Comparison of the Effectiveness of a Virtual Simulator With a Plastic Arm Model in Teaching Intravenous Catheter Insertion Skills

Use and Effectiveness of Innovative Virtual Reality Application in Teaching Fetal Development: A Randomized Controlled Trial

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.

Developing student nurses' evaluative judgement in clinical practice tertiary education: A systematic scoping review of teaching and assessment methods

OBJECTIVES

This review aimed to systematically scope undergraduate or postgraduate tertiary higher education nursing students' clinical practice teaching and assessment methods to identify features that align with promoting students' evaluative judgement.

INTRODUCTION

Evaluative judgement is a new concept to nursing tertiary education. Currently, there are no published reviews of evaluative judgement in nursing clinical practice education. This review aims to assist nursing educators to operationalise the concept of evaluative judgement in clinical practice education. As such the starting point was to determine features of evaluative judgement in current clinical teaching and assessment designs.

INCLUSION CRITERIA

Peer reviewed qualitative or quantitative studies that have evaluated teaching and/or assessment of tertiary (university/higher education) pre-registration (undergraduate) or post-registration (postgraduate) nursing students' clinical practice.

METHODS

The systematic scoping review was prospectively registered systematic review (OSF DOI 10.17605/OSF.IO/PYWZ6) reported using PRISMA guidelines. A systematic search of five databases (Medline, Scopus, Web of Science, ProQuest, CINAHL) was conducted, limited from 1989 onwards and in English. Two reviewers independently screened titles and abstracts, then full text, with disagreements resolved with a third independent author. Data were extracted, including the frequency and methods of developing students' evaluative judgement across the categories of discerning quality, judgement process, calibration and feedback. A narrative synthesis was performed.

RESULTS

Seventy-one studies were included (n=53 teaching, n=18 assessment). Most of the included studies, included some, but not all, of the features to develop nursing students' evaluative judgment. For teaching methods, the most identified evaluative judgement features in the included studies were discerning quality (n=47), feedback (n=41) and judgement process (n=21). Only three studies included a method of calibration. For the assessment methods, feedback (n=16), discerning quality (n=15), judgement process (n=9) and calibration (n=4) were included. Many clinical practice teaching and assessment methods in nursing included features that develop students' evaluative judgement, with methods relating to discerning quality and feedback well embedded. Further adjustments are required to include methods to assist students to judge and calibrate their own performance.

CONCLUSION

This systematic scoping review identified that evaluative judgement in current nursing clinical teaching and assessment is not an overt aim. With minor adjustment to teaching and assessment design, nursing students could be better supported to develop their ability to judge the value of their own work.

Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review

Higher education for health care professionals faces numerous challenges. It is important to develop and apply methods supporting education, especially the practical skills. This scoping review aimed to explore the activities and learning outcomes of digital technology in practical skills teaching and learning in higher education for the social and health professions. Scoping review recommendations and the PRISMA-ScR checklist were applied. Randomized controlled trials published between 2016 and 2021 involving students in higher education who were taking courses in the social sciences and health care and reported interventions with digital technology activities and practices in practical teaching and learning were included. The CINAHL Plus, PubMed, Scopus, ERIC, and Sociological Abstracts/Social Services Abstracts databases were searched. Teaching methods were blended, e-learning or other online-based, and digital simulation-based activities. Teaching and learning environments, methods, resources, and activity characteristics varied, making a summary difficult. Interventions were developed in a face-to-face format prior to digitalization. The outcomes were measured at the knowledge level, not at the performance level. One-third of the studies showed a significant improvement in practical skills in the intervention group in comparison to the control conditions. The use of digital technology in the learning and teaching process have potential to develop of students' skills, knowledge, motivation, and attitudes. The pedagogy of technology use is decisive. The development of new digital methods for teaching and learning practical skills requires the engagement of students and teachers, in addition the researchers.

Peripheral Intravenous Catheter Insertion Competence and Confidence in Medical/Surgical Nurses

The objective of this study was to implement an evidence-based practice project to improve peripheral intravenous catheter (PIVC) insertion confidence and competence and to improve first-attempt success. The researcher used a blended online learning module and live simulation to increase PIVC insertion confidence and competence. Internal application of a blended curriculum model improved the first-attempt PIVC insertion success of nurses. A validated confidence assessment was completed by participants (n = 38) preintervention, immediately postintervention, and 30 days postintervention. A Mann-Whitney U test determined that nurses' confidence was significantly higher immediately following the intervention compared with preintervention (P = .003), and the increase was sustained 30 days after the intervention (P < .001). While placing a PIVC in simulation, the observer measured competence using a validated tool verifying 28 steps required, with a 76% success rate for all 28 steps. Nurses' self-reported first-attempt PIVC success increased significantly from the preintervention survey to the 30-day postintervention survey (P = .00004).

Effectiveness of Immersive Virtual Reality in Nursing Education: Systematic Review

BACKGROUND

Digital education using immersive virtual reality (VR) technology is available in nursing. Evidence of its effectiveness is essential.

PURPOSE

This review analyzed the effectiveness of and barriers to using immersive VR in nursing education.

METHODS

A structured search was performed in PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, PsycINFO, Web of Science, and ProQuest Nursing & Allied Health Database. The Medical Education Research Study Quality Instrument was used to assess the quality of studies.

RESULTS

The final review was composed of 9 studies of moderate to high quality published between 2018 and 2020. The review indicated that immersive VR increased learning, cognitive, and psychomotor performance. Most participants of the studies preferred using immersive VR in education and with a variety of experiential scenarios. Barriers were associated with technological hardware and software (eg, simulation sickness, lack of visual comfort).

CONCLUSION

The review supports the viability of immersive VR technology in nursing education.

Virtual Reality in Nursing Education 3D Intravenous Catheterization E-Learning: A Randomized Controlled Trial

BACKGROUND

The use of virtual reality in nursing student training for intravenous catheterization and fluid delivery was investigated.

METHODS

In this experimental study, 29 students were part of the experimental group while 27 were in the control group. The application was presented to the experimental group using virtual reality technology and to the control group using an intravenous injection arm model.

RESULTS

A statistically significant difference was found between the Intravenous Catheter Application and Fluid Delivery Skills Checklist scores of the students in the experimental and control groups. According to the Bondy Evaluation Scale, there was a statistically significant difference between the students who were at the "supervised" level in the experimental and control groups.

CONCLUSION

Virtual reality technology was found effective as a teaching method in the development of intravenous catheter application and fluid delivery skills. An increase in its use in nursing training is recommended.

Does the use of infrared technology (AccuVein AV-500®) for Peripheral Intravenous Cannulation (PIVC) increase the success rate in nursing students? A randomized controlled trial

BACKGROUND

PIVC is one of the essential procedures of modern medicine, and is one of the most widely used and important treatments in the clinical setting. Nevertheless, it is one of the most difficult skills to teach in nursing education, and it is the skill which causes the most anxiety in nursing students.

OBJECTIVES

The aim of the study was to examine the effect of the teaching method using infrared technology on PIVC success, duration, and the level of psychomotor skills and knowledge in the acquisition of PIVC skills in nursing students.

METHODS

This was a pre-test post-test randomized experimental study with a control group. The research was conducted in the Skills and Simulation Laboratory of a Nursing Faculty of a university between December 2019 and February 2020 to examine the effects of teaching PIVC measurement via infrared light on students' success rate. A theory lesson on PIVC followed 15 days later by laboratory practical was carried out with all of the students included in the study. The PIVC Knowledge Evaluation Form as a pre-test. The researchers completed the PIVC Skills Performance Test from observation during the application of the checklist. Immediately after the procedure, the PIVC Knowledge Evaluation Form was applied as a post-test.

RESULTS

The procedure success rate of the experimental group was 90%, and that of the control group was 46%. Comparing PIVC skill scores between the groups, the difference was found to be statistically significant (Z = -2.741; p < 0.05). The groups' PIVC knowledge levels increased in a similar way.

CONCLUSION

Teaching with infrared technology contributes more to students' success in PIVC skills than does standard teaching. Both methods were effective in developing knowledge of PIVC.

Effects of simulation technology-based learning on nursing students' learning outcomes: A systematic review and meta-analysis of experimental studies

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.

Effect of simulation-based teaching on nursing skill performance: a systematic review and meta-analysis

Objective

To summarize and produce aggregated evidence on the effect of simulation-based teaching on skill performance in the nursing profession. Simulation is an active learning strategy involving the use of various resources to assimilate the real situation. It enables learners to improve their skills and knowledge in a coordinated environment.

Methods

Systematic literature search of original research articles was carried out through Google Scholar, Medline, and Cochrane Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Studies conducted on simulation-based teaching and skill performance among nursing students or clinical nursing staff from 2010 to 2019, and published in the English language, were included in this study. Methodological quality was assessed by Joanna Briggs Institute, and the risk of bias was also assessed by Cochrane risk of bias and the risk of bias assessment tool for non-randomized studies (ROBINS-I) checklists.

Results

Initially, 638 titles were obtained from 3 sources, and 24 original studies with 2209 study participants were taken for the final analysis. Of the total studies, 14 (58.3%) used single group prep post design, 7 (29.1%) used high fidelity simulator (HFS), and 7 (29.1%) used a virtual simulator (VS). Twenty (83.3%) studies reported improved skill performance following simulation-based teaching. Simulation-based teaching improves skill performance among types of groups (single or double), study regions, high fidelity (HF), low fidelity (LF), and standard patient (SP) users. But the effect over virtual and medium fidelity simulators was not statistically significant. Overall, simulation-based teaching improves the skill performance score among the experimental group (d = 1.01, 95% confidence interval [CI] [0.69–1.33], Z = 6.18, P < 0.01, 93.9%). Significant heterogeneity and publication bias were observed during the pooled analysis.

Conclusions

Simulation did improve skill performance among the intervention groups, but the conclusion is uncertain due to the significant heterogeneity. The large extent of difference among original research has necessitated the development of well-defined assessment methods for skills and standardized simulation set-up for proper assessment of their effects.

Effectiveness of simulation-based peripheral intravenous catheterization training for nursing students and hospital nurses: A systematic review and meta-analysis

BACKGROUND

Peripheral intravenous catheterisation (PIVC) is a complex procedure.

AIM

This study reviewed studies evaluating the effects of different simulators in comparison with traditional methods used in PIVC training for nursing students and hospital nurses.

DESIGN

A systematic review and meta-analysis of randomised (RCT) and non-randomised controlled (N-RCT) studies.

METHODS

MEDLINE, Cochrane, Scopus, ERIC, Web of Science, and ScienceDirect were searched using PIVC, simulation and nursing education. The quality of evidence was assessed using the GRADE system; the risk of bias was assessed using the RoB 2 (for RCTs) and A Cochrane Risk of Bias Assessment Tool for N-RCTs. The study was conducted as per the PRISMA guidelines.

RESULTS

In total, 2,812 records were identified, and 12 studies published between 2002 and 2018 were finally included. Most studies included Virtual IV simulator and the plastic IV arm model in PIVC training for hospital nurses and nursing students, reported on outcomes such as PIVC-related knowledge, skills, confidence, state/trait anxiety and satisfaction. Seven studies were included in the meta-analysis, the effect sizes for all the outcomes ranged from small to moderate. However, the effect sizes were non-significant for all outcomes. The quality of evidence was assessed as being low for skills, knowledge, satisfaction, and trait/state anxiety, and moderate for confidence.

CONCLUSIONS

The effect of Virtual IV training on PIVC-related skills, knowledge, satisfaction and anxiety among nursing students and hospital nurses, in comparison with the plastic arm training method, remains unclear. However, Virtual IV training was found to increase PIVC confidence.

RELEVANCE TO CLINICAL PRACTICE

There is a small effect in favour of VR in PIVC education although non-significant. More evidence is needed to determine the superiority of simulation methods. In PIVC training of nurses and nursing students, hospitals and schools can choose a method in accordance with their resources.

TRIAL REGISTRATION

PROSPERO 2019 CRD42019124599.

The effectiveness of virtual reality simulation as learning strategy in the acquisition of medical skills in nursing education: a systematic review

PURPOSE

This review was aimed to evaluate the effectiveness of virtual reality simulation as a teaching / learning strategy on the acquisition of clinical skills and performance, self-confidence, satisfaction and anxiety level in nursing education.

METHODOLOGY

The Preferred Reporting Items for Systematic Reviews guidelines, using the PICO model that is based on an evidence-based practice process was matched. A total of twenty-three studies included six themes: performance skills (n = 13), self-confidence (n = 8), satisfaction (n = 10), anxiety level (n = 3), self-efficacy (n = 4), and knowledge (n = 15). Experimental randomised control trials and quasi-experimental studies from 2009 to 2019, conducted in English, were included. Nursing students (n = 1797; BSN, ADN, MSc, LPN) participated.

RESULTS AND CONCLUSION

This review was indicated that virtual reality simulation provides learning strategy to acquire clinical skills, improve knowledge acquisition, increase self-confidence, self-efficacy, and satisfaction level, and decrease anxiety levels among nursing students.

The Predictive Strength of Students' Self-Efficacy, Problem Solving Skills to Perform Catheter Care

PURPOSE

The aim of this study was to determine the predictive strength of students' self-efficacy, problem-solving skills, and other characteristics in performing intravenous practices and monitor phlebitis and infiltration.

METHODS

This cross-sectional study was carried out with 736 third and fourth-year students studying at the Health Sciences Faculties of Balikesir and Sakarya universities. The data were collected using the Self-Efficacy Scale, Problem-Solving Inventory and Catheter Care and Infiltration Monitoring Questionnaire.

RESULTS

The participants' mean Catheter Care and Infiltration Monitoring Questionnaire score significantly and positively correlated with their mean Self-Efficacy Scale score on a moderate level (r=.25; p <.001) but significantly and negatively correlated with their mean Problem-Solving Inventory score on a moderate level (r=-.21; p <.001). In other words, because a low Problem-Solving Inventory score indicates that the person's problem-solving skill is high, the Care and Infiltration Monitoring Questionnaire score increased as the problem-solving skill increased. While the Self-Efficacy Scale predicted the year of study and catheter care and infiltration monitoring variables positively, the Problem-Solving Inventory predicted the satisfaction with the profession variable negatively.

CONCLUSION

Self-efficacy, problem-solving, liking the profession, and year of study predict success in catheter care and infiltration monitoring. For this reason, guidance may be provided in the development of a comprehensive education system toward increasing students' problem-solving skills, self-efficacy, and professional knowledge and skills.

Effectiveness of virtual reality training in improving knowledge among nursing students: A systematic review, meta-analysis and meta-regression

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.

The use of virtual reality simulation among nursing students and registered nurses: A systematic review

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.

Effectiveness of Virtual Reality in Nursing Education: Meta-Analysis

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.

Simulación de la capacitación en emergencias para estudiantes de enfermería

Introducción: La capacitación de los estudiantes de enfermería en maniobras de reanimación cardiopulmonar (RCP) es esencial para un desempeño seguro y de calidad en diferentes escenarios de desempeño de enfermería. La integración a los escenarios de práctica clínica, desde los primeros años del programa, proporciona una mayor seguridad para actuar en situaciones de emergencia. El objetivo era evaluar los conocimientos de los estudiantes de enfermería recién graduados antes y después de realizar una capacitación sobre soporte vital básico (SVB) mediante simulación. Materiales y métodos: Se trata de un estudio cuasiexperimental llevado a cabo en 2015 en una institución pública de educación superior en el sureste de Brasil. Los estudiantes respondieron una prueba previa y, justo después de la intervención, respondieron otra prueba posterior. Para el análisis, se utilizaron las pruebas emparejadas de McNemar y Wilcoxon. Resultados: Se identificó que inmediatamente después de tomar el curso, los estudiantes mostraron tener conocimientos satisfactorios  (≥ 80%) en varios temas. Sin embargo, las preguntas de la prueba relacionadas con los eslabones de la cadena de supervivencia (-18.7%; p = 0.004) y con la secuencia de la maniobra de apertura de vía aérea (-16.0%; p = 0.091) mostraron una reducción del número de respuestas correctas después de la intervención. Discusión: El uso de estrategias combinadas, incluida la simulación de fidelidad media para la enseñanza de SVB, ha facilitado la comprensión del contenido de SVB. Conclusiones: El uso de la simulación mostró una evolución positiva del conocimiento sobre los temas relacionados con la profundidad de la compresión torácica, la secuencia de la RCP y la relación compresión-ventilación por minuto en la RCP. Como citar este articulo: Costa, Christefany Régia Braz; Melo, Elizabete Santos; Reis, Renata Karina. Simulação no ensino de emergência para estudantes de enfermagem. Revista Cuidarte. 2020; 11(2): e853. http://dx.doi.org/10.15649/cuidarte.853

How does virtual reality simulation compare to simulated practice in the acquisition of clinical psychomotor skills for pre-registration student nurses? A systematic review

INTRODUCTION

Simulated practice, both face-to-face and computer-based, is well established within healthcare education, allowing rehearsal and refinement of clinical skills. Virtual reality is a new and relatively untested method of delivering simulation learning.

AIMS

This project aims to systematically review, critically appraise and synthesise the published evidence in order to answer the question 'How does virtual reality simulation compare to simulated practice in the acquisition of clinical psychomotor skills for pre-registration student nurses?'

METHODS

The databases CINAHL, Medline, Psychinfo, PubMed and the University of Portsmouth 'Discover' database were searched between 4th June 2018 and 7th July 2018 using the terms; pre-registration, pre-licensure, "pre-registration", "pre licensure", trainee, student, students, nurs*, virtual-reality, VR, "virtual reality", "augmented reality", clinical, skil*, competenc* and mastery. Inclusion and exclusion criteria relating to type of paper, population, intervention, comparison and outcome were applied. Selected articles were appraised using the Centre for Reviews and Dissemination guidelines. As clinical psychomotor skill mastery requires the application of theoretical knowledge to a motor skill in a range of contexts, outcomes relating to these elements (namely knowledge, cognitive gain, skill performance, skill success and time to complete) were analysed.

FINDINGS

Nine studies were included in the review. All studies employed a quasi-experimental design but were of mixed methodological quality. There was significant heterogeneity in methods and missing data, limiting synthesis and precluding meta-analysis. Virtual reality groups performed favourably in comparison to simulation groups in posttest knowledge scores, cognitive gain, skill performance scores and skill success rate. There was divergence of results in relation to time taken to complete the skill.

DISCUSSION

Whilst the results are generally favourable for virtual reality, variation in devices, data collection tools and outcome measurements mean that caution must be used in their interpretation. Outcomes relating to psychomotor skill performance support the use of virtual reality as an educational intervention. Time taken to undertake and complete the skill is questioned as a valid outcome measurement due to the potential to forgo skill accuracy in favour of speed.

CONCLUSION

Virtual reality is an emerging technology with a limited body of evidence, which is of variable methodological quality. It appears that virtual reality leads to educational outcomes similar or superior to traditional simulated practice. Consensus in definitions is needed along with further research to advance knowledge of this developing area of practice. Such research is needed to justify the cost of investing in this new technology.

Differences in Psychomotor Skills Teaching and Evaluation Practices in Undergraduate Nursing Programs

AIM

The purpose of this study was to understand the methods faculty use to teach and evaluate psychomotor skill performance in associate and baccalaureate nursing programs, resources available to students to master these skills, and policies and procedures related to summative evaluation of psychomotor skills.

BACKGROUND

Despite the importance of psychomotor skills competency in registered nursing programs, published methods for teaching and evaluating competency vary. The literature does not support a particular strategy for teaching or evaluation.

METHOD

In this primarily quantitative descriptive study, participants completed a 28-item questionnaire developed by the authors based on a review of the literature and personal teaching experience.

RESULTS

All respondents indicated that their institutions conducted summative assessment of psychomotor skills; however, the methods for teaching and evaluation varied widely.

CONCLUSION

Well-designed control studies and consensus guidelines from professional nursing education organizations would assist faculty in implementing consistent, effective, evidence-based strategies.