The recently developed training platform vrClinicals for Nursing amplifies the “everyday unpredictability of nursing”.
New immersive virtual reality (VR) technology transports nursing students at Herzing University to a busy hospital floor where they have to deal with multiple patients and frequent interruptions – just like in the real world.
vrClinicals for Nursing, an immersive VR nursing experience, was recently developed by Wolters Kluwer, Health and Laerdal Medical. Students using vrClinicals for Nursing with a Meta™ Quest 2 headset are immersed in an authentic, virtual clinical environment where they must overcome real-world challenges nurses face on the job: prioritizing multiple patients with diverse, complex cases; colleague interruptions; and patient requests.
With the current shortage of care and limited clinical options, newly registered nurses are faced with increasingly higher patient cases and need to hone their independent clinical judgment earlier in their careers, Wolters Kluwer said. Metaverse-related technologies used in many nursing schools can provide the experiences to better prepare today’s nursing students for this environment.
The new technology reflects the “everyday unpredictability of nursing,” says Leila Casteel, DNP, APRN, NP-C, practicing family nurse and associate vice president, curriculum & innovation at Herzing University, a Milwaukee, Wisconsin-based private university.
Casteel spoke to HealthLeaders about how the new technology will benefit and prepare the university’s nursing students.
This transcript has been edited slightly for brevity and clarity.
HealthLeaders: How much of the current learning is in-person clinical work and how much is virtual simulation?
Leila Casteel: About 45% to 50% of our clinical hours across all of our clinical courses are simulations and in that simulation there is a campus based high fidelity component which is a smaller component. So overall I would say that about 35% of our clinical hours are done with a virtual clinical experience.
HL: As a practicing nurse and also as an educator, how effective is virtual simulation in preparing nurses for the real world of nursing?
Casteel: It might sound a bit blasphemous to say, but in many ways it prepares the students better than some of the live internships, and for a number of reasons. We’ve noticed that with new nurses, things have gotten a little worse, and you’re like, ‘How did we get here? Over the past 20 years, how have we become less effective at the bedside as we graduate?”
Part of this is the unpredictability of where your students end up, and so much depends not only on the strength of the clinical instructor, but also on the environment itself – the patients, the staff, and the willingness and interest of the nurses. There are also nurses out there who don’t know the clinical assessment model because they haven’t learned it.
So we need to make sure that our students get that full experience and that we get measurable results. One of the best things about virtual experiences is that they can be very intentional and have very specific outcomes that are assigned and aligned with what is happening in that class. And you can make sure all your students have that experience from start to finish, which feels a lot better than the uncertainty of just sending them away.
HL: Virtual learning seems to offer a less stressful environment where students can make mistakes without endangering a patient. How does this help with learning?
Casteel: It’s absolutely a part of their learning. This freedom to fail and the formative assessment that we can take in this type of environment is so crucial to their own confidence when they go out and work with live patients that it’s almost necessary. You need to explore because at the heart of clinical assessment is decision making and how we determine next steps. In order for students to think this way, they need to start thinking not only about the choices they make, but why they make them, what the risks are, and making alternative choices.
This is exactly what the virtual simulation offers, namely the opportunity to explore and make a decision. It may not be the right one, but now you have this opportunity, this excellent opportunity, to examine that decision more meaningfully so that you can try again.
HL: What does the new vrClinicals for Nursing technology bring to your students compared to previous platforms?
Casteel: First and foremost, the concept of having multiple patients, different patient experiences, and the idea of learning to multitask. So often virtual products focus on a single patient at a given point in time, and that has many limitations. There’s a lot we can do to improve even those experiences, and we’re doing this because we love all virtual clinical experiences.
However, this is unique as it is much more in line with what you would expect in an actual facility or workplace: multiple patients, different conditions and things to consider. They are fully built so there is their story, their history, the chart and everything else so the students can dive in and learn a lot about the patients before they come to the clinic, which is extremely important and something they can’t currently do.
The priority level is slightly different. In most virtual experiences, the student has a little more control over that urgency and sense of stress because they can hit a pause button and focus on a single patient. This experience really requires them to think, “What’s the next best thing if I have 10 conflicting priorities?” They need to think this through and articulate it to their teacher. It’s so much more complex, but in a positive way.
What’s really interesting about this experience is the way it weaves in and out of clinical urgency and then into contemplation and reflection and then back into clinical urgency and back out again into reflection, contemplation and discussion. This is good for many reasons, but mostly for the deeper learning that can take place in this guided experience.
HL: How do the students feel about the use of virtual simulation technologies?
Casteel: We’ve had this interesting group for about a decade, made up of very experienced engineers and some who didn’t want to be involved. But what we’re seeing now, especially after the pandemic, is that even those who were a bit late are now used to using technology for everything.
We use our phones for everything, so there’s a lot less resistance. You’re almost drawn to it because it’s the norm now. When the experience itself is meaningful, students report that not only did they learn something, but it gave them the space to reflect on what they learned to make it stick a little bit more. And they’ll be able to explain that to someone tomorrow because it was an experience and not just following a nurse and trying to mimic behavior. So when it’s done well, the students really like it.
Carol Davis is the Nursing Editor at HealthLeaders, a brand of HCPro.
