Effects of Nursing Simulation Using Mixed Reality: A Scoping Review

Integrating mixed reality preparation into acute coronary syndrome simulation for nursing students: a single-group pretest-posttest study

BACKGROUND

Timely and effective intervention within the 'golden hour'-the critical first 90 min after the symptom onset-is crucial for initiating life-saving treatment and reducing mortality in acute coronary syndrome (ACS). This highlights the need for nursing students to be proficient in ACS care, emphasizing the importance of preparatory training. This study enhanced traditional simulation methods by integrating a mixed reality (MR) preparation step, offering a more immersive learning experience. We aimed to evaluate the effectiveness of integrating MR preparation into ACS simulation education, focusing on enhancements in knowledge, self-confidence in learning, and self-efficacy in learning. Additionally, we examined performance, practice immersion, and satisfaction to comprehensively evaluate the MR application.

METHODS

One-group pretest-posttest design was implemented in a convenience sample of thirty-nine senior nursing students from a university in South Korea in August 2022. We developed a simulation program integrating MR preparation into ACS simulation (IMRP-ACSS), which was validated through expert review for content validity. The students participated in the simulation program over six hours across two days, including a 40-minute individual session of MR-based simulation preparation using head-mounted displays (the HoloLens 2). Individual changes in knowledge, self-confidence in learning, and self-efficacy in learning evaluated by the survey were analyzed using paired t-tests. Additionally, group performance assessed using the checklist was analyzed. Immersion and satisfaction were measured with a tool and a 10-point Likert scale, respectively.

RESULTS

Individually, participants demonstrated significantly increased knowledge (t = 11.87, p < .001), self-confidence in learning (t = 7.17, p < .001), and self-efficacy in learning (t = 4.70, p < .001) post-education. Group performance yielded a mean score of 56.43/70 ± 7.45. Groups scored higher in electrocardiogram interpretation, patient safety, and heparin administration. Participants reported a practice immersion level of 37.82/50 ± 9.13 and expressed satisfaction with the program, achieving an average score of 8.85/10 ± 1.35.

CONCLUSION

Integrating MR preparation into ACS simulation enhanced nursing students' knowledge, self-confidence in learning, and self-efficacy in ACS care, providing a replicable and immersive learning experience. This method is an effective addition to nursing education, preparing students through comprehensive, technology-enhanced training.

Educational effects of and satisfaction with mixed-reality-based major trauma care simulator: A preliminary evaluation

Mixed reality (MR) is a hybrid system that projects virtual elements into reality. MR technology provides immersive learning using various real-world tools. However, studies on educational programs using MR are scarce. This study aimed to investigate the educational effects of and satisfaction with an MR-based trauma decision-making simulator. A total 40 of trainees self-selected to participate in this study. All of them participated in the MR trauma simulator for approximately 30 minutes and conducted voluntary learning without any external help. Declarative knowledge, measured using 20 multiple-choice questions, was assessed before and after MR trauma training. To confirm the educational effect, test scores before and after MR trauma training were compared using a paired t-test. Student satisfaction after training was measured using a ten-item questionnaire rated on a five-point Likert scale. A pretest-posttest comparison yielded a significant increase in declarative knowledge. The percentage of correct answers to multiple choice questions increased (from a mean of 42.3, SD 12.4-54.8, SD 13) after the MR-based trauma assessment and treatment training (P < .001). Of the participants, 79.45% were satisfied with the overall experience of using the MR simulator. This study demonstrated a meaningful educational effect of the MR-based trauma training system even after a short training time.

3D human anatomy augmentation over a mannequin for the training of nursing skills

BACKGROUND

The in-depth understanding of human anatomy is the foundation for safety in nursing practice. Augmented reality is an emerging technology that can be used for integrative learning in nursing education.

OBJECTIVE

The study aimed to develop a human anatomy-based skill training system and pilot test its usability and feasibility.

METHODS

Twenty-seven nursing students participated in 3D anatomy-based skill training for intramuscular injection and Levin tube feeding using HoloLens 2. Various user interfaces including pictures, videos, animation graphics, and annotation boxes assisted users with a comprehensive understanding of the step-by-step procedures for these techniques. A one-group pre-post test was conducted to observe changes in skill performance competency, usability, and learning satisfaction.

RESULTS

After study participation, a statistically significant improvement in skill performance competency (p< 0.05) was observed. The usability results showed that students were satisfied with the usefulness of the program (9.55 ± 0.49) and scored highly for the intention to participate in other educational programs (9.62 ± 0.59). A high level of learning satisfaction was achieved (9.55 ± 0.49), with positive responses in fostering students' engagement and excitement in the application of cutting-edge technology.

CONCLUSION

The 3D anatomy-based nursing skill training demonstrated good potential to improve learning outcomes and facilitate engagement in self-directed practice. This can be integrated into undergraduate nursing education as an assistant teaching tool, contributing to the combination of knowledge and practice.

Innovative digital technology adapted in nursing education between Eastern and Western countries: a mini-review

Advanced digital technologies have overcome the limitation of on-site teaching, especially after the COVID-19 epidemic. Various newly-developed digital technologies, such as e-learning, virtual reality, serious games, and podcasts, have gained renewed interest and come into the spotlight. Podcasts are becoming increasingly popular in nursing education as they provide a convenient and cost-effective way for students to access educational content. This mini-review article provides an overview of the development of podcasts in nursing education in Eastern and Western countries. It explores potential future trends in the use of this technology. The literature review demonstrates that nursing education in Western countries has already integrated podcasts into curriculum design, using the podcast to convey nursing education knowledge and skills and to improve students' learning outcomes. However, few articles address nursing education in Eastern countries. The benefits of integrating podcasts into nursing education appear far greater than the limitations. In the future, the application of podcasts can serve not only as a supplement to instructional methodologies but also as a tool for clinical practicing students in nursing education. In addition, with the aging population increasing in both Eastern and Western countries, podcasts have the potential to serve as an effective delivery modality for health education in the future, particularly for the older adult, whose eyesight declines with age, and those populations with visual impairments.

The Use of Metaverse in Nursing Education: An Umbrella Review

BACKGROUND

Given the wide range of metaverse technologies, there is a need to synthesize evidence of metaverse pedagogy used effectively for nursing education.

PURPOSE

This umbrella review synthesized systematic reviews on the use of metaverse in nursing education.

METHODS

A search was performed in MEDLINE, EMBASE, CINAHL, Web of Science, and Education Full Text. This umbrella review was conducted with reference to the Joanna Briggs Institute (JBI) Reviewer's Manual and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The JBI Critical Appraisal Checklist for Systematic Review was used to assess the quality of studies.

RESULTS

The final review comprised 15 articles published between 2013 and 2021, most of which indicate that metaverse interventions support increased knowledge, self-confidence, engagement, satisfaction, and performance in nursing students. Several articles in this review presented mixed findings related to certain learning outcomes.

CONCLUSION

This umbrella review supports the viability and effectiveness of metaverse in nursing education.

Nursing students’ experience of using HoloPatient during the COVID-19 pandemic: A qualitative descriptive study

Background

Due to the COVID-19 pandemic, nursing schools have implemented alternative approaches to teaching clinical competency. This study examined nursing students’ experiences of using HoloPatient to learn COVID-19-related patient care.

Methods

In this qualitative descriptive study, focus group interviews were held virtually with 30 nursing student participants in South Korea. Data were collected from January 25 to February 8, 2022 and analyzed using a mixed content analysis.

Results

Participants shared their experiences of using the HoloPatient, addressing advantages, challenges, and concerns associated with this new approach. Overall, they reported satisfaction associated with having gained patient assessment and critical thinking skills, self-confidence, and knowledge about the care of patients with COVID-19. Barriers identified included the program's novelty, inadequate number of devices, instructions in English, learning environment, and issues such as poor Wi-Fi access.

Conclusion

HoloPatient in nursing education can improve learning motivation, critical thinking skills, and confidence. Efforts should be made to engage users by providing an orientation, supplementary materials, and an environment conducive to learning.

Digital Technologies for Children and Parents Sharing Self-Management in Childhood Chronic or Long-Term Conditions: A Scoping Review

Worldwide, the prevalence of chronic (or long-term) conditions in children and young people from birth to 18 years (children) is increasing. Promoting competent and effective self-management skills early in the trajectory is important to improve adherence to treatment and optimise quality of life. Successful self-management, therefore, requires parents and children who are developmentally able to develop a range of complex skills, including the use of digital technologies. This scoping review aimed to identify primary research investigating digital technologies for children and parents sharing self-management in childhood chronic illnesses. A comprehensive search of electronic databases was conducted. Nineteen papers were included, assessed for quality and methodological rigour using the Hawker tool and thematically analysed. Three themes were identified: (i) the feasibility and acceptability of using technology, (ii) the usability of technologies and (iii) the effect of technologies on adherence and self-management skills. The results indicate that technologies such as mobile apps and websites can assist the management of long-term conditions, are an acceptable method of delivering information and can promote the development of effective self-management skills by parents and children. However, future technology design must include children and parents in all stages of development.

Integration of Extended Reality and a High-Fidelity Simulator in Team-Based Simulations for Emergency Scenarios

Wearable devices such as smart glasses are considered promising assistive tools for information exchange in healthcare settings. We aimed to evaluate the usability and feasibility of smart glasses for team-based simulations constructed using a high-fidelity simulator. Two scenarios of patients with arrhythmia were developed to establish a procedure for interprofessional interactions via smart glasses using 15-h simulation training. Three to four participants formed a team and played the roles of remote supporter or bed-side trainee with smart glasses. Usability, attitudes towards the interprofessional health care team and learning satisfaction were assessed. Using a 5-point Likert scale, from 1 (strongly disagree) to 5 (strongly agree), 31 participants reported that the smart glasses were easy to use (3.61 ± 0.95), that they felt confident during use (3.90 ± 0.87), and that that responded positively to long-term use (3.26 ± 0.89) and low levels of physical discomfort (1.96 ± 1.06). The learning satisfaction was high (4.65 ± 0.55), and most (84%) participants found the experience favorable. Key challenges included an unstable internet connection, poor resolution and display, and physical discomfort while using the smart glasses with accessories. We determined the feasibility and acceptability of smart glasses for interprofessional interactions within a team-based simulation. Participants responded favorably toward a smart glass-based simulation learning environment that would be applicable in clinical settings.