Donor funding used to create VR simulation lab for Nursing Department

The hospital room isn’t terribly big, with not a lot a lot of space for senior nursing student Sadie Ferguson to move around.

Her patient is lying on the hospital bed waiting for an examination. He’s a Type 2 diabetic and is seeking treatment for an ulcer on his left leg, which has been propped up on a stack of pillows.

Dr. Lisa Beals encourages Ferguson explore the room before doing anything else.

“Open the doors,” she says, asking her student to see what supplies are available in the med cart. “Grab that bottle of sterile water.”

There’s a peal of laughter from the other nursing students watching as Ferguson reaches for the patient and accidentally removes his hospital gown, which then completely disappears from view.

“Where did it go?” Ferguson asks, unable to hold back her own laughter as she peers around the room for the missing garment.

It’s no harm, no foul where the patient’s dignity is concerned, given that he only exists in a virtual environment. The students gathered are here for a sneak peek at the VR technology that is about to be incorporated into the Nursing Department’s curriculum.

The new virtual reality simulation lab – located on the third floor of the Julio S. León Health Sciences Center – was made possible by a substantial monetary gift from an anonymous donor. The gift was made with the intent to use innovative technology within the department to enhance the student learning experience.

The department has transformed a classroom into a dedicated space for VR simulation, purchasing four sets of Oculus headsets and controllers, as well as a large SMART Board and access to Evolve: Elsevier – an online healthcare-education service that offers a library of more than 200 VR scenarios.

“The scenarios run the gamut from the foundational principles of nursing – such as putting on personal protective equipment – all the way up to how to deal with patients during a pandemic,” says Beals, chair of the Nursing Department. “It includes clinical care, working in the med-surg area, caring for patients who have a mental-health issue, and how to effectively communicate with patients.

“The VR simulations are centered on building the students’ cognitive skills … what we call ‘Thinking like a nurse.’ It’s part of a tiered approach to our new curriculum. Students can learn the theory of why we do the things we do in the classroom, then experience it in virtual reality, then in our Simulation Center for Interdisciplinary Studies, and finally in an actual clinical setting.”

‘Another level of simulation’

In a 2020 study published in the Journal of Medical Internet Research entitled “Effectiveness of Virtual Reality in Nursing Education,” researchers concluded that while further rigorous studies are needed, there are benefits to incorporating the technology in the classroom.

“As VR technology advances and becomes increasingly affordable, nursing education is being transformed,” the authors state. “VR simulations can give nursing students the opportunity to practice skills in a safe environment without risk to patients.”

Caleb Lewis, director of the Simulation Center for Interdisciplinary Education – a fully functioning lab that simulates a hospital environment with state-of-the-art human patient simulators – says virtual reality is yet another way for students to learn the cognitive skills required in the nursing field.

“Virtual reality is just another level of simulation,” says Lewis. “In the last two or three years, VR technology has caught up with medical education.”

The technology is not far off from the type of gaming software some students have been using for years.

“This (technology) is from their generation,” Lewis says. “Every part of it is realistic. It can take them from a patient room to a (newborn intensive care unit) … settings we can’t always reproduce here.”

Caleb Wolf, a senior nursing major, immediately took to the virtual environment. Pulling the Oculus headset over his eyes, he began exploring from a starting point in a virtual hospital lobby.

“I’ve been using an Oculus for about four years, mostly for gaming,” he says.

While the scenarios are not games, some of the mechanics of using the controls aren’t that different, which made Wolf feel right at home.

“With this simulation, you’re fairly stationary in a hospital setting rather than moving around through a big map,” he says. “I’m a big advocate for virtual reality. It’s very immersive.

Wolf says he’s also a fan of the VR experience in that students can use tools such as the patients’ facial expressions and answers to questions that aren’t available when working with the physical patient simulators.

“It’s hard for me to communicate with the mannequins,” he says. “I’m personable and talking to people is one of my strong suits. It’s harder to do with a mannequin. The immersion factor of virtual reality is going to be insane compared to traditional simulations.”

Best practices

Even students unaccustomed to the technology could immediately see its value.

“I’m excited for it,” says senior nursing major Melody Xiong after spending a few minutes checking out the virtual environment. “The experience is very realistic and there’s so much for us to do within the simulation.”

Beals says the rollout of VR simulation this fall will take place in several of the clinical courses required for the nearly 50 students in the department’s two nursing cohorts.

Students will be able to participate in the VR simulations independently or even in small groups, depending on the scenario. As they work, other students in the room will be able to watch actions unfold on the SMART board.

“Instructors will serve as moderators … there is also canned text offered as patient responses,” says Beals. “It can help students if they’re not going down the right path. We can also let them make mistakes and then talk about what they did wrong during the debriefing.”

Since virtual reality is still relatively new when it comes to nursing education, the department will be adapting to it as needed.

“Best practices are now starting to come out from the studies being done,” Beals says. “Each person using VR will have a spotter in case they get vertigo. In nursing, self-care and resiliency are also important. There are great yoga and meditation apps included, so students could even use it for relaxation.

“This program and department have made tremendous strides over the past two years. The generous support from the university administration and Foundation donors have helped in moving innovative nursing education to the forefront of the BSN program.”