Authors
Stephanie Justice, DNP, RN, CHSE1
1Center for Healthcare Innovation and Leadership, The Ohio State University College of Nursing, Columbus, Ohio
Conflict of Interest Statement
This session has been partially funded by The Ohio State University's College of Nursing Reimagining Nursing grant from the American Nurses Foundation.
Corresponding Author
Stephanie Justice, Center for Healthcare Innovation and Leadership, The Ohio State University College of Nursing, Columbus, Ohio
(email: justice.85@osu.edu)
Introduction
The Ohio State University College of Nursing (OSUCON) has embarked on a transformative journey to revolutionize nursing education through the innovative application of extended reality (XR). Funded by the American Nurses Foundation Reimagining Nursing Grant, the initiative aims to disrupt the traditional methods of preparing pre-licensure nursing students, ensuring they are practice-ready in an increasingly complex healthcare environment.
Nursing education has traditionally relied on classroom instruction, hands-on skills training, and high-fidelity simulations. While these methods have proven effective, they have limitations in terms of scalability, accessibility, and the ability to replicate complex, real-world scenarios. With the advent of XR, there is an opportunity to create a more immersive and flexible learning environment that can better prepare students for the demands of modern healthcare.
Traditional high-fidelity simulations, though valuable, are resource-intensive and often limited in availability. This is particularly challenging as scenarios with multiple patients increases the need for more faculty, staff, and physical space. These simulations are often completed in groups of 3 to 4 students, limiting the opportunity for nursing students to exercise individual clinical judgement.
Often, the weaker student relies heavily on the strongest student in the group. VR can provide consistent, repeatable experiences to many students, making learning more engaging and realistic. Immersive technologies can enhance student engagement and realism. The ability to offer immediate feedback helps students learn from their mistakes and improve their skills. Students can repeat simulations in the headset without a significant increase in staffing or space needs. VR allows for a more personalized learning experience, optimizing each student's educational journey.
Project
The project includes a variety of clinical scenarios, covering clinical decision-making, pharmacological principles, and skills-based interventions. Scenarios also incorporate essential skills such as therapeutic communication, patient history-taking, and addressing social determinants of health. Students are screened for potential cybersickness to ensure they can participate comfortably in VR experiences. Feedback on patient care simulations is provided to each student at the end of the simulation, along with rationale and links to patient care guidelines. Students can repeat the simulation as many times as they want because they can access the program on a computer or headset and can log in from anywhere.
Community health students experienced homelessness in a VR headset by entering the tent of a homeless woman and viewing her lived experiences. They interacted with the few keepsakes she still possessed and were present in her current living situation, gaining insights into the social determinants of health. This application is free from Meta without a screen-based alternative. It was noted many students would opt out of the headset-based activity until an alternative screen-based scenario was created. Following the creation of the alternative experience, the number of students choosing to opt out of the headset decreased significantly. In the medical-surgical courses, students engaged in patient care simulations both in VR and on screen. Sophomore students participated in cardiac and respiratory assessment tutorials. Junior students cared for a young child or a pregnant woman experiencing complications.
Graduate entry students performed a cardiac arrest scenario. These scenarios ranged from cardiac and respiratory assessments to managing complications in pregnant women and pediatric patients. In addition to individual simulations, the project also explored the potential of XR for group learning. In a junior medical-surgical course, a student in a VR headset projected the simulation onto a screen, allowing classmates to guide decision-making and procedures. This approach fostered collaboration and collective problem-solving, turning the experience into a group activity. The simulation was completed a second time to improve the group's performance.
Discussion
The success of the initial phase of the pilot has paved the way for expanded use of XR in nursing education. Looking to the future, we are planning to develop additional scenarios, including advanced clinical situations and communication skills for students to learn job interview techniques and how to navigate difficult conversations. Longitudinal studies will be conducted to evaluate the impact of VR on student outcomes and career readiness.
Lessons learned from the pilot include the need for a robust and standardized orientation to not only the software, but to the headset. Students struggled to use the headsets and controllers without formalized training. Screening for cybersickness was altered as the original version led to an exceptionally high number of students self-reporting cybersickness. Challenges include gaining faculty support, integrating the experience into the curriculum, and scheduling large numbers of students for VR experiences.
Conclusion
This innovative pilot project demonstrates the transformative potential of VR in nursing education. By providing immersive, scalable, and adaptable learning experiences, VR can significantly enhance the preparedness of nursing students for the complexities of modern healthcare. The initial outcomes are promising, lessons learned will assist other programs looking to implement VR successfully. This project lays a strong foundation for continued innovation and improvement in nursing education.