Learning to Manage COVID-19-induced Respiratory Distress in the Immersive Virtual Reality Simulation: A Pre-Experimental Study
Main Article Content
Abstract
Introduction: Undergraduate nursing students have limited theoretical knowledge of and practical learning opportunities to manage COVID-19 respiratory distress. Immersive virtual reality simulations in nursing represent a new area of educational interest that has been understudied in Canada.
Objective: This study aimed to measure the potential impact of immersive virtual reality simulation on content knowledge in respiratory distress induced by COVID-19, as well as perceived learning and perceived confidence in managing this condition among senior undergraduate nursing students.
Methods: A pre-experimental design with a one-group pretest-post-test was employed. Nursing students (n = 30) were recruited through convenience sampling to participate in a single immersive virtual reality simulation session. Data were collected using the Respiratory Distress Management Knowledge Test, the Simulation Effectiveness Tool-Modified (subscales: Learning and Confidence), and an open-ended question.
Results: The results showed an increase in knowledge (p=0.01). Participants reported a high perception of learning and confidence, and shared that this simulation helped them identify areas for improvement and strengthened their existing skills.
Discussion and Conclusion: These results suggest that this immersive virtual reality simulation has the potential to enhance students’ knowledge about respiratory distress. Subjective evaluations highlight its educational potential. Further studies could explore simulation’s impact on nursing students and professionals by integrating a control group and other validated measures.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors hold the copyright on their papers without restrictions and retain it without restrictions after publication of the papers on the journal’s website.
References
Adhikari, R., Kydonaki, C., Lawrie, J., O'Reilly, M., Ballantyne, B., Whitehorn, J., & Paterson, R. (2021). A mixed-methods feasibility study to assess the acceptability and applicability of immersive virtual reality sepsis game as an adjunct to nursing education. Nurse education today, 103, 104944. https://doi.org/10.1016/j.nedt.2021.104944
Aksoy, E. (2019). Comparing the Effects on Learning Outcomes of Tablet-Based and Virtual Reality-Based Serious Gaming Modules for Basic Life Support Training: Randomized Trial. JMIR serious games, 7(2), e13442. https://doi.org/10.2196/13442
Brown, K. M., Perretta, J., Miller, G., Gilbert, G., Anderson, M., Horvath, C., Sullivan, N., Jeffers, J., Swoboda, S., Shilkofski, N., Green, D., & Mudd, S. (2023). Deconstructing Healthcare Silos: Multi-Player Virtual Reality for Interprofessional & Intraprofessional Education. Journal of Interactive Learning Research, 34(3), 495–517.
Bucher, K., Blome, T., Rudolph, S., & von Mammen, S. (2019). VReanimate II: Training first aid and reanimation in virtual reality. Journal of Computers in Education, 6(1), 53–78. https://doi.org/10.1007/s40692-018-0121-1
Buttussi, F., Chittaro, L., & Valent, F. (2020). A virtual reality methodology for cardiopulmonary resuscitation training with and without a physical mannequin. Journal of biomedical informatics, 111, 103590. https://doi.org/10.1016/j.jbi.2020.103590
Chang, Y. M., & Lai, C. L. (2021). Exploring the experiences of nursing students in using immersive virtual reality to learn nursing skills. Nurse education today, 97, 104670. https://doi.org/10.1016/j.nedt.2020.104670
College of Nurses of Ontario. (2019, April). Entry-to-practice competencies for Registered Nurses (publication no 41037). https://www.cno.org/globalassets/docs/reg/41037-entry-to-practice-competencies-2020.pdf
Cook, D. A. (2010). One drop at a time: Research to advance the science of simulation. Simulation in healthcare: journal of the Society for Simulation in Healthcare, 5(1), 1–4. https://doi.org/10.1097/SIH.0b013e3181c82aaa
Dubovi, I. (2022). Cognitive and emotional engagement while learning with VR: The perspective of multimodal methodology. Computers and Education, 183, 104495. https://doi.org/10.1016/j.compedu.2022.104495
Erlingsson, C., & Brysiewicz, P. (2017). A hands-on guide to doing content analysis. African Journal of Emergency Medicine, 7(3), 93–99. https://doi.org/10.1016/j.afjem.2017.08.001
Farra, S., Hodgson, E., Miller, E. T., Timm, N., Brady, W., Gneuhs, M., Ying, J., Hausfeld, J., Cosgrove, E., Simon, A., & Bottomley, M. (2019). Effects of Virtual Reality Simulation on Worker Emergency Evacuation of Neonates. Disaster medicine and public health preparedness, 13(2), 301–308. https://doi.org/10.1017/dmp.2018.58
Fromm, J., Radianti, J., Wehking, C., Stieglitz, S., Majchrzak, T. A., & vom Brocke, J. (2021). More than experience? - On the unique opportunities of virtual reality to afford a holistic experiential learning cycle. Internet and Higher Education, 50, 100804. https://doi.org/10.1016/j.iheduc.2021.100804
Head, M. L., Acosta, S., Bickford, E. G., & Leatherland, M. A. (2022). Impact of COVID-19 on Undergraduate Nursing Education: Student Perspectives. Academic medicine: journal of the Association of American Medical Colleges, 97(3S), S49–S54. https://doi.org/10.1097/ACM.0000000000004530
Herron, E. K. (2018). New graduate nurses’ preparation for recognition and prevention of failure to rescue: A qualitative study. Journal of Clinical Nursing, 27(1–2), e390–e401. https://doi.org/10.1111/jocn.14016
Hoffman, J. L., Wu, T. Y., & Argeros, G. (2023). An Innovative Community Health Nursing Virtual Reality Experience: A Mixed Methods Study. Creative nursing, 29(3), 303–310. https://doi.org/10.1177/10784535231211700
Jeong, S. Y. S., & Lee, K. O. (2019). The Emergence of Virtual Reality Simulation and Its Implications for Nursing Profession. Korean journal of women health nursing, 25(2), 125–128. https://doi.org/10.4069/kjwhn.2019.25.2.125
Kang H. (2021). Sample size determination and power analysis using the G*Power software. Journal of educational evaluation for health professions, 18, 17. https://doi.org/10.3352/jeehp.2021.18.17
Kolb, D. A. (1984). Experiential Learning: Experience as the Source of Learning and Development. Prentice-Hall.
Kumar, L. M., Stephen, J., George, R., Harikrishna, G. L., & Anisha, P. S. (2022). Use of Effect Size in medical research: A brief primer on its why and how. Kerala Journal of Psychiatry, 35(1), 78–82. https://doi.org/10.30834/KJP.35.1.2022.322
Lavoie, P., Lapierre, A., Maheu-Cadotte, M. A., Brien, L. A., Ledoux, I., & Gosselin, É. (2024). Nursing Students' Engagement in Virtual Reality and Hybrid Simulations: A Quasi-Experimental Study. Clinical Simulation in Nursing, 87, 101496. https://doi.org/10.1016/j.ecns.2023.101496
Leighton, K., Ravert, P., Mudra, V., & Macintosh, C. (2015). Updating the Simulation Effectiveness Tool: Item Modifications and Reevaluation of Psychometric Properties. Nursing education perspectives, 36(5), 317–323. https://doi.org/10.5480/15-1671
Leonardsen, A., Gulbrandsen, T., Wasenius, C., & Fossen, L. T. (2022). Nursing perspectives and strategies in patients with respiratory insufficiency. Nursing in critical care, 27(1), 27–35. https://doi.org/10.1111/nicc.12555
Linde, A. S., & Miller, G. T. (2019). Applications of Future Technologies to Detect Skill Decay and Improve Procedural Performance. Military medicine, 184(Suppl 1), 72–77. https://doi.org/10.1093/milmed/usy385
Makransky, G., Terkildsen, T. S., & Mayer, R. E. (2019). Adding immersive virtual reality to a science lab simulation causes more presence but less learning. Learning and Instruction, 60, 225–236. https://doi.org/10.1016/j.learninstruc.2017.12.007
McMillan, K., Akoo, C., & Catigbe-Cates, A. (2023). New Graduate Nurses Navigating Entry to Practice in the Covid-19 Pandemic. The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres, 55(1), 78–90. https://doi.org/10.1177/08445621221150946
Oculus. (2015). Health and safety warnings. https://theclarice.umd.edu/sites/default/files/files/Oculus%20Headset%20Health%20and%20Safety%20Warnings.pdf
Odum, J. D., Real, F. J., Rice, J., Meisman, A., Sahay, R., Zhang, B., & Zackoff, M. W. (2023). Virtual Reality to Assess Resident Recognition of Impending Respiratory Failure During COVID-19. Hospital pediatrics, 13(6), e135–e139. https://doi.org/10.1542/hpeds.2022-006917
Raab, D. L., Ely, K., Israel, K., Lin, L., Donnellan, A., Saupe, J., Klein, M., & Zackoff, M. W. (2024). Impact of Virtual Reality Simulation on New Nurses' Assessment of Pediatric Respiratory Distress. American journal of critical care: an official publication, American Association of Critical-Care Nurses, 33(2), 115–124. https://doi.org/10.4037/ajcc2024878
Şahin G, Başak T. (2021). Debriefing Methods in Simulation-Based Education. Journal of Education and Research in Nursing, 18(3), 341–346. https://doi.org/10.5152/jern.2021.57431
Salcedo, D., Regan, J., Aebersold, M., Lee, D., Darr, A., Davis, K., & Berrocal, Y. (2022). Frequently Used Conceptual Frameworks and Design Principles for Extended Reality in Health Professions Education. Medical science educator, 32(6), 1587–1595. https://doi.org/10.1007/s40670-022-01620-y
Sidani, S., & Braden, C. J. (2021). Nursing and Health Interventions: Design, Evaluation, and Implementation (2nd ed.). John Wiley & Sons, Inc. https://doi.org/10.1002/9781119610113
Wilensky G. R. (2022). The COVID-19 Pandemic and the US Health Care Workforce. JAMA health forum, 3(1), e220001. https://doi.org/10.1001/jamahealthforum.2022.0001
Zackoff, M. W., Lin, L., Israel, K., Ely, K., Raab, D., Saupe, J., Klein, M., & Sitterding, M. (2020). The Future of Onboarding: Implementation of Immersive Virtual Reality for Nursing Clinical Assessment Training. Journal for Nurses in Professional Development, 36(4), 235–240. https://doi.org/10.1097/NND.0000000000000629