An Exploration of Debriefing in Virtual Simulation

Come and see through my eyes: A systematic review of 360-degree video technology in nursing education

OBJECTIVES

Viewers can watch 360-degree videos from any angle, like a panorama, and experience the virtual environment directly. Recently, there has been a growing interest in immersive and interactive technologies in education, and the use of 360-degree videos has become popular. This systematic review was conducted to present the current use of 360-degree videos in nursing education.

DESIGN

Systematic review.

DATA SOURCES

In addition to screening the Google Scholar, MEDLINE, SCOPUS, and EBSCO databases, we also performed hand searching.

REVIEW METHODS

Relevant keywords were used to identify trials published in the above-mentioned databases from inception to March 1, 2023. In the first step, the titles, abstracts, and full texts of the retrieved studies were independently reviewed by two authors according to the inclusion criteria. Studies on which there was disagreement were reviewed by all authors, and a consensus decision was reached. The data from the studies included in the review were analyzed and reported using the PRISMA 2020 checklist.

RESULTS

Twelve articles that met the inclusion criteria were reviewed. It was determined that 360-degree video scenarios used in nursing education were mostly related to mental health nursing, and the videos were mostly viewed through head-mounted displays, without any interactive features. Most difficulties encountered in the use of these videos were related to motion sickness. The main implications of the reviewed studies were that 360-degree videos contributed to the development of students' knowledge, skills, and attitudes and that the use of these videos was recommended.

CONCLUSIONS

As an innovative application the use of 360-degree videos in nursing education was examined from various perspectives in this review. The results showed that the use of such videos was convenient and effective for nursing education.

Virtual simulation and problem-based learning enhance perceived clinical and cultural competence of nursing students in Asia: A randomized controlled cross-over study

BACKGROUND

Both clinical and cultural competencies are of paramount importance in ensuring patients' safety and high-quality care. While problem-based learning (PBL) is a widely applied pedagogy in nursing education, an emerging technology-based pedagogy, virtual simulation provides a realistic clinical learning experience for students. It can be an effective solution for continuing clinical and cultural learning across countries in the era of the pandemic.

OBJECTIVES

This study aimed to compare the effectiveness of virtual simulation and PBL on the perceived clinical and cultural competence for nursing students.

DESIGN

A randomized controlled cross-over study design was used.

SETTINGS AND PARTICIPANTS

Sixty-one undergraduate and postgraduate nursing students from five Asian regions were selected for participation.

METHODS

Participants were randomized to receive either virtual simulation (group A) or PBL (group B) for one day, followed by another intervention on the second day. Three self-reported questionnaires were used: Clinical Competence Questionnaire (CCQ), Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals-Student Version (IAPCC-SV), and demographic questionnaire.

RESULTS

The results revealed that students in both arms had significant improvements in CCQ total score (A: d = 21.500, P < 0.001; B: d = 16.710, P = 0.001), nursing professional behavior (A: d = 8.233, P < 0.001; B: d = 6.323, P < 0.001), and advanced nursing skills (A: d = 2.533, P = 0.008; B: d = 2.129, P = 0.029) after two interventions. In addition, both arms demonstrated significant improvements in IAPCC-SV total score (A: d = 3.467, P = 0.037; B: d = 4.032, P = 0.010) and cultural skills (A: d = 0.767, P = 0.012; B: d = 1.000, P = 0.001). No significant differences were observed between the two arms.

CONCLUSIONS

The findings indicated that both virtual simulation and PBL were effective in promoting students' perceived clinical and cultural competence. As both education modes have their own uniqueness and effectiveness in both outcomes, the combination of both could enhance the variability of learning modalities. Notably, the use of virtual simulation first could engage students better in learning and achieve better educational outcomes.

Comparison of Learning Facilitated by Traditional and Virtual Case Studies for Teaching the Nursing Approach to Care

Aim:

The objective of this study is to investigate the adoption of these two strategies for teaching the steps of the care process to Moroccan nursing students. We attempt to answer the following questions: What is the preference of nursing students between traditional case studies and virtual case studies? What are their suggestions for improving teaching practices? According to their point of view, which of the teaching strategies is more conducive to the appropriation of knowledge and the development of skills related to the care process?

Background:

Case-based learning has long been one of the active teaching strategies widely used by nursing educators. However, the constraints inherent to traditional case study learning have prompted educators to seek alternative teaching practices. Today, virtual case studies are recognised as one of the most recommended and innovative teaching approaches to address these constraints in the nursing context.

Objective:

the present study aims to explore students' perceptions of traditional case studies and virtual case studies as facilitated learning methods for teaching the nursing process.

Methods:

We conducted a questionnaire survey at the Higher Institute of Nursing Professions and Health Techniques Casablanca in 2021 among first-year polyvalent nursing students. The course ‘Conceptualization and Care Planning’ was taught based on these two different pedagogies.

Results:

Comparing the means via a t-test of the paired samples showed that there was a significant difference for all items (p-value&lt;0.005) between learning facilitated by traditional case studies and virtual case studies.

Conclusion:

These results demonstrate that virtual case studies are an innovative and well-received educational tool for nursing students compared to traditional case studies.

The effect of asynchronous group discussions on nurse practitioner student debriefing experience in virtual simulation

ABSTRACT

Debriefing facilitates student learning of critical concepts and faculty evaluation of simulation learning outcomes. However, effective practices in debriefing after virtual simulation, including the impact of software-generated performance feedback and asynchronous group debriefing, are not well understood. Student perceptions of two different methods of postsimulation debriefing were explored by comparing software-generated performance feedback only versus software-generated feedback combined with an asynchronous, faculty-facilitated, online discussion based on the 3D Model of Debriefing. The Debriefing Experience Scale was used to evaluate self-reported debriefing experiences in 68 advanced practice nursing students before and after implementation of an online discussion-board debriefing strategy. Students reported an improved debriefing experience when simulation software-generated feedback was combined with asynchronous online discussion compared with automated software-generated feedback alone. Implications for faculty are discussed including lessons learned to support online, asynchronous debriefing experiences, and how to engage students in meaningful discussions that triangulate feedback from the simulation software, peers, and their instructor.

Considerations for the Effective Integration of Virtual Simulation in the Undergraduate Nursing Curriculum

Nursing education employs a cadre of strategies to address faculty shortages, increased student admissions, and the decreased availability of clinical sites. Virtual simulation provides an innovative way to provide a robust learning experience that can be used in conjunction with or in lieu of some portion of clinical experiences. The authors highlight how virtual simulation can be used and outline considerations for educators considering virtual simulation integration.

Nursing Students' Perceptions and Experiences of Using Virtual Simulation During the COVID-19 Pandemic

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.

Using Debriefing for Meaningful Learning With Screen-Based Simulation

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.

The Big Bang: A Virtual Subarachnoid Hemorrhage Simulation for Preclinical Medical Students

Simulation-based learning is important for rare, high mortality cases, which are unlikely to be witnessed during clinical rotations but are likely to be encountered during future practice such as a subarachnoid hemorrhage. Neurology case simulations, especially those targeted at preclinical learners, are underrepresented in simulation pedagogy, and preclinical learners are underrepresented in a meta-analysis of the efficacy of simulation-based medical education. We designed a virtual simulation of subarachnoid hemorrhage for preclinical medical students, which can be implemented during restricted access to clinical learning. The simulation is 15 minutes long and requires only one standardized patient and one evaluator, which makes this simulation accessible to institutions with limited simulation resources. We adapted the validated questions from the "Simulation Evaluation Tool - Modified" for our post-simulation survey, which will detect the students' level of confidence and their perceived learning post-simulation. The analysis of student experiences using this validated tool will contribute to the literature base surrounding the efficacy of virtual simulation as a training tool for preclinical learners.

Incorporating the Reflective Pause in Simulation: A Practical Guide

Many articles exist today espousing the value of debriefing following a simulation or gaming event. Although debriefing, a reflection-on-action strategy, is important, a useful reflection strategy may accentuate the reflection-in-action process that is arguably even more important than the debriefing. In this article, we explain a concept called the reflective pause and how it can be used during simulation cases to lead the learners to the objectives and enhance the learning process. We provide a review of the literature concerning reflection-in-action and ways that the reflective pause may be used during key learning events. The reflective pause is relatively absent from the simulation-based education lexicon. Used effectively, the reflective pause may become one of the most valuable learning strategies in a simulation educator's tool belt. [J Contin Educ Nurs. 2020;51(1):32-38.].

A review of virtual-simulation for assessing healthcare students' clinical competency

OBJECTIVES

Health professional education is transitioning to online platforms to meet students' need for flexibility and international access. However, there is a necessity for authentic presentation of educational material particularly in regard to clinical skills development. There has been major growth in the delivery of virtual simulated-based learning and assessment to provide clinical skill acquisition in an online platform. The aim of this review was to explore the use of virtual simulation to assess clinical competence in health education.

DESIGN

Integrative review.

DATA SOURCES

Peer reviewed studies published between 2008 to March 2020 were searched across PubMed, Embase, Cochrane Library, CINAHL Medline, Scopus, and PsycINFO.

REVIEW METHODS

The Preferred Reporting Items for Systematic reviews and Meta-Analyses was followed. Twenty-three studies, which met the inclusion criteria, were downloaded, and a quality appraisal and analysis was completed by the research team.

RESULTS

A thematic analysis identified four themes; pedagogy differences across disciplines, debriefing to enhance learning, preparing healthcare professionals in a safe and cost-effective environment, and managing challenges of virtual simulation. Debriefing with students within the online environment enabled students to share experience and reflect on choices for a deeper learning experience.

CONCLUSIONS

Virtual simulation can prepare students for the clinical environment by providing safe practice within complex clinical situations. Challenges related to managing and debriefing students must be overcome to ensure best student learning outcomes. Virtual simulation is a feasible strategy to assess students' clinical competency and support their learning in both medical and nursing programs, however simulation should be authentic and incorporate reflection.

Student preferences and perceptions of learning from vSIM for Nursing™

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.