Virtual and Augmented Realities in Nursing Education: State of the Science

Adoption of Augmented Reality in Educational Programs for Nurses in Intensive Care Units of Tertiary Academic Hospitals: Mixed Methods Study

BACKGROUND

In the wake of challenges brought by the COVID-19 pandemic to conventional medical education, the demand for innovative teaching methods has surged. Nurse training, with its focus on hands-on practice and self-directed learning, encountered significant hurdles with conventional approaches. Augmented reality (AR) offers a potential solution to addressing this issue.

OBJECTIVE

The aim of this study was to develop, introduce, and evaluate an AR-based educational program designed for nurses, focusing on its potential to facilitate hands-on practice and self-directed learning.

METHODS

An AR-based educational program for nursing was developed anchored by the Kern six-step framework. First, we identified challenges in conventional teaching methods through interviews and literature reviews. Interviews highlighted the need for hands-on practice and on-site self-directed learning with feedback from a remote site. The training goals of the platform were established by expert trainers and researchers, focusing on the utilization of a ventilator and extracorporeal membrane oxygenation system. Intensive care nurses were enrolled to evaluate AR education. We then assessed usability and acceptability of the AR training using the System Usability Scale and Technology Acceptance Model with intensive care nurses who agreed to test the new platform. Additionally, selected participants provided deeper insights through semistructured interviews.

RESULTS

This study highlights feasibility and key considerations for implementing an AR-based educational program for intensive care unit nurses, focusing on training objectives of the platform. Implemented over 2 months using Microsoft Dynamics 365 Guides and HoloLens 2, 28 participants were trained. Feedback gathered through interviews with the trainers and trainees indicated a positive reception. In particular, the trainees mentioned finding AR particularly useful for hands-on learning, appreciating its realism and the ability for repetitive practice. However, some challenges such as difficulty in adapting to the new technology were expressed. Overall, AR exhibits potential as a supplementary tool in nurse education.

CONCLUSIONS

To our knowledge, this is the first study to substitute conventional methods with AR in this specific area of critical care nursing. These results indicate the multiple principal factors to take into consideration when adopting AR education in hospitals. AR is effective in promoting self-directed learning and hands-on practice, with participants displaying active engagement and enhanced skill acquisition.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05629663; https://clinicaltrials.gov/study/NCT05629663.

Prebrief Time for Immersive Virtual and Augmented Reality Simulation: An Integrative Review

BACKGROUND

Virtual reality and augmented technology are rapidly advancing and hold the potential to transform nursing education by offering a convenient, efficient, learner-centered way to educate students. A comprehensive and time-oriented prebrief is essential to the process.

PURPOSE

This review analyzes the status of scientific exploration regarding the prebrief and time allotments for virtual and augmented reality simulation.

METHODS

Whittemore and Knafl's 5-stage method guided this integrative review. The authors searched 6 databases and selected 7 articles based on inclusion criteria.

RESULTS

The findings from this review demonstrated objectives, a safe learning environment, orientation, preparation materials, and time in the prebrief; yet, inconsistencies persist in the virtual and augmented reality prebrief.

CONCLUSIONS

Defining a comprehensive and consistent prebrief is essential for high-quality simulation. A more standardized process, including time allotments, must be established for virtual and augmented reality.

Simulation- vs. Didactic-Based Learning for Rehabilitation Nurses Caring for Patients With Autonomic Dysreflexia

PURPOSE

Autonomic dysreflexia (AD) is associated with spinal cord injury, manifesting in symptoms of high blood pressure, bradycardia, headache, diaphoresis, and anxiety. Nurses often manage these symptoms; thus, nursing knowledge of AD is crucial. The purpose of this study was to improve AD nursing knowledge while exploring differences between simulation and didactic learning in nurse education.

DESIGN AND METHODS

This prospective pilot study used two types of learning (simulation vs. didactic) to determine if one was superior to the other regarding nursing knowledge of AD. Nurses were given a pretest, randomized to simulation or didactic learning, and then given a posttest 3 months later.

RESULTS

Thirty nurses were enrolled in this study. Seventy-seven percent of nurses held a BSN degree with an average of 15.75 years in nursing. The mean knowledge scores for AD at baseline for the control (13.9 [2.4]) and intervention (15.5 [2.9]) groups were not statistically different ( p = .1118). The mean knowledge scores for AD after either didactic- or simulation-based education for the control (15.5 [4.4]) and intervention (16.5 [3.4]) groups were not statistically different ( p = .5204).

CLINICAL RELEVANCE

Autonomic dysreflexia is a critical clinical diagnosis that requires prompt nursing intervention to prevent threatening consequences. This study focused on how different methods of education best benefited AD knowledge acquisition and how simulation versus didactic learning impacts overall nursing education.

CONCLUSIONS

As a whole, providing nurses with AD education was helpful in improving their understanding of the syndrome. However, our data suggest that both didactic and simulation are equally effective methods to increase AD knowledge.