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Background: Virtual simulation-based education is in healthcare education. This study explored nurse educators' use of the INACSL Standards of Best Practice: Simulation© during facilitation and debriefing of virtual simulation during the pandemic. Design: A quantitative exploratory research design with a researcher developed survey was used to the answer the research questions. Results: A total of 129 participants responded to the survey. A plethora of strategies were reported regarding pre-briefing and debriefing. Conclusion: Overall, nurse educators followed the INACSL Standards of Best Practice: Simulation© either synchronously or asynchronously. However, research is needed on the best method for pre-briefing and debriefing virtual simulation.

Immersive technologies have been utilized in nursing education and other disciplines as effective learning and teaching tools. Many virtual reality (VR) simulations provide users immersive experiences through audiovisual stimuli. However, these systems do not enable haptic and tangible interactions, preventing them from utilizing higher multisensory stimuli for learning.There is a need in nursing education for more realistic VR experiences that allow direct hand manipulation in the acquisition of assessment skills, especially Leopold's Maneuvers which require palpating the patient's abdomen. To meet this need, a haptic-enabled virtual reality simulation called Leopold's Maneuvers VR was developed. This application utilized a set of commercial haptic gloves called SenseGlove to allow users to touch and feel the virtual patient's abdomen and fetus in the virtual exam room. To investigate the quality of haptic interactions from Leopold's Maneuvers VR, two sets of user studies were conducted. Study 1 was an explorative haptic experience study to investigate the effectiveness and usability of the haptic interactions. Study1 included three tasks to evaluate four different haptic device settings and a subjective poststudy questionnaire to measure sense of presence for each device. Four different haptic device settings consisted of VIVE controller, SenseGlove, Custom-made Vibration glove, and the combination of Vibration glove and SenseGlove. The results show that SenseGlove showed the highest performance in task 1 and Vibration glove showed highest performance in task 2 and 3.According to the quantitative analysis, the combination of the SenseGlove and the Vibration glove provided the highest presence.Study 2 was conducted with three of the haptic devices which showed high performance and presence. Study 2 investigated haptic interactions in the Leopold's Maneuvers process using iii Leopold's Maneuvers VR application. Most participants showed improvements in Leopold's Maneuvers knowledge after using the application and expressed positive feedback about using haptic devices in the application. This implies that the application may prove to be an effective educational tool in nursing education. In the future, we would like to improve the application based on the user feedback and conduct user studies with more students. iv DEDICATION This thesis is dedicated to my family, who have provided me with great love, support, and care during this journey. No words can express how grateful I am to them for always being there for me and encouraging me. v ACKNOWLEDGEMENTS I would like to thank my committee chair, Dr. Jinsil Hwaryoung Seo, for her guidance and continuous support throughout this research. I would also want to thank my committee members, Caleb Kicklighter and Dr. Elizabeth Wells-Beede, for their encouragement and insightful feedback.A special thanks goes to the developers, Jack Greene and Tomas Arguello for bringing this idea to life. I would also like to thank the Texas A&M Department of Visualization, the department ...

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality and morbidity. Effective nurse training for PPH management can reduce negative health impacts on childbearing women. This article discusses a framework for the development of an innovative immersive virtual reality simulator for PPH management training. The simulator should consist of: 1) a virtual world, including virtual physical and social environments, and simulated patients, and 2) a smart platform, providing automatic instructions, adaptive scenarios, and intelligent performance debriefing and evaluations. This simulator will provide a realistic virtual environment for nurses to practice PPH management and promote women's health.

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Clinical learning in the first semester of nursing school is often challenging and difficult for students to assimilate multiple subjects while applying clinical skills. One college of nursing created a first semester simulation experience that helped students to enhance clinical reasoning by aligning content in multiple courses, allowing for application of information, and linked clinical skills learned each week to the concept of total patient care. The resulting change to course structure combined basic physical assessment and fundamental nursing care to one course allowing students to understand the application of assessment to nursing practice and skill.