking ability, communication skills and clinical judgement ability). These findings can provide guidance for nursing educators, indicating that the use of High-fidelity simulation teaching represents an effective solution for transitioning students from the learning environment to clinical practice.
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Affiliation(s)
- Yan-Yuan Lei
- School of Nursing, Yanbian University, 977 Park Road, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China.
| | - Li Zhu
- School of Nursing, Yanbian University, 977 Park Road, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China.
| | - Ya Tuo Ren Sa
- School of Nursing, Yanbian University, 977 Park Road, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China.
| | - Xiang-Shu Cui
- School of Nursing, Yanbian University, 977 Park Road, Yanji City, 133000 Yanbian Prefecture, Jilin Province, China.
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25
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Pence PL. Student satisfaction and self-confidence in learning with virtual simulations. TEACHING AND LEARNING IN NURSING 2022. [DOI: 10.1016/j.teln.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mulyadi M, Tonapa SI, Rompas SSJ, Wang RH, Lee BO. Effects of simulation technology-based learning on nursing students' learning outcomes: A systematic review and meta-analysis of experimental studies. NURSE EDUCATION TODAY 2021; 107:105127. [PMID: 34482208 DOI: 10.1016/j.nedt.2021.105127] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/21/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Gaps between theory and clinical practice represent challenges for nursing students during their learning processes. Providing simulation technology-based learning for nursing students is essential for modern nurse education, but evidence of efficacy remains scarce. OBJECTIVES To determine the effects of simulation technology-based learning for nursing students. DESIGN A systematic review and meta-analysis. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Five databases (CINAHL, Embase, MEDLINE, PubMed, and Web of Science) were electronically searched through May 30, 2021. Eligibility criteria included nursing students, simulated technology-based learning as the primary intervention, and randomised controlled trials or quasi-experimental studies published in English. The methodological quality of included studies was evaluated by the Cochrane risk-of-bias tool. Comprehensive Meta-Analysis Version 3.0 was used to conduct a meta-analysis using the random-effects model. Begg's and Egger's tests were performed to assess publication bias, and sensitivity analysis performed using a remove one study method. RESULTS A total of 17 studies were included in this study. Simulated technology-based learning significantly increased nursing student knowledge acquisition (standard mean difference [SMD]: 0.72, 95% confidence interval [CI]: 0.25-1.18, p < 0.001), enhanced student's confidence (SMD: 0.50, 95% CI: 0.02-0.99, p = 0.043), and increased student's satisfaction in learning (SMD: 0.81, 95% CI: 0.61-1.00, p < 0.001). Subgroup analyses showed that receiving simulation by manikins simulator had a greater effect on knowledge acquisition (SMD: 1.01, 95% CI: 0.27-1.74, p = 0.007). CONCLUSIONS Simulation technology use may meet the expectations of undergraduate nursing students and prepare them for clinical practice, representing an opportunity to fill gaps between theory and clinical practice while simultaneously developing new teaching scenarios.
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Affiliation(s)
- Mulyadi Mulyadi
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Nursing, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia.
| | - Santo Imanuel Tonapa
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Nursing, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia.
| | | | - Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.
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27
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Zhang D, Liao H, Jia Y, Yang W, He P, Wang D, Chen Y, Yang W, Zhang YP. Effect of virtual reality simulation training on the response capability of public health emergency reserve nurses in China: a quasiexperimental study. BMJ Open 2021; 11:e048611. [PMID: 34551944 PMCID: PMC8460527 DOI: 10.1136/bmjopen-2021-048611] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To develop a virtual reality simulation training programme, and further verify the effect of the programme on improving the response capacity of emergency reserve nurses confronting public health emergencies. DESIGN A prospective quasiexperimental design with a control group. PARTICIPANTS A total of 120 nurses were recruited and randomly divided into the control group and the intervention group. INTERVENTION Participants underwent a 3-month training. The control group received the conventional training of emergency response (eg, theoretical lectures, technical skills and psychological training), while the intervention group underwent the virtual reality simulation training in combination with skills training. The COVID-19 cases were incorporated into the intervention group training, and the psychological training was identical to both groups. At the end of the training, each group conducted emergency drills twice. Before and after the intervention, the two groups were assessed for the knowledge and technical skills regarding responses to fulminate respiratory infectious diseases, as well as the capacity of emergency care. Furthermore, their pandemic preparedness was assessed with a disaster preparedness questionnaire. RESULTS After the intervention, the scores of the relevant knowledge, the capacity of emergency care and disaster preparedness in the intervention group significantly increased (p<0.01). The score of technical skills in the control group increased more significantly than that of the intervention group (p<0.01). No significant difference was identified in the scores of postdisaster management in two groups (p>0.05). CONCLUSION The virtual reality simulation training in combination with technical skills training can improve the response capacity of emergency reserve nurses as compared with the conventional training. The findings of the study provide some evidence for the emergency training of reserve nurses in better response to public health emergencies and suggest this methodology is worthy of further research and popularisation.
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Affiliation(s)
- Dandan Zhang
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Hongwu Liao
- Institute of Clinical Research, Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Yitong Jia
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Wenren Yang
- Institute of Clinical Research, Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Pingping He
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Dongmei Wang
- Institute of Clinical Research, Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Yongjun Chen
- Institute of Clinical Research, Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Wei Yang
- Institute of Clinical Research, Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Yin-Ping Zhang
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
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Abstract
Background The COVID-19 pandemic has disrupted the methods used to develop clinical judgment in the simulation setting. In many cases, virtual simulation has replaced face-to-face simulation but lack of interaction between the students and educators is a limitation. Sample Ninety-six prelicensure baccalaureate nursing students at a Midwestern university participated in the end-of-semester simulation as part of the course. Method Based on the review of aggregate standardized test results, a simulation scenario was developed using a synchronous online format with educators portraying nurses and patients using a fun approach. At three predetermined stopping points, students discussed further nursing actions which were performed by the educators, followed by debriefing at the end of the scenario. Results Simulation evaluation as part of routine systematic simulation program assessment indicated students perceived both pauses for discussion during the scenario and debriefing at the end were valuable in promoting their learning. Conclusion This project is consistent with research which found virtual simulation enhances student learning and clinical judgment. The positive perception of students about the use of humor through implementation of the simulation scenario was consistent with current research related to student engagement and motivation to participate.
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Fung JTC, Zhang W, Yeung MN, Pang MTH, Lam VSF, Chan BKY, Wong JYH. Evaluation of students' perceived clinical competence and learning needs following an online virtual simulation education programme with debriefing during the COVID-19 pandemic. Nurs Open 2021; 8:3045-3054. [PMID: 34331397 PMCID: PMC8441701 DOI: 10.1002/nop2.1017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/20/2021] [Accepted: 07/19/2021] [Indexed: 11/26/2022] Open
Abstract
Aims and objectives This study aimed to evaluate the effect of a virtual simulation education programme with debriefing in undergraduate nursing students. Perceived clinical competence and learning needs of students in a simulation environment were also measured. Background Evidence showed virtual simulation education programmes provided better knowledge acquisition. However, these studies to date did not incorporate virtual simulation in the combination of a debriefing model in nursing students. Design A one‐group pre‐test and post‐test design. Methods 188 final year undergraduate nursing students participated in the study. Linear mixed model analysis was conducted to evaluate the effect of the programme. Results Students have perceived a significant improvement in clinical competence and nursing process. Self‐efficacy has also boosted. Communication and critical thinking were applied better in the traditional clinical environment. Conclusion Perceived clinical competence of Chinese nursing students has significant improvements by using virtual simulation combining a debriefing model during the COVID‐19 period. Virtual simulation met students' learning needs. Future studies should include a control group for comparison and long‐term measurement. Relevance to clinical practice The study provided an innovative clinical learning pedagogy to serve as a potential alternative with traditional clinical practicum during the COVID‐19 period as this is substantially limited.
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Affiliation(s)
- John Tai Chun Fung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wen Zhang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Man Nga Yeung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Michelle Tsz Ha Pang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Veronica Suk Fun Lam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Bobo Kai Yin Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Janet Yuen-Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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Zaragoza-García I, Ortuño-Soriano I, Posada-Moreno P, Sánchez-Gómez R, Raurell-Torredà M. VIRTUAL SIMULATION FOR LAST-YEAR NURSING GRADUATE STUDENTS IN TIMES OF COVID-19: A QUASI-EXPERIMENTAL STUDY. Clin Simul Nurs 2021; 60:32-41. [PMID: 34336011 PMCID: PMC8315944 DOI: 10.1016/j.ecns.2021.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background The COVID-19 pandemic has made it necessary to adapt university health-education. Virtual simulation has been proposed to be a suitable tool. Methods A quasi-experimental study was conducted on nursing students in the final year. The virtual simulation platform vSim® was used. Improvements in knowledge, skills during simulation, satisfaction and selfconfidence obtained through the training provided were analyzed, as well as satisfaction with the platform. Results Prepost training knowledge improved. Skill acquisition improved between the first and last attempts in all cases. The levels of selfconfidence and satisfaction with the training and the platform used were high. Conclusions The vSim® was a useful solution during the pandemic. Knowledge improved and high selfconfidence was obtained.
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Affiliation(s)
- I Zaragoza-García
- Department of Nursing. Faculty of Nursing, Physiotherapy and Podology. University Complutense of Madrid. Plaza de Ramón y Cajal, 3, 28040 Madrid, Spain. & Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12). Centro de Actividades Ambulatorias, 6ª Planta Bloque D Avda. de Córdoba, s/n 28041 Madrid, Spain
| | - I Ortuño-Soriano
- Department of Nursing. Faculty of Nursing, Physiotherapy and Podology. University Complutense of Madrid. Plaza de Ramón y Cajal, 3, 28040 Madrid, Spain. & FIBHCSC, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC). Address: Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain
| | - P Posada-Moreno
- Department of Nursing. Faculty of Nursing, Physiotherapy and Podology. University Complutense of Madrid. Plaza de Ramón y Cajal, 3, 28040 Madrid, Spain. & FIBHCSC, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC). Address: Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain
| | - R Sánchez-Gómez
- Department of Nursing. Faculty of Nursing, Physiotherapy and Podology. University Complutense of Madrid. Plaza de Ramón y Cajal, 3, 28040 Madrid, Spain
| | - M Raurell-Torredà
- Department of Fundamental and Medical Surgical Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Spain. Pavelló de Govern, Feixa Llarga, s/n. 08907 L'Hospitalet del Llobregat, Spain
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Kim MJ, Kang HS, De Gagne JC. Nursing Students' Perceptions and Experiences of Using Virtual Simulation During the COVID-19 Pandemic. Clin Simul Nurs 2021; 60:11-17. [PMID: 34249183 PMCID: PMC8257426 DOI: 10.1016/j.ecns.2021.06.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background This study aimed to understand prelicensure nursing students’ perceptions and experiences of using virtual simulation as an alternative to clinical practice during the coronavirus 2019 (COVID-19) pandemic in South Korea. Methods A total of 20 students from a 4-year baccalaureate nursing program participated in this descriptive qualitative study. Six focus group interviews using Zoom video communications were conducted with three to four participants to understand their experiences. Data were analyzed using an inductive content analysis approach. Results The following three major themes emerged: (a) difficulties encountered in using virtual simulation, (b) benefits to student confidence and competence to provide patient-centered care, and (c) gaps in satisfaction due to needed improvements. Conclusions Virtual simulation could be beneficial for improving prelicensure nursing students’ confidence and competence; however, improvements to virtual simulation realism and engagement are needed to maximize user satisfaction and performance.
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Affiliation(s)
- Mi Jong Kim
- Department of Nursing, Hannam University, Daejeon, Korea, 70 Hannamro, Daedeok-Gu Daejeon 34430, Korea
| | - Hee Sun Kang
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea, 84 Heukseok-ro, Dongjak-gu, 06974 Seoul, Korea
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Abstract
BACKGROUND COVID-19 has led to increased use of screen-based simulation. However, the importance of including a robust debriefing as a component of these simulations is often neglected. PROBLEM Failing to include debriefing with screen-based simulation could negatively impact student learning outcomes. APPROACH Debriefing, including recollection, discussion to reveal understanding, feedback and reflection, is a process of helping learners make sense of learned content and knowledge as it is applied to the patient care experience. Debriefing for Meaningful Learning (DML) is an evidence-based method derived from theory, which can be easily incorporated into screen-based simulation to augment the clinical learning experience. CONCLUSION By guiding learners to consistently engage in DML, clinical decisions and actions taken during virtual simulations can be uncovered, discussed, challenged, corrected, and explored. Including a synchronous, structured debriefing like DML ensures that screen-based simulation results in meaningful learning in addition to performance feedback to foster safe and quality patient care.
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Abstract
BACKGROUND Minimal evidence compares nursing student outcomes when replacing clinical hours with manikin-based high-fidelity patient simulation (HFPS) or virtual simulation. PURPOSE The study aims were to compare differences in outcomes: (1) between 2 intervention groups (HFPS or virtual simulation) when replacing 25% of pediatric/obstetrics clinical hours and (2) pass/fail for clinical practice between the intervention groups and a face-to-face clinical group (control). METHODS A quasi-experimental study was conducted to determine differences in knowledge between intervention groups participating in 6 pediatric/obstetrics simulation scenarios. RESULTS No differences in composite knowledge were found between simulation groups (P = .319). There also was no difference in clinical practice pass/fail among the groups. CONCLUSIONS HFPS and virtual simulation were equally effective in achieving learning goals.
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Liu W. Virtual Simulation in Undergraduate Nursing Education: Effects on Students' Correct Recognition of and Causative Beliefs About Mental Disorders. Comput Inform Nurs 2021; 39:616-626. [PMID: 33935205 DOI: 10.1097/cin.0000000000000745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Virtual simulation as an emerging nursing pedagogy can facilitate optimal learning through the use of experiential learning and technology. The purpose of this prospective cohort study was to assess the long-term effects of virtual simulation on undergraduate nursing students' recognition of and causative beliefs about depression and schizophrenia. Students' responses from the simulation cohort (n = 149) and the nonsimulation cohort (n = 150) at a school of nursing in the United States were compared. While students' responses were fairly similar between the two cohorts, students who received virtual simulations more often rated character weakness as an unlikely cause for schizophrenia than those who did not receive virtual simulations. The major difference supports the use of virtual simulation in influencing positive changes in nursing students' perceptions and attitudes toward mental illness.
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Affiliation(s)
- Wei Liu
- Author Affiliation: College of Nursing and Public Health, Adelphi University, Garden City, NY
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Shorey S, Ng ED. The use of virtual reality simulation among nursing students and registered nurses: A systematic review. NURSE EDUCATION TODAY 2021; 98:104662. [PMID: 33203545 DOI: 10.1016/j.nedt.2020.104662] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/09/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Due to technological advancements and the current generation being more tech-savvy, the use of virtual worlds in nursing education and clinical practice is increasingly popular. We performed a systematic review on randomised controlled trials and quasi-experimental studies to examine the current evidence on the use of virtual worlds as a teaching tool and to ascertain the outcomes measured. DESIGN Systematic review of randomised controlled trials and quasi-experimental studies. DATA SOURCES Six electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, Web of Science, and ProQuest) were searched by title and abstract from each database's date of inception to December 2019. REVIEW METHODS The Joanna Briggs Institute's Critical Appraisal Tool was used to conduct critical appraisal of the selected articles. RESULTS Eighteen studies were included in the narrative summary. Studies were mostly conducted in developed countries and focused on nursing students. Advantages of virtual worlds include higher time-cost-effectiveness as compared to mannequin-based simulations and face-to-face lectures. Two major disadvantages were technological issues and the lack of realism. CONCLUSIONS Among the three learning outcomes (skills-based, cognitive, and affective), virtual worlds are the most effective in improving cognitive outcomes such as theoretical knowledge. This suggests that virtual worlds may be used as an alternative or complementary method to teach theoretical knowledge in nursing education.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Esperanza Debby Ng
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore
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Woon APN, Mok WQ, Chieng YJS, Zhang HM, Ramos P, Mustadi HB, Lau Y. Effectiveness of virtual reality training in improving knowledge among nursing students: A systematic review, meta-analysis and meta-regression. NURSE EDUCATION TODAY 2021; 98:104655. [PMID: 33303246 DOI: 10.1016/j.nedt.2020.104655] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES We aimed to (1) evaluate the effectiveness of virtual reality (VR) training in improving knowledge among nursing students and (2) identify the essential features of training. DESIGN This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. DATA SOURCES Randomised controlled trials (RCTs) were obtained from PubMed, EMBASE, Cochrane Library, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest and Scopus databases from inception up until 15 October 2019. REVIEW METHODS Meta-analysis and random-effects meta-regression was performed using the Comprehensive Meta-analysis 3.0 software. The overall effect was measured using Hedges' g and determined using Z-statistics at the significance level of p < 0.05. Heterogeneity was assessed using χ2 and I2 statistics. The risk of bias tool and the Grading of the Recommendation, Assessment, Development and Evaluation (GRADE) system were employed to assess individual and overall quality of evidence, respectively. RESULTS Among the 1993 records identified, 14 trials were included. Meta-analysis demonstrated a significant improvement in knowledge, with a small-to-medium effect (g = 0.47) in the VR group compared to the control group (Z = 2.66, p = 0.01). Subgroup analyses highlighted that VR training was more efficacious in delivering procedural knowledge to undergraduate nursing students when conducted in multiple, self-guided, short sessions within 30 min and by using low-moderate level of immersion. Meta-regression did not detect significant covariates that influenced knowledge scores. CONCLUSIONS Virtual reality may be a viable teaching strategy to improve knowledge acquisition, but it is presently suitable for supplementing conventional teaching methods. Nonetheless, VR could complement current pedagogy to address challenges associated with decreased clinical placement opportunities. Larger, well-designed RCTs are required to strengthen the evidence about the effectiveness of VR training.
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Affiliation(s)
- Adele Pei Ning Woon
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Wen Qi Mok
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ying Jia Shermin Chieng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Hui Min Zhang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Patricia Ramos
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Haryani Binte Mustadi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Liu W. The Effects of Virtual Simulation on Undergraduate Nursing Students' Mental Health Literacy: A Prospective Cohort Study. Issues Ment Health Nurs 2021; 42:239-248. [PMID: 32783682 DOI: 10.1080/01612840.2020.1793248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This prospective cohort study aimed to evaluate the long-term effects of virtual simulation on nursing education by measuring undergraduate nursing students' mental health literacy. Students' beliefs about the helpfulness of specific interventions for managing depression and schizophrenia were compared between the simulation cohort (n = 149) and the non-simulation cohort (n = 150) from a school of nursing in the U.S. Students in the simulation cohort showed significant increase in knowledge and acceptance of available treatment options for managing depression and schizophrenia over a one-year period. The finding supports the use of virtual simulation in undergraduate mental health nursing education with active faculty engagement.
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Affiliation(s)
- Wei Liu
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA
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Fogg N, Wilson C, Trinka M, Campbell R, Thomson A, Merritt L, Tietze M, Prior M. Transitioning from direct care to virtual clinical experiences during the COVID-19 pandemic. J Prof Nurs 2020; 36:685-691. [PMID: 33308572 PMCID: PMC7540562 DOI: 10.1016/j.profnurs.2020.09.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/26/2020] [Accepted: 09/29/2020] [Indexed: 11/28/2022]
Abstract
When the COVID-19 pandemic forced university campuses and healthcare agencies to temporarily suspend both undergraduate and graduate direct care educational experiences, nursing programs had to formulate alternative plans to facilitate clinical learning. Texas Woman's University used this opportunity to assemble a faculty group tasked with creating a set of college-wide guidelines for virtual simulation use as a substitution for traditional face-to-face clinical. The process included completing a needs assessment of both undergraduate and graduate level programs across three campuses and identifying regulatory requirements and limitations for clinical experiences. The task force utilized the information gathered to develop evidence-based recommendations for simulation hour equivalence ratios and compiled a list of virtual activities and products faculty could use to complete clinical experiences. Undergraduate and graduate student surveys were conducted to determine the effectiveness of the transition to virtual clinical experiences. Overall, the majority of survey results were positive regarding virtual simulation experiences providing students with valuable opportunities to enhance their learning. Negative comments regarding the impact of COVID-19 on a personal level included issues involving internet access and web conferencing logistics, lack of motivation to study, family difficulties, and faculty inexperience teaching in an online environment. Undergraduate pre-licensure students were provided with opportunities to successfully complete all remaining required clinical hours virtually, while graduate students were allowed to complete non-direct care hours as applicable using virtual clinical experiences.
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Affiliation(s)
- Niki Fogg
- Texas Woman's University, United States of America.
| | | | | | | | - Anne Thomson
- Texas Woman's University, United States of America
| | | | - Mari Tietze
- Texas Woman's University, United States of America
| | - Merry Prior
- Texas Woman's University, United States of America
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Chen FQ, Leng YF, Ge JF, Wang DW, Li C, Chen B, Sun ZL. Effectiveness of Virtual Reality in Nursing Education: Meta-Analysis. J Med Internet Res 2020; 22:e18290. [PMID: 32930664 PMCID: PMC7525398 DOI: 10.2196/18290] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/17/2020] [Accepted: 07/26/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Virtual reality (VR) is the use of computer technology to create an interactive three-dimensional (3D) world, which gives users a sense of spatial presence. In nursing education, VR has been used to help optimize teaching and learning processes. OBJECTIVE The purpose of this study was to evaluate the effectiveness of VR in nursing education in the areas of knowledge, skills, satisfaction, confidence, and performance time. METHODS We conducted a meta-analysis of the effectiveness of VR in nursing education based on the Cochrane methodology. An electronic literature search using the Cochrane Library, Web of Science, PubMed, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature), up to December 2019 was conducted to identify studies that reported the effectiveness of VR on knowledge, skills, satisfaction, confidence, and performance time. The study selection and data extraction were carried out by two independent reviewers. The methodological quality of the selected studies was determined using the Cochrane criteria for risk-of-bias assessment. RESULTS A total of 12 studies, including 821 participants, were selected for the final analysis. We found that VR was more effective than the control conditions in improving knowledge (standard mean difference [SMD]=0.58, 95% CI 0.41-0.75, P<.001, I2=47%). However, there was no difference between VR and the control conditions in skills (SMD=0.01, 95% CI -0.24 to 0.26, P=.93, I2=37%), satisfaction (SMD=0.01, 95% CI -0.79 to 0.80, P=.99, I2=86%), confidence (SMD=0.00, 95% CI -0.28 to 0.27, P=.99, I2=0%), and performance time (SMD=-0.55, 95% CI -2.04 to 0.94, P=.47, I2=97%). CONCLUSIONS The results of this study suggest that VR can effectively improve knowledge in nursing education, but it was not more effective than other education methods in areas of skills, satisfaction, confidence, and performance time. Further rigorous studies with a larger sample size are warranted to confirm these results.
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Affiliation(s)
- Feng-Qin Chen
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yu-Fei Leng
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jian-Feng Ge
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Dan-Wen Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Cheng Li
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Bin Chen
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi-Ling Sun
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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42
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Virtual Simulation in Nursing Education: A Systematic Review Spanning 1996 to 2018. ACTA ACUST UNITED AC 2020; 15:46-54. [DOI: 10.1097/sih.0000000000000411] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kononowicz AA, Woodham LA, Edelbring S, Stathakarou N, Davies D, Saxena N, Tudor Car L, Carlstedt-Duke J, Car J, Zary N. Virtual Patient Simulations in Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res 2019; 21:e14676. [PMID: 31267981 PMCID: PMC6632099 DOI: 10.2196/14676] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 12/29/2022] Open
Abstract
Background Virtual patients are interactive digital simulations of clinical scenarios for the purpose of health professions education. There is no current collated evidence on the effectiveness of this form of education. Objective The goal of this study was to evaluate the effectiveness of virtual patients compared with traditional education, blended with traditional education, compared with other types of digital education, and design variants of virtual patients in health professions education. The outcomes of interest were knowledge, skills, attitudes, and satisfaction. Methods We performed a systematic review on the effectiveness of virtual patient simulations in pre- and postregistration health professions education following Cochrane methodology. We searched 7 databases from the year 1990 up to September 2018. No language restrictions were applied. We included randomized controlled trials and cluster randomized trials. We independently selected studies, extracted data, and assessed risk of bias and then compared the information in pairs. We contacted study authors for additional information if necessary. All pooled analyses were based on random-effects models. Results A total of 51 trials involving 4696 participants met our inclusion criteria. Furthermore, 25 studies compared virtual patients with traditional education, 11 studies investigated virtual patients as blended learning, 5 studies compared virtual patients with different forms of digital education, and 10 studies compared different design variants. The pooled analysis of studies comparing the effect of virtual patients to traditional education showed similar results for knowledge (standardized mean difference [SMD]=0.11, 95% CI −0.17 to 0.39, I2=74%, n=927) and favored virtual patients for skills (SMD=0.90, 95% CI 0.49 to 1.32, I2=88%, n=897). Studies measuring attitudes and satisfaction predominantly used surveys with item-by-item comparison. Trials comparing virtual patients with different forms of digital education and design variants were not numerous enough to give clear recommendations. Several methodological limitations in the included studies and heterogeneity contributed to a generally low quality of evidence. Conclusions Low to modest and mixed evidence suggests that when compared with traditional education, virtual patients can more effectively improve skills, and at least as effectively improve knowledge. The skills that improved were clinical reasoning, procedural skills, and a mix of procedural and team skills. We found evidence of effectiveness in both high-income and low- and middle-income countries, demonstrating the global applicability of virtual patients. Further research should explore the utility of different design variants of virtual patients.
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Affiliation(s)
- Andrzej A Kononowicz
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland
| | - Luke A Woodham
- Institute of Medical and Biomedical Education, St George's, University of London, London, United Kingdom.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Samuel Edelbring
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Learning and Professional Development Group, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Natalia Stathakarou
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - David Davies
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Nakul Saxena
- Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jan Carlstedt-Duke
- President's Office, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Nabil Zary
- Games for Health Innovations Centre, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Gu YH, Xiong L, Bai JB, Hu J, Tan XD. Chinese version of the clinical learning environment comparison survey: Assessment of reliability and validity. NURSE EDUCATION TODAY 2018; 71:121-128. [PMID: 30286369 DOI: 10.1016/j.nedt.2018.09.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/15/2018] [Accepted: 09/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Simulation is recommended as a substitute for clinical practice among nursing students. No current guidelines exist regarding the accurate percentage of simulation hours versus clinical practice hours. Comparing simulation with clinical practice is needed so that both strategies can be optimally combined in nursing education. The 29-item Clinical Learning Environment Comparison Survey (CLECS) is validated to compare the traditional and simulated clinical environment in meeting nursing students' learning needs. This type of tool is not available in China. OBJECTIVES This study aimed to translate and test the psychometric properties of CLECS for Chinese undergraduate nursing students. DESIGN This is a cross-sectional study. SETTINGS Two nursing schools in Central and East China. PARTICIPANTS A total of 179 undergraduate nursing students who had participated in both traditional and high fidelity simulated clinical practice were recruited. METHODS A standard procedure with forward translation, back translation, cultural adaptation and pilot testing was followed to test the CLECS (Chinese version). An exploratory factor analysis was used to establish a modified factor structure of CLECS (Chinese version); a confirmatory factor analysis verified its construct validity. Reliability of the CLECS (Chinese version) was estimated using the intraclass correlation coefficients (ICCs) and Cronbach's alpha coefficients. RESULTS The exploratory factor analyses explained 61.43% and 60.11% of the total variances in traditional and simulated clinical environment. The proposed factor solution of the CLECS (Chinese version) obtained satisfactory model fit and nesting model between two nursing schools. In the proposed model, ICCs were 0.61 and 0.93, and Cronbach's alpha coefficients were 0.75 and 0.95 in the traditional and simulated clinical environment. CONCLUSIONS The CLECS (Chinese version) showed satisfactory reliability and validity among Chinese undergraduate nursing students. Further validation of the CLECS (Chinese version) is needed in a more representative and larger sample. The CLECS (Chinese version) should be further tested as an effective tool to compare the traditional and simulated clinical practice among Chinese nursing schools.
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Affiliation(s)
- Yao-Hua Gu
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, No. 115, Dong Hu Street, Wuhan, Hubei 430071, China.
| | - Li Xiong
- Department of Nursing, School of Health Sciences, Wuhan University, No. 115, Dong Hu Street, Wuhan, Hubei 430071, China
| | - Jin-Bing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA.
| | - Jing Hu
- Department of Nursing, Sanda University, No. 2727, Jinhai Street, Pudong New District, Shanghai 201209, China
| | - Xiao-Dong Tan
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, No. 115, Dong Hu Street, Wuhan, Hubei 430071, China.
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Foronda CL, Swoboda SM, Henry MN, Kamau E, Sullivan N, Hudson KW. Student preferences and perceptions of learning from vSIM for Nursing™. Nurse Educ Pract 2018; 33:27-32. [PMID: 30223110 DOI: 10.1016/j.nepr.2018.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 05/23/2018] [Accepted: 08/17/2018] [Indexed: 11/15/2022]
Abstract
This study explored BSN students' perceptions of learning with vSim for Nursing™. Using a mixed methods design with 99 students, key points of learning were medication administration and respiratory interventions. Qualitative data demonstrated learning of assessment, prioritization, and emergency management. The top student preferences of how to use virtual simulation were as a clinical makeup or to enhance lecture. The findings support the use of virtual simulation and provide data to guide nurse educators to more strategically integrate virtual simulation exercises.
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Affiliation(s)
- Cynthia L Foronda
- University of Miami, School of Nursing and Health Studies, 5030 Brunson Dr., Coral Gables, FL, 33146, United States.
| | - Sandra M Swoboda
- Johns Hopkins University, Schools of Medicine and Nursing, 600 N. Wolfe Street Osler 603, Baltimore, MD, 21287, United States.
| | - Myrthle N Henry
- University of Miami, School of Nursing and Health Studies, 5030 Brunson Dr., Coral Gables, FL, 33146, United States.
| | - Emma Kamau
- University of Miami, School of Nursing and Health Studies, 5030 Brunson Dr., Coral Gables, FL, 33146, United States.
| | - Nancy Sullivan
- Johns Hopkins University, School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, United States.
| | - Krysia Warren Hudson
- Johns Hopkins University, School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, United States.
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Tjoflåt I, Brandeggen TK, Strandberg ES, Dyrstad DN, Husebø SE. Norwegian nursing students' evaluation of vSim® for Nursing. Adv Simul (Lond) 2018; 3:10. [PMID: 29946485 PMCID: PMC6008924 DOI: 10.1186/s41077-018-0070-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/08/2018] [Indexed: 11/10/2022] Open
Abstract
Background vSim® for Nursing is the first web-based platform linked to the nursing education curriculum. It is an American simulation tool, developed in 2014 through a collaboration between Wolters Kluwer Health, Laerdal Medical and the National League for Nursing. To our knowledge, no studies have evaluated vSim® for Nursing from the nursing students’ perspective in Norway. The aim of the study was to evaluate second year Norwegian nursing students’ experiences with the virtual clinical simulation scenario in surgical nursing from vSim® for Nursing. Methods A descriptive and a convergent mixed method design was utilised. The method comprised a 7-item questionnaire with five open-ended questions. Sixty-five nursing students participated in the study. Results The majority of Norwegian nursing students evaluated the virtual clinical scenario in surgical nursing from vSim® for Nursing useful, realistic and educational in preparing for clinical placement in surgical care. However, a small portion of the nursing students had trouble understanding and navigating the American vSim® for Nursing program. Conclusions Introducing virtual simulation tools into the nursing education encompasses faculty and student preparation, guidance from faculty members during the simulation session and support for students who are facing difficulties with the simulation program.
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Affiliation(s)
- Ingrid Tjoflåt
- Department of Surgery, University Hospital, Stavanger, Norway
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