Ethical Considerations When Designing and Implementing Immersive Realities in Nursing Education.

Immersive realities such as Augmented Reality (AR), Virtual Reality (VR), Mixed Reality (MR), and all future realities yet to be introduced, offer transformative potential as a new teaching methodology. VR and AR technologies in nursing education provide immersive experiences to students and allow them to practice clinical skills in a safe and controlled learning environment. However, VR and AR developers, along with educators who create simulated scenarios, must address ethical considerations such as accessibility, diversity, and inclusion in the design and implementation processes. While these innovative technologies are promising, they must be offered in a safe and effective manner. This editorial delves into ethical considerations that are involved in designing and implementing AR and VR as immersive realities in nursing education.

Twenty-first-Century Skills: Teaching Empathy to Health Professions Students.

A key component of therapeutic relationships is the ability of medical professionals to empathize with patients, as research indicates a link between a healthcare worker's ability to empathize with patients and improved patient outcomes. Empathy - the ability to perceive the meaning and feelings of another and to communicate those feelings to others - may be an innate concept, but it is shaped through behaviours and experiences. It is imperative, then, that post-secondary students entering the medical field be taught to develop empathy in order to facilitate positive patient outcomes. Embedding empathy-based education in the curriculum of medical, nursing, and allied health programs early in the course of study can help students understand the patient's perspective and facilitate positive therapeutic relationships early in students' professional careers. The shift from traditional teaching and learning styles to online learning has created deficiencies such as gaps in communication, empathy, and the development of emotional intelligence. To address these gaps, new and innovative ways to teach empathy, such as simulation, can be employed.

Shifting to Delivering Simulation Virtually Within a Healthcare Education Setting.

The coronavirus disease 2019 (COVID-19) pandemic has changed how healthcare education is being delivered, creating a global shift towards virtual modalities. Various approaches, each with their own benefits and limitations, have been developed to bridge this gap and continue to provide comprehensive education to healthcare students. To understand which approach to implement, we must consider what each can offer and what is best suited for the situation. Much of this will focus on the learning goals and outcomes with research strongly favouring modalities focused on the areas of cognitive, affective, and behavioural skill acquisition as opposed to technical skills.  The use of simulated persons offers the most diverse application for these areas of focus. This approach can provide opportunities for both synchronous and asynchronous learning. While novel in its approach, virtual simulations can leverage existing success and performance indicators used for in-person approaches to best understand the experiences of the learners and the facilitators. Evidence can be compared with outcomes of previous in-person groups to understand how this approach can be best implemented into curricula/programs. Future applications are numerous for this modality and the development of pilot studies focused on smaller groups of learners will provide opportunities for educators and program developers to review and understand the challenges that may arise. Simulation is a widely drawn upon teaching-learning approach deeply rooted in experiential learning. With the purpose of replicating real-world scenarios to increase knowledge transfer and reduce the shock of encountering challenging real-world situations, simulated environments are proven to be an effective tool in building learners' self-confidence and bridging the gap between theory and practice within the healthcare realm. Simulation can be, and is, applied within healthcare-education contexts from undergraduate to graduate levels and into ongoing professional development.

Using Simulation-Based Methods to Support Demonstration of Competencies Required by Micro-Credential Courses.

The rise of the digital revolution has disrupted entire industries and job markets, leading individuals to either upgrade or transfer their skills in order to continue within their designated fields or transition to new workplace contexts. Employers expect their employees to apply their knowledge to real-world settings, analyze and solve problems, connect choices to actions, and innovate and create. Moreover, the COVID-19 pandemic has exacerbated changes to the educational landscape by forcing online and remote contexts; physical distancing and other preventive measures have necessitated a shift towards increasing the use of disruptive digital technologies- extended reality (e.g., virtual and augmented reality), gaming, and additive manufacturing-in simulation delivery. Yet Canada's economic and demographic data suggests that many new graduates struggle to transition from school to working life. The confluence of these factors has led to a need for both individuals and higher education institutions to upgrade and adapt to new digital techniques and modalities. As these needs grow, simulation-based education (SBE) techniques and technologies-already an integral part of training for some professions, including nursing, medicine, and various other health professions-are increasingly being used in digital contexts. In this editorial, we provide our perspective of the socio-technological movement associated with health-professions education (HPE) within the SBE context and examine the application and implementation of micro-credentialing within this field. We also discuss the various levels of expertise that learners may acquire. From this vantage point, we address how SBE can complement the assessment of competencies that learners must demonstrate to attain micro-credentials and explore micro-credentialing's advantages for, and use in, HPE.