Virtual simulation in healthcare education: a multi-professional, pan-Canadian evaluation.

BACKGROUND: As we experience a shortage of healthcare providers in Canada, it has become increasingly challenging for healthcare educators to secure quality clinical placements. We evaluated the impact of virtual simulations created for the virtual work-integrated learning (Virtu-WIL) program, a pan-Canadian project designed to develop, test, and offer virtual simulations to enrich healthcare clinical education in Canada. Evaluation was important since the virtual simulations are freely available through creative commons licensing, to the global healthcare community. METHODS: Students self-reported their experiences with the virtual simulations and the impact on their readiness for practice using a survey that included validated subscales. Open-ended items were included to provide insight into the students' experiences. RESULTS: The evaluation included 1715 Nursing, Paramedicine and Medical Laboratory students enrolled in the Virtu-WIL program from 18 post-secondary universities, colleges, and institutions. Results showed most students found the virtual simulations engaging helped them learn and prepare for clinical practice. A key finding was that it is not sufficient to simply add virtual simulations to curriculum, careful planning and applying simulation pedagogy are essential. CONCLUSION: Virtual simulation experiences are increasingly being used in healthcare education. Results from this rigorous, large-scale evaluation identified ways to enhance the quality of these experiences to increase learning and to potentially decrease the number of hours healthcare students need in clinical practice to meet professional competencies. Further research is needed regarding many aspects of virtual simulations and, in particular, curriculum integration and the timing or sequencing of virtual simulations to best prepare students for practice.

An educator's toolkit for virtual simulation: A usability study.

BACKGROUND: The rapid change brought on by COVID-19 meant that many educators adopted virtual simulation quickly, often without having a strong background in the pedagogical principles of virtual simulation. To address this resource gap, a team of 21 Ontario virtual simulation-experienced educators created the freely available, online, interprofessional Virtual Simulation Educator's Toolkit. The Toolkit provides the theory, practical strategies and resources needed to teach effectively with virtual simulation. Because the Toolkit would include new content, resources and numerous untested design elements, the team conducted a usability test. DESIGN: A usability study, that followed a three-step process, was conducted. Participants were asked to carefully review the Toolkit, including all interactive components and complete an online survey based on the Technology Acceptance Model, to measure the ease of use and utility of the Toolkit. Lastly, participants were interviewed. PARTICIPANTS: In keeping with sampling principles for usability studies, twenty experienced virtual simulation educators from different disciplines participated in the study. METHODS: A validated survey and one-on-one interviews were used to measure educators' perceptions of the ease of use and utility of the Toolkit and their recommendations to improve it. Quantitative data were analyzed using descriptive statistics and qualitative data were coded and themes developed. CONCLUSION: The score of 90 % on the Toolkit Experience Survey indicated that participants found the Toolkit both easy to use and useful. Results from the interviews indicated that a practical, accessible professional development tool is urgently needed to support education with virtual simulation. Because the Toolkit introduces educators to different ways of implementing virtual simulation, as well as options, process considerations, and tools to enhance their teaching with virtual simulation, different disciplines and educators with different levels of simulation experience may benefit by using it.

User Engagement Using an Etextbook: A Descriptive Study.

Engagement is an integral pedagogical component underpinning effective educational activities and is of importance for educators using online platforms. Carefully designed, technology-enabled learning resources can increase student engagement. We developed an open educational resource etextbook on vital sign measurement using an interactive and multimodal platform to facilitate student learning. The etextbook design was informed by experiential teaching-learning theory. Students progressed through the etextbook at their own pace, following pedagogy informed by the iterative process of read, observe, practice, and test, commonly used in nursing education. The etextbook was introduced as a required reading in a first-year health assessment course at one university and two colleges. In this project, we explored the level of engagement experienced by users of the etextbook. We conducted a descriptive study using the User Engagement Scale to measure students' degree of engagement using the etextbook. Results from participants (N = 455) who used the etextbook in the study indicated a high level of engagement. The responses to an open-ended item on the survey provided context to the results and shed light on effective design practices. Several recommendations for best practices in developing etextbooks are identified for educators to consider.

Curricular uptake of virtual gaming simulation in nursing education.

In nursing education, virtual simulations are used to augment in-person simulation and prepare and supplement students for clinical placements. More recently, as a result of the COVID-19 pandemic, virtual simulations are being used to replace clinical hours. Many virtual simulations require the user to make decisions that affect the outcome of the simulated experience. In this article, we provide a historical account of the virtual gaming simulations that members of our team developed and the processes that led to successful uptake into curriculum. In addition, we share lessons learned from our experiences in terms of maximizing curricular uptake. We found engagement of the teaching team is essential when using VGS in a course. In addition, when using VGS, it is important to follow the process of prebrief, enactment, debrief and evaluation. Educators can build on and grow from our lessons learned so that the path to embedding virtual gaming simulation in curriculum becomes clear.

Using Virtual Interactive Digital Simulator to Enhance Simulation Experiences for Undergraduate Nursing Students.

It is increasingly difficult to find quality clinical placements that allow nursing students to work with high acuity patients. To address this need, simulation is recommended; however, human patient simulation is costly from a human and resource perspective. In a search for alternatives, we offered a simulation experience using a virtual interactive digital simulator and evaluated student outcomes. This emerging technology, although not intended to replace human patient simulation, shows promise in enabling easier, more self-directed access to simulation for students.

Using Think Aloud in Health Assessment: A Mixed-Methods Study.

BACKGROUND: Health assessment courses are foundational to prepare students in nursing baccalaureate programs for clinical practice. Nurse educators are interested in testing strategies to improve students' ability to perform physical assessment techniques. METHOD: A mixed-methods design was used to examine nursing students' experiences with the Think Aloud (TA) approach and its affect on their ability and perceived self-efficacy when performing physical assessment skills. RESULTS: The participants in the TA intervention group made significant pre-post self-efficacy score gains and had higher focused physical examination marks. There was no significant difference in pre-post self-efficacy scores with the control group. A focus group yielded the following themes: benefits of TA, student challenges, and transferring physical assessment skills to practice. CONCLUSION: The TA approach encourages students to focus on the critical steps in physical assessment skills aiding memory, knowledge gains and preparation for practical testing, and transition to clinical practice. [J Nurs Educ. 2018;57(11):684-686.].

Virtual gaming simulation of a mental health assessment: A usability study.

Providing safe and realistic virtual simulations could be an effective way to facilitate the transition from the classroom to clinical practice. As nursing programs begin to include virtual simulations as a learning strategy; it is critical to first assess the technology for ease of use and usefulness. A virtual gaming simulation was developed, and a usability study was conducted to assess its ease of use and usefulness for students and faculty. The Technology Acceptance Model provided the framework for the study, which included expert review and testing by nursing faculty and nursing students. This study highlighted the importance of assessing ease of use and usefulness in a virtual game simulation and provided feedback for the development of an effective virtual gaming simulation. The study participants said the virtual gaming simulation was engaging, realistic and similar to a clinical experience. Participants found the game easy to use and useful. Testing provided the development team with ideas to improve the user interface. The usability methodology provided is a replicable approach to testing virtual experiences before a research study or before implementing virtual experiences into curriculum.

Virtual Gaming Simulation in Nursing Education: A Focus Group Study.

BACKGROUND: The use of serious gaming in a virtual world is a novel pedagogical approach in nursing education. A virtual gaming simulation was implemented in a health assessment class that focused on mental health and interpersonal violence. The study's purpose was to explore students' experiences of the virtual gaming simulation. METHOD: Three focus groups were conducted with a convenience sample of 20 first-year nursing students after they completed the virtual gaming simulation. RESULTS: Analysis yielded five themes: (a) Experiential Learning, (b) The Learning Process, (c) Personal Versus Professional, (d) Self-Efficacy, and (e) Knowledge. CONCLUSION: Virtual gaming simulation can provide experiential learning opportunities that promote engagement and allow learners to acquire and apply new knowledge while practicing skills in a safe and realistic environment. [J Nurs Educ. 2017;56(5):274-280.].

Virtual gaming to develop students' pediatric nursing skills: A usability test.

BACKGROUND: As competition for specialty clinical placements increases, there is an urgent need to create safe, stimulating, alternative learning environments for students. OBJECTIVE: To address that clinical gap, our team developed a virtual game-based simulation to help nursing students develop their pediatric nursing skills. DESIGN: A usability study was conducted using the Technology Acceptance Model as a research framework. SETTING AND PARTICIPANTS: The study was conducted at a community college and included nursing students, nursing faculty/clinicians and two gaming experts. METHODS: The two experts evaluated the game using a heuristic checklist after playing the game. Participants engaged in a think-aloud activity while playing the game and completed a survey and interview based on the Technology Acceptance Model to explore ease of use and utility of the game. RESULTS: We found a high degree of user satisfaction with the game. Students reported that they had learned about pediatric care, they had become immersed in the game and they were keen to keep playing. Several design changes were recommended. CONCLUSION: Usability testing is critical in the early stages of simulation development and the study provided useful direction for the development team in the next stage of game development.