My hands are running away – learning a complex nursing skill via virtual reality simulation: a randomised mixed methods study

Abstract

Background Clinical skills training is an essential component of nursing education. However, sometimes education does not sufficiently prepare nurses for the real world. Virtual reality (VR) is an innovative method to complement existing learning strategies, yet few studies investigate its effectiveness. This study compared educational outcomes achieved by three groups learning with either of two different VR simulation variants, with varying technological features, or a video training on the endotracheal suctioning skill. Methods The investigated outcomes were knowledge and skill acquisition, learner satisfaction, and technology acceptance. 131 undergraduate nursing students were randomised into three groups, based on the interventions they received. Knowledge was assessed through a pre-post-test design, skill through a post-intervention objective structured clinical examination on a manikin, learning satisfaction and technology acceptance through standardised questionnaires, and qualitative feedback through focus groups. Results All interventions led to a significant knowledge acquisition, with no significant difference between the groups. The video intervention group performed significantly better than the VR groups in skill demonstration. One of the two VR intervention groups had a significantly higher learner satisfaction than the video group. Technology acceptance was high for both VR groups, with the simpler VR simulation resulting in higher technology acceptance than the one with more experimental features. Students described the VR experience as realistic, interactive, and immersive, and saw the opportunity to practise skills in a safe environment, learn from mistakes, and increase knowledge and confidence. Conclusions For the development of VR trainings, we recommend keeping them simple and targeting a specific educational outcome since trying to optimise for multiple outcomes is resource intensive and hard to achieve. Psychomotor skills were easier for participants to learn by watching a video on the procedure rather than practically learning it with the VR hardware, which is a more abstract representation of reality. We therefore recommend using VR as a complementing resource to skills labs, rather than replacing existing learning strategies. Perhaps VR is not ideal for practising practical psychomotor skills at the moment, but it can increase knowledge, satisfaction, motivation, confidence and prepare for further practical training. Trial registration Not applicable.

Effect of Virtual Game–Based Integrated Clinical Practice Simulation Program on Undergraduate Nursing Students' Attitude Toward Learning

“…4 The learning method of VR simulation lends itself to practicing clearly structured procedures, as the simulation can be carried out multiple times in succession, depending on the need for practice. 5 Academic educators may consider using VR technology to provide nursing students with self-directed and repeatable practices to maintain students' clinical competence over the long term. 6 Deliberate repetition of nursing practices in VR simulation gave students more confidence in their performance.…”

“…Virtual reality (VR) system provides real-time feedback so that nursing students may have a clear idea of whether their practice is normative or not and remedies for delayed or incorrect care procedures 4 . The learning method of VR simulation lends itself to practicing clearly structured procedures, as the simulation can be carried out multiple times in succession, depending on the need for practice 5 . Academic educators may consider using VR technology to provide nursing students with self-directed and repeatable practices to maintain students' clinical competence over the long term 6 .…”