Nursing students' experiences of virtual simulation when using a video conferencing system - a mixed methods study.

OBJECTIVES: There is limited knowledge about students' experiences with virtual simulation when using a video conferencing system. Therefore, the aim of this study was to explore how second-year undergraduate nursing students experienced learning through virtual simulations during the COVID-19 pandemic. METHODS: The study had an exploratory design with both quantitative and qualitative approaches. In total, 69 nursing students participated in two sessions of virtual simulation during spring 2020, and 33 students answered online questionnaires at session 1. To further explore students' experiences, one focus group interview and one individual interview were conducted using a video conferencing system after session 2. In addition, system information on use during both sessions was collected. RESULTS: Changes in the students' ratings of their experiences of virtual simulation with the Body Interact™ system were statistically significant. The virtual simulation helped them to bridge gaps in both the teaching and learning processes. Four important aspects of learning were identified: 1) learning by self-training, 2) learning from the software (Body Interact™), 3) learning from peers, and 4) learning from faculty. CONCLUSIONS: We conclude that virtual simulation through a video conferencing system can be useful for student learning and feedback from both peers and faculty is important.

Exploring dialogue in virtual simulation in nursing education - An observational study.

Objectives: Simulation is an important learning activity in nursing education. There is little knowledge about dialogue and communication between students and facilitators in a virtual simulation setting. The current study, conducted in Norway, explores the dialogic teaching approaches applied by facilitators in a virtual classroom and adapt an analytic tool from a physical classroom in lower education to a virtual classroom in higher education. Methods: Sixteen virtual simulation sessions of groups with nursing students were video-taped. The videos were coded with a coding scheme developed for physical classrooms and adapted to the virtual setting. The dialogic approaches from the facilitator were analysed using descriptive analysis. Results: The most frequently used approaches from the facilitator were categorised as asking ("Big questions") and listening ("Wait time after a question"). The most frequent pattern seen in the use of dialogic approaches fall under the category listening. Conclusions: The coding scheme is suitable to analyse facilitators' dialogic approaches in a virtual setting in nursing education. Further research should examine how the facilitator can strategically deploy dialogic approaches in other types of simulations with students. Innovation: The coding scheme was developed from lower to higher education, and from a physical to a virtual setting.

Exploring facilitation in virtual simulation in nursing education: A scoping review.

Objective: To systematically map existing research regarding the reflective feedback in virtual simulation in undergraduate nursing education. Methods: A scoping review was conducted based on the Arksey and O'Malley framework and the PRISMA-ScR. Results: We included 41 studies from 15 different countries. The simulation interventions allowed for interaction between the student and the virtual patient, the software, faculty, peers, or a combination of two or more of these. Students valued reflective feedback during and after the simulation. Conclusions: Our review emphasizes the importance of a human in the loop. Feedback before, during, and after the simulation is possible in virtual simulation where the facilitator can pause the virtual scenario and stimulate reflections during the simulation to obtain deep learning. Virtual simulation provides opportunities to give feedback from the software, such as cues or direct feedback. Innovation: There is a lack of focus on the feedback process and there is a need to revitalize the role of facilitators in a virtual simulation to determine their relative contribution in this process. Several studies reported the usefulness or the effect of virtual simulation on learning processes, but most lacked emphasis on investigating the significance of including a human in the loop.