Virtual reality (VR) has emerged as an accepted methodology in nursing education to enhance knowledge and skill by offering impactful experiences through various methods by simulating real scenarios for the learner to interact. The Healthcare Simulation Dictionary (ssih.org) defines VR as creating an interactive experience using computer technology, where three dimensional characteristics result in spatial presence. Foronda et al.(2020) defined three unique characteristics of VR: creation of a digitally simulated world, immersion of the user in a simulated world, and the ability of the learner to interact within the simulation.
VR simulation scenarios in nursing education are designed to replicate real situations in healthcare in the format of computer-based and immersive experiences. Examples of computer-based VR simulations include products such as ATI Real Life, Second Life and vSim. Immersive VR refers to the use of 3D, computer-generated simulated experiences that are facilitated by audio and visual stimuli through use of head-mounted display (Chang and Weiner, 2016, INACSL, 2016). Immersive VR allows for added interface with motion sensors and vocal recognition. Immersive VR is donning of an oculus rift headset to experience a 360 degree, 3 dimensional interaction that includes audio-visual interplay. Examples of immersive VR simulation can be home grown products or products such as Embodied Labs
Beginning with a partnership with TLi, the Nursing Program launched into piloting VR using Embodied Labs scenarios in Spring 2018. The immersive platform of Embodied Labs was found to be well grounded in concepts that aligned to nursing curriculum and course content, in particular, improving knowledge, increasing empathy and potentially fostering self-efficacy and confidence. The VR pilot integrated three scenarios related to sensory issues, cognitive decline and end of life across multiple levels of medical surgical courses. Data was collected via student surveys after obtaining IRB approval which showed significant positive results.
Based on the student responses in the pilot and faculty support, the decision was made to fully integrate immersive VR across the curriculum, starting in AY 2019 – 2020, which was supported by the CSU Lab Innovations with Technology (LIT) grant. In tandem with immersive VR using Embodied Labs scenarios, the Nursing Program faculty committed to increasing integration of computer-based VR across the curriculum.
Planning for full implementation of immersive VR was done strategically by aligning Embodied Lab scenarios to specific courses after reviewing the scenario objectives, course learning outcomes, and level of the learner. Discussion with lead faculty occurred to assure buy-in and optimize successful teaching – learning experiences. Two elements were felt key to the implementation in integrating immersive VR:
- Faculty development and support, including training that involved viewing the scenario
- Development of faculty templates and student information based on evidence-based findings that support simulated experiences, i.e., INACSL Standards of Best Practice: Simulation℠
Implementation with selection of five (5) Embodied Lab scenarios was mapped into semester 1, year 1 with Introduction of Professional Nursing Practice through the final year with Care of the Complex Patient. The scenarios addressed sensory, cognitive, end of life, Lewy Body & Parkinsons, and LGBTQ concepts unique to those types of patients. The Embodied Lab scenarios were designed as individual experiences for learners, donning head gear and immersed as the patient in the scenario.
In the spring of 2020, the individual experience was paused due to the pandemic where access and effective delivery had limitations. Embodied Labs was proactive in recommending a means to deliver the immersive VR experience remotely via Zoom by fall of 2021. We found this equally successful, recognizing that consideration should be given as to scenarios where student experience may be enhanced individually or in a group mode.
- Hannans, J. A., Nevins, C. M., & Jordan, K. (2021). See it, hear it, feel it: Embodying a patient experience through immersive virtual reality. Information & Learning Sciences.
- Hannans, J., & Nevins, C. (2021). Transitioning to online facilitation of immersive vr simulations. In A. deNoyelles, A. Albrecht, S. Bauer, & S. Wyatt (Eds.), Teaching online pedagogical repository. Orlando, FL: University of Central Florida Center for Distributed Learning.
- Hannans, J. & Nevins, C. (2019, Mar. 12) Virtual embodiment: High impact learning. [web log comment]
- Hannans, J. & Nevins, C. (2019). Virtual reality: A strategy to improve patient centered care. American Nurse Today, 14(12), 18.
- Hannans, J., Leafstedt, J. & Drescher, T. (2018, Jun. 15). Student Learning and Virtual Reality: The Embodied Experience. Transforming Higher Ed: Educause.
- Hannans, J. (2018, Apr. 9) Becoming Alfred … to learn empathy. [web log comment]