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November 14, 2022

Implementing the Virtual Reality Simulation Day

Author

Christine Vogel
MSN, RN, CHSE, CHSOS
Lead Nurse Educator

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Hands in a virtual reality simulation over a black male patient in bed.

Are you thinking about using virtual reality simulation in nursing education, but are not sure how you would structure the activity? Our article has you covered. Read on to learn more about how to structure and implement an immersive VR simulation day using best practice standards.

Immersive virtual reality (VR) simulation empowers nursing educators to provide robust learning experiences to nurse learners throughout their education. There are many benefits to using VR simulation in your nursing program. When learners don headsets, they become fully immersed in a realistic virtual clinical environment, where they care for diverse patients across the life span. VR simulation has also been shown to improve cognitive, psychomotor and affective skills, while helping learners to bridge the theory-practice gap in a realistic environment. Learners describe VR simulation as fun, captivating, innovative, and empowering. Educators are increasingly utilizing VR simulation because of these benefits, and as a solution to prepare learners to provide safe and high quality care to patients in their communities upon graduation.

Watch a nurse learner assess a patient during a VR simulationThis article will describe how educators can structure and implement a VR simulation day with a prebrief, immersive VR simulation, and debrief. The recommendations in this article are based on the INACSL Healthcare Simulation Standards of Best Practice (HSSOBP), which guide educators in providing structured and meaningful simulation learning experiences. The discussion in this article is intended as an example, and educators should refer to their specific state boards of nursing and accreditation bodies when determining the clinical hours that can be substituted with virtual simulations.

flowchart with prebriefing information for vr simulation

An immersive VR simulation day structure that aligns with the INACSL HSSOBPPrebriefing: Preparation and BriefingIt is best practice to hold a structured prebriefing before the simulation scenario. The goal of prebriefing is to ensure that learners are prepared for the educational content of the scenario, and understand the ground rules and expectations for the simulation-based experience. Prebriefing is an essential process prior to the start of the simulation which includes preparation and briefing. Each UbiSim immersive VR scenario has embedded preparation and briefing materials that guide educators through the standardized prebriefing process.

prebrief showing a pregnant female in labor

Prebriefing is crafted by our nurse educators and includes preparation and briefing

Preparation

UbiSim’s amazing team of nurse educators have developed preparation activities for each VR simulation that are ready for educators to implement. These preparation activities are created according to the purpose and learning objectives of the simulation-based experience to ensure learners are prepared and can meet the scenario objectives. Learners instantly access robust preparation materials including a scenario introduction with an SBAR report, scenario medications, and documents such as lab results and diagnostic reports. Educators are able to easily customize the preparation activities and tailor them based on the learner level. For example, novice learners may need more preparation activities or guidance to determine salient concepts of the patient report.

Briefing

UbiSim’s ready-to-go briefing reinforces a safe learning environment, orients the learner to VR, and explains the role of the learner. Curated tutorials for each VR scenario provide learners with an opportunity to don the VR headset, explore the simulated hospital room, and operate the virtual equipment. Each tutorial helps learners to have confidence and understand how to interact with the patient, equipment, and environment prior to starting the scenario. Educators can easily customize the briefing if desired. When using the UbiSim platform we recommend an open area measuring at least 7 feet x 7 feet for each learner that is engaged in the VR scenario.

Although prebriefing times may vary depending on the scenario complexity and level of the learner, 1 hour is a reasonable designated time for a prelicensure nurse learner.
laboure college nursing students using UbiSim

Nurse learners participate in prebriefing before the immersive VR scenario

Facilitating the VR Simulation Scenario

Educators have the flexibility to implement UbiSim’s immersive VR simulation in a variety of ways including in a peer-to-peer learning model and a faculty-led model in a classroom setting. Both of these models can be facilitated using a single player or multiplayer mode.Peer-to-Peer ModelPeer-to-peer learning teaches learners teamwork, communication, and collaboration skills. Educators can choose the size of the peer group that best fits their situation. When using UbiSim, many educators choose to run the peer-to-peer model in groups of two or three learners. Using a group of three peers as an example, the learners will rotate between participating in the VR scenario, operating the standardized patient dialog on the computer, and taking notes during the simulation as an actively engaged observer. Each learner has a defined role during the simulation experience and remains an active participant even when they are not immersed inside the VR scenario.

Using a 20-minute UbiSim scenario as an example, it would take 1 hour for each of the three learners to participate in the simulation using the peer-to-peer model.
Nurse learners care for the patient using a peer-to-peer model
Nurse learners care for the patient using a peer-to-peer model Faculty-Led in a Classroom

While one learner is immersed in the VR scenario, a faculty facilitator populates authentic, customized patient dialog from the computer. A group of actively engaged observers watch the simulation and take structured notes on what occurs during the scenario. Educators can pause the scenario at key moments so both the participant and observers can reflect in action and collaborate on the nursing care of the virtual patient.

Using a 20-minute UbiSim scenario, it could take faculty an estimated 20 to 30 minutes to facilitate the VR simulation depending on the number of pauses.
A nurse learner immersed in a faculty-led immersive VR simulation with active observers

A nurse learner immersed in a faculty-led immersive VR simulation with active observers

Multiplayer Mode

Educators can choose to facilitate UbiSim’s immersive VR simulations in multiplayer mode with up to 3 learners simultaneously donning headsets to care for a patient within the VR scenario. Multiplayer mode is a highly interactive option where learners have a shared vantage within the VR setting, and can communicate and collaborate with each other, hand each other objects such as a stethoscope, and optimize the care of the patient with teamwork and collaboration. Multiplayer mode can also be used to accomplish interprofessional education, and learners can even participate in the same simulation from different physical locations.

Nurse learners collaborate in multiplayer mode - providing patient- and family-centered care
Nurse learners collaborate in multiplayer mode - providing patient- and family-centered careExcited to learn more about immersive virtual reality simulation? Contact us for a free demo!

Debriefing: Feedback, Guided Reflection, and Post-Scenario Activities

To align with best practice, a structured debriefing should follow each simulation-based experience. A general guide is for the debriefing to last twice the time of the simulation scenario. The UbiSim platform has a built-in, comprehensive debriefing experience that includes feedback, guided reflection, and post-scenario activities, including quiz questions and unfolding case studies.

A UbiSim curated debriefing with automatic, evidence-based feedback based on the learner's performance, and easy access to the guided reflection and post-simulation quizFeedback

After learners care for the patient in VR, they automatically receive a session feedback report which includes a recording of the simulation and evidence-based feedback. This feedback populates in response to the learners’ actions or inaction during the scenario. Learners can easily see the critical actions, performance gaps, and additional actions from the session, with robust feedback to support best practice.Guided Reflection UbiSim’s debriefing also includes customizable guided reflection questions based on the PEARLS Healthcare Debriefing Tool. This provides learners with an opportunity to reflect on their performance, connect theory to practice, and develop key takeaways to improve their nursing care. Post-Scenario ActivitiesUbiSim scenarios include post-scenario activities including quiz questions with a variety of standalone and unfolding Next Generation NCLEX item types and evidence-based rationales. UbiSim scenarios also feature unfolding case studies which expand upon the scenario, and provide vignettes of a patient’s situation at a future point in time. Educators can also assign additional post-scenario activities that help learners synthesize their learning. Examples include documentation exercises, concept maps, or completing a nursing care plan for the virtual patient. These activities can be planned to mirror the activities learners complete after their in-person clinicals.Debriefing can be done in several different ways, depending on how the educator chooses to implement the scenario with learners.

If the scenario is faculty-led in a classroom, a 40-minute debrief would follow the 20-minute simulation scenario.

In the peer-to-peer model, learners can debrief between each run of the scenario before the next learner participates in the simulation. After the third learner completes the scenario, the final debriefing can focus on reflecting beyond action as they identify key takeaways from the simulation experience that they can apply to their nursing practice. In this model, a debrief would occur three times, which would collectively account for 120 minutes of debriefing time.

Conclusion

When implementing a VR simulation day with your learners, UbiSim has you covered from start to finish. Each of our immersive VR scenarios guide faculty through the prebriefing, facilitation and debriefing so that learners receive a robust and meaningful simulation experience that meets best practice standards.

Excited to learn more about immersive virtual reality simulation? Contact us for a free demo!
Interested in trying UbiSim in your healthcare institution?
Request a Demo
Christine Vogel
Lead Nurse Educator

Christine Vogel is actively engaged in designing, piloting, and evaluating evidence-based immersive VR simulations for nurse learners. She has over 25 years of experience in nursing, and over a decade in nursing academia where she developed, facilitated, and evaluated high-fidelity simulations using various modalities.

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