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

Clinical virtual simulation: predictors of user acceptance in nursing education

BACKGROUND

Using virtual patients integrated in simulators expands students' training opportunities in healthcare. However, little is known about the usability perceived by students and the factors/determinants that predict the acceptance and use of clinical virtual simulation in nursing education.

OBJECTIVES

To identify the factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing education.

METHODS

Observational, cross-sectional, analytical study of the use of clinical virtual simulation in nursing to answer the research question: What factors/determinants predict the acceptance and use of a clinical virtual simulator in nursing education? We used a non-probabilistic sampling, more specifically a convenience sample of nursing degree students. The data were collected through a questionnaire adapted from the Technology Acceptance Model 3. In technology and education, the Technology Acceptance Model is a theoretical model that predicts the acceptance of the use of technology by users.

RESULTS

The sample comprised 619 nursing students, who revealed mean values of perceived usefulness (M = 5.34; SD = 1.19), ease of use (M = 4.74; SD = 1.07), and intention to use the CVS (M = 5.21; SD = 1.18), in a Likert scale of seven points (1-the worst and 7 the best possible opinion). This study validated the use of Technology Acceptance Model 3 adapted and tested the related hypotheses, showing that the model explains 62% of perceived utility, 32% of ease of use, and 54% of intention to use the clinical virtual simulation in nursing by nursing students. The adequacy of the model was tested by analysis of the direct effects of the relationships between the internal constructs (PU-BI, β = 0.11, p = 0.012; PEOU-BI, β = -0.11, p = 0.002) and the direct relations between some of the constructs internal to the Technology Acceptance Model 3 and the external determinants Relevance for learning and Enjoyability. In the proposed model, the external constructs that best predicted perceived usefulness, ease of use, and behaviour intention to use the clinical virtual simulation in nursing were Relevance for learning and Enjoyability.

CONCLUSIONS

These study results allowed us to identify relevance for learning and enjoyability as the main factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing.

Educating nursing students for sustainable future rural health-care services: An umbrella review

BACKGROUND

Rural nursing education stands as a way to contribute to a sustainable nurse workforce in rural areas. Different approaches to organizing rural nursing education are described in the existing literature.

OBJECTIVE

To explore scientific reviews about rural nursing education and synthesize current knowledge as "best practice" recommendations for rural nursing education regarding the required organization of rural nursing education programs, what are the competencies required to function as a nurse in rural health-care settings, and the key environmental features for learning in rural nursing education programs.

DESIGN

An umbrella review.

PARTICIPANTS

Nursing students, newly graduated nurses, and clinical supervisors involved in nursing education in rural areas.

DATA SOURCES

A systematic literature search was conducted. Of the 276 review articles found, 93 were screened by title and abstract and 27 were screened in full text. The period searched was 2000-2022, and the literature search was peer-reviewed and published.

REVIEW METHODS

The Joanna Briggs Institute (JBI) methodology for umbrella reviews guided the design, search, and the reporting of the findings of the included reviews. Four reviewers screened for inclusion and exclusion using Covidence in a double blinded process. The analysis was guided by the JBI guidelines for umbrella review syntheses. Two reviewers conducted the analysis.

RESULTS

Sixteen reviews were included; eight scoping reviews, six integrative reviews, one narrative review, and one rapid review. The synthesis of current evidence provides the following "best practice" suggestions: (a) fostering context-sensitive and collaboratively designed education environments is recommended; (b) integrating curricula tailored for the nursing role and rural practice is recommended (c) establishing a supportive learning environment that encourages students' motivation and academic success; and (d) clinical placements in locally developed learning settings address the educational needs required for practice in the rural workforce.

CONCLUSIONS

Rural nursing education needs to be properly aligned with the context and health-care development, to educate nurses who can meet the community's needs today and in the future. A well-functioning collaboration between university faculty and local community stakeholders in a co-creation process stands out as vital to build a sustainable, flexible, rural nursing education program.

TWEETABLE ABSTRACT

Umbrella review: Flexible, co-created education might be "best practice" in rural undergraduate nursing programs.

Exploring medical students' perceptions of individual and group-based clinical reasoning with virtual patients: a qualitative study

BACKGROUND

Virtual Patients are computer-based simulations used to teach and evaluate patient interviews, medical diagnoses, and treatment of medical conditions. It helps develop clinical reasoning skills, especially in undergraduate medical education. This study aimed to and investigate the medical students' perceptions of individual and group-based clinical reasoning and decision-making processes by using Virtual Patients.

METHODS

The study group comprised 24 third-year medical students. Body Interact® software was utilized as a VP tool. The students' readiness and the courses' learning goals were considered when choosing the scenarios. Semi-structured interview forms were employed for data collection. MAXQDA 2020 qualitative analysis software was used to analyze the data. The students' written answers were analyzed using content analysis.

RESULTS

The participants perceived individual applications as beneficial when making clinical decisions with Virtual Patients, but they suggested that group-based applications used with the same cases immediately following individual applications were a more appropriate decision-making method. The results indicated that students learn to make decisions through trial and error, based on software scoring priorities, or using clinical reasoning protocols.

CONCLUSION

In group-based reasoning, the discussion-conciliation technique is utilized. The students stated that the individual decision-making was advantageous because it provided students with the freedom to make choices and the opportunity for self-evaluation. On the other hand, they stated that the group based decision-making process activated their prior knowledge, assisted in understanding misconceptions, and promoted information retention. Medical educators need to determine the most appropriate method when using Virtual Patients, which can be structured as individual and/or group applications depending on the competency sought.