Background: COVID-19 presents many challenges for nursing educators due to rapidly evolving research and best practices as well as the highly contagious nature of the virus. The biggest challenge is educating pre-licensure and licensed registered nurses about the COVID-19 disease process and the provision of patient care while simultaneously avoiding the risk of unnecessary exposure to the virus that comes with hands-on learning opportunities.

Purpose: The purpose of this study was to determine the impact that immersive virtual reality (VR) patient simulation has on the perceived clinical competency of pre-licensure and licensed registered nurses learning to care for patients with COVID-19. Immersive VR simulation goes beyond the traditional lab experience to immerse learners in an environment with a realistic holographic patient (D'Errico, 2021).

Method: Learners were presented with an asynchronous, computer-based education module introducing the COVID-19 disease process and patient care information. Learners then viewed a series of video clips depicting a holographic patient with COVID-19. Learners were also provided with basic patient information, a case scenario, an SBAR report, vital signs, a description of evolving symptoms/behaviors as the virus progressed, and guiding questions. Objectives of the simulation were to equip learners to: 1) identify signs and symptoms typical of COVID-19, 2) discuss the assessment and risk stratification of patients with suspected or confirmed COVID-19, and 3) correlate the signs and symptoms indicating deterioration and need for escalation of care.

Results: This study utilized a quasi-experimental research design with pre- and post-questionnaires to measure learners’ perceived clinical competency. Learners were asked to rate their level of confidence with various nursing skill competencies and nursing professional behaviors related to the care of patients with COVID-19. From a sample of 509 pre-licensure and licensed registered nurses, learners expressed the most significant gains in their level of confidence with the following nursing skills: developing care plans for patients (+11.2%), answering questions for patients or families (+14.8%), administering oxygen therapy (+17.6%), and educating patients or families with disease-related care knowledge (+18.5%). Learners also expressed gains in their level of confidence with the following nursing professional behaviors: communicating verbally with precise and appropriate terminology in a timely manner with patients and families (+5.8%) and with healthcare professionals (+4.4%).

Conclusions: Learners’ perceived clinical competency related to the care of patients with COVID-19 increased as a result of immersive VR patient simulation, despite the absence of hands-on clinical training. The simulation allowed learners to visualize a declining patient with COVID-19 and to think critically about the nursing interventions related to the patient’s care. Using virtual reality (VR) simulation to improve COVID-19 perceived clinical competency is not only applicable in a collegiate setting but also in ambulatory care settings for staff education, orientation, and annual competencies.

Reference
1) D’Errico, M. (2021, January 7). Virtual simulation versus immersive virtual reality: What’s the difference? UbiSim Inc. https://www.ubisimvr.com/virtu...

Rachel Whitney MM

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