Oxford Medical Simulation, Author at Oxford Medical Simulation

How to Bolster Critical Thinking in Nursing with Virtual Reality

Oxford Medical Simulation — Fri, 12 Jul 2024 08:36:16 +0000

In nursing, critical thinking is a vital and necessary skill. It’s not only critical thinking – clinical reasoning, clinical decision-making, and clinical judgment are all core components of nursing.

While the nuances of these terms have been much discussed, they are all interrelated and function together as nurses observe, analyze, and take action.

For example, nurses are often responsible for identifying cues of deterioration and escalating care quickly to prevent poor patient outcomes.

As novice nurses enter the field, there is significant concern about their readiness for practice, particularly regarding clinical decision-making.

One study reports that only about 20% of employers are “satisfied with decision-making abilities of new nurses”. Another study demonstrates that only about 9% of new graduate nurses meet the threshold for acceptable levels of competency.

There has been a push to address these issues with the Next Gen NCLEX, which is now measuring clinical judgment as part of the exam.

Considering that critical care nurses make a decision every 30 seconds, it’s clear how important it is to be prepared in all aspects of the clinical decision-making process.

Many institutions are now embracing technology like augmented or virtual reality to complement their didactic learning and their simulation programs.

Evidence supporting VR and critical thinking in nursing

Many of those core components of nursing practice, like clinical judgment, have several subcomponents.

Virtual reality and virtual simulation have shown positive impacts on factors like knowledge, critical thinking, and clinical decision-making.

In one systematic review, spanning 1996-2018, authors found that about 86% of studies showed positive outcomes on student learning with virtual simulation. That includes components like knowledge, skills, critical thinking, and – importantly – self-confidence.

The unique properties of virtual reality and virtual simulation allow for a new wave of practice that simply isn’t feasible in other forms of teaching and learning.

The flexibility of VR means that learners can access scenarios at any time, regardless of their location.

This means more simulation more often, and learners can repeat scenarios as often as needed to feel comfortable and confident in their clinical skills.

Learners can experience situations that would otherwise be impossible to recreate. Not only that, they can immerse themselves in these situations.

Even having one experience of a rare occurrence can be meaningful when the situation arises in the real world.

But how exactly do these simulations challenge and bolster confidence and critical thinking skills?

How to bolster clinical judgment using VR scenarios

With the OMS platform, learners can access simulations from a library of over 240 existing scenarios, across disciplines and specialties.

If you’re inclined, you can also align the simulations to competency frameworks.

Data collected during the simulation will be provided after the scenario is completed. Tagged actions and rationale will pinpoint the core components of your chosen framework with actions taken during the scenario.

For example:

Meet George

George is feeling generally unwell. While you’ll gain some information about his status from the nursing assistant, it’ll be up to you to figure out what’s going on with George.

Assuming you’ve performed your hand hygiene, you’ll want to introduce yourself to George, look through his chart, and gather information about what brought him in today.

As you learn more, you must filter out the most critical information to determine what to do next.

During your history taking, George mentions that he’s undergoing cancer treatment. As you assess his vitals, you note a high respiratory rate, low blood pressure, rapid heart rate, and low oxygen saturation. You also find that George has a fever.

Gathering the appropriate information and analyzing it speaks directly to the domains of clinical judgment – cue recognition and analysis.

At this stage, you’ll need to record your findings, use your information to start formulating a hypothesis, and decide what to do next.

If you’re suspicious of possible sepsis by now, you’d be correct in thinking that. George is acutely septic and will need urgent attention to prevent a worsening of his condition.

To arrive at this conclusion, you’ll need to have considered the relevant information and critically considered the patient’s case as a whole. His past medical history, current symptoms, and vital signs (alongside other tests and measures) all point to an acutely unwell patient. But it’s up to you as the lead to assess, prioritize, and formulate that hypothesis.

Because you’re concerned about the possibility of sepsis, you’ll need to determine the next steps to take in his care.

As the learner, you will need to do what you think is in the best interest of your patient. You will also need to determine when it’s appropriate to escalate care and provide an SBAR report to the wider team.

Then, you’ll need to take action to initiate treatment. With help from the wider team, you’ll have standing orders on medications to place, but it’s up to you to administer the medication appropriately and in a timely manner.

Once you’ve started treatment, you’ll also need to monitor and evaluate outcomes. Of course, you can decide to leave the room at any time, but only once you determine the patient is stable and safe.

If you’ve satisfied all of these components and determined the outcomes are positive, you’ve successfully utilized your clinical judgment to recognize and address an acute condition.

After completing the scenario, you’ll receive immediate feedback with rationale and tagged actions corresponding to your chosen competency framework.

In the above image, you can see that you’ve successfully utilized the 5 rights of medication administration – which related to clinical judgment and psychosocial integrity.

If you’ve missed an action, like contacting the charge nurse, you can see why that action is critical, important, or additional. You can take that feedback as you continue your training and practice.

Having access to individualized feedback—with rationale, tagged actions, and links to resources—allows for deliberate practice and reflective thinking.

VR simulations like the above take you from start to finish in a safe learning environment. You can make mistakes and learn from them without fear of judgment or doing harm to a patient.

However, the immersive nature of VR scenarios means you’re the one in the room taking charge, and you’ll feel the empowerment of those decisions as you move through the scenario.

Leading a patient case from beginning to end is an opportunity that many students only have once they’re in practice, but with the opportunity to take the lead, learners can engage their critical thinking to make sound clinical decisions in real time, preparing them for real-world scenarios.

They can see the consequences of those actions play out. Because scenarios are accessible anytime, anywhere, learners can take feedback and immediately put it back into practice. Scenarios can be repeated as many times as needed for learners to build confidence, remediate knowledge gaps, and bolster their skills.

If you’re interested in taking a deeper dive into these scenarios, set up a time for a demonstration with one of our Educational Specialists.

The post How to Bolster Critical Thinking in Nursing with Virtual Reality appeared first on Oxford Medical Simulation.

Unlocking Success in Healthcare: How VR Training Elevates Patient Care, Staff, and New Nurses

Oxford Medical Simulation — Thu, 27 Jun 2024 14:55:03 +0000

Virtual reality is a hot topic these days, particularly in healthcare education and training – and for good reason.

VR scenarios are helping learners across the lifespan of their careers. From junior learners working on building foundational skills to newly licensed practitioners transitioning to practice to advanced clinicians continuing their education, there’s something there for everyone.

The implementation of VR scenarios can provide an immersive and meaningful learning experience that directly impacts learners and ultimately leads to better patient care.

Building confidence in new healthcare professionals

Making the transition from student to fully-fledged healthcare professional is a significant time in a provider’s professional life.

Learning the ropes of a new facility, taking on new responsibilities, and maintaining top-notch care all at the same time can be daunting.

Providing support and ongoing training opportunities can help new healthcare professionals feel more confident in their clinical skills while taking that next step in their careers.

In one study, authors used OMS with their medical trainees in preparation for the management of diabetic emergencies.

Following completion of the OMS scenarios, 100% of learners reported that the experience would improve their daily practice – an exciting insight into how learners feel about using VR to support their clinical practice.

Learners reported that they enjoyed VR and found it helpful for their learning. Practicing in OMS scenarios also improved their confidence. From pre-VR to the 3-month follow-up, learners’ confidence in their ability to manage a diabetic emergency rose by 28%.

Three months after completing the OMS scenarios, 89% of learners reported incorporating the knowledge they gained into their daily practice.

One learner made their feelings clear:

“…honestly, this was the single most useful learning experience I’ve had so far in my medical training.”

With such positive responses from learners, alongside a significant increase in confidence which rose to the level of Kirkpatrick level 3, the authors concluded that VR is both useful and a well-liked educational tool that can support junior doctors in the management of diabetic emergencies.

This study is not the only one to demonstrate how positively learners feel about the use of virtual reality in their learning. In a study by Brown (2023), 100% of learners rated the learning experience highly, and in yet another study by Seager (2021), nearly 96% of participants would recommend VR simulation to their peers.

Additionally, the OMS Library houses a set of scaffolding scenarios specifically designed to facilitate the transition to practice for new nurses.

These scenarios, called OMS Multi-Patient scenarios, provide learners with the unique opportunity to manage multiple patient cases just as expected in practice.

At this stage, learners will focus on providing care to patients with varying levels of complexity to their cases. These situations require learners to prioritize, delegate, and manage care in a timely manner.

The ability to lead patient care as a student preparing for licensure can provide the opportunity for repeated practice of clinical and critical thinking skills. Learners can place themselves directly in the room with a patient, deliberately practicing to better their skills and provide optimal patient care.

With the option to repeatedly practice, learners can build their skills and their confidence, bringing all that with them to the floor when they begin their work in patient care.

Patient-related outcomes

More training options with more frequent access can mean more time spent preparing for emergent clinical situations.

One review reported that 9 of the 11 selected studies on the use of virtual reality in medical education demonstrated improvements in categories such as knowledge, skills, confidence, and empathy.

With VR training, healthcare professionals can build and maintain their skills and immerse themselves in situations they may not often face, requiring quick thinking and timely intervention for positive outcomes.

The early recognition and treatment for sepsis, for example, can lead to better patient outcomes, and nurses in the Carle BroMenn Medical Center have experienced the impact VR training can have on their patient care.

As part of a larger sepsis initiative, nurses underwent training in OMS scenarios to bolster their understanding and management of the condition. The results showed that nurses who participated in this program felt more confident in their ability and competency to manage a case involving sepsis, and the facility reported that the use of OMS scenarios “translated” to their work on the floor.

Another hospital system, Boston Children’s Hospital, found OMS scenarios had a direct impact on nurse preparedness in patient care. The team in the Cardiac ICU at BCH have been using OMS scenarios as part of their onboarding and training processes, familiarizing new nurses with the work environment and preparing them for situations that arise on the floor.

Following training with the OMS modules, one nurse faced a real emergency and attributed her success in that situation to her training with OMS scenarios.

VR can do more than simply help staff train. It can act as another learning tool that engages staff, and helps them build skills and confidence that they take with them as they care for patients.

Continuing education for staff

Current healthcare professionals, regardless of level of experience can gain new insight and benefit from virtual reality as a part of their ongoing education.

For staff, scheduling and completing a required training module may mean taking time out during the day from patient care or during a lunch hour. Not to mention how difficult it can be to align multiple schedules for a day of simulation.

Flexible training options are a must for staff to get all the opportunities they need to continue their training without disrupting the flow of care.

OMS modules, for example, can be completed in a VR headset or on a desktop screen, meaning staff can access scenarios whenever they’re able to. Whether during an unplanned open window of time or at home, truly flexible training means providing staff with multiple avenues to access what they need.

Because of this flexibility, OMS training can be scaled to meet the needs of any number of learners without the hassle of aligning multiple schedules or taking full days to provide simulation experiences.

Learners can also work interprofessionally, even when they’re not in the same location. Teams of people from all departments can work together in the virtual environment, whether they’re five feet apart or across the world from each other.

One study used VR to facilitate team-based training in the management of pediatric sepsis, finding positive results.

Due to the objective nature of the OMS platform, all OMS scenarios are standardized. As facilities are also able to align scenarios with their own protocols, staff can train in a realistic environment that reflects the standards of practice they will maintain at work.

This can mean a reduction in variation in care and an adherence to protocols, as all staff will have the same opportunity to complete VR scenarios.

Continuing education involves learning new skills and maintaining learned skills, keeping fresh for any situation.

While there are many emergent situations that may only arise a handful of times, it remains imperative to be prepared in the event these instances occur.

More simulation, more often, with easier access means more opportunities to individually and intentionally practice clinical skills, which can also increase staff confidence in managing conditions.

Carle BroMenn Medical Center is one such institution using OMS VR scenarios to maintain skills and stay prepared for the early recognition and treatment of conditions like sepsis.

Nurses completing the OMS modules reported an increase in confidence, on average, from 6.6 pre-VR to 8.4 following the sepsis initiative, nearly a 2-point gain across all who participated.

As one nurse put it, “Doing the VR made me feel more confident in treating sepsis, and the biggest reason is because of the feedback.”

What it all means

Appropriate, relevant, and impactful learning experiences can help clinicians at any stage prepare for emergent or difficult situations.

A platform like OMS can assess and track competency, providing real-world insights into readiness to practice and skill progression, standardizing and individualizing the learning experience.

As clinicians can demonstrate competency, build, and maintain skills, they can also build their confidence and apply what they’ve learned to their practice.

This can lead to more timely recognition of arising situations, earlier interventions, and better patient outcomes.

For more information on the outcomes associated with VR training, check out the research page of our site.

The post Unlocking Success in Healthcare: How VR Training Elevates Patient Care, Staff, and New Nurses appeared first on Oxford Medical Simulation.

VR: Supporting & Spanning the Nursing Career

Oxford Medical Simulation — Wed, 22 May 2024 19:19:16 +0000

‘Tis the season!

Nursing students all across the United States are getting ready for graduation, preparing to sit for the Next Gen NCLEX, and gearing up for the transition to practice.

While a very exciting time, it’s certainly a transition to go from nursing student to practicing bedside nurse.

New nurses need support and mentorship, which is why many elect to move forward in a nurse residency program. And the learning doesn’t stop there (as you likely know!).

Lifelong learning is a hallmark of clinical practice, and with so many new ways to learn, it only makes sense to think about which methods can be carried across a nursing career.

Augmented reality, mixed reality, virtual reality – and now AI – these rapidly-evolving technologies are here to stay, and while you might think that VR is a learning tool for students (and you’d be right about that), it’s a much more robust and flexible tool nurses can take with them throughout their practice.

From the beginning stages of learning nursing fundamentals through exam prep and the transition to practice, VR is undoubtedly supporting nursing students along their journey to licensure.

Once nurses are licensed and practicing, VR can support continuing education with annual competencies and help nurses stay ahead of the curve in gaining knowledge around new advancements in patient care and nurse training.

This article will touch on three main areas where VR can be useful for a new nurse:

Preparing for the Next Generation NCLEX
Transitioning to practice in nurse residency
Refreshing and building clinical skills with ongoing education

Using VR to prepare for the NCLEX

2023 was a big year for the NCSBN, whose researchers created the Clinical Judgment Model – the foundation of the Next Gen NCLEX.

This move is a first in shifting to testing that looks at critical thinking in nursing.

As clinical judgment is a complex cognitive skill, it remains difficult to measure – and even to define.

For the NCSBN, clinical judgment involves layered skill sets that involve the intersection of environmental factors, personal factors, and the ability to recognize, analyze, prioritize, and reprioritize information. All to come to a clinical decision, take action, and measure results.

Where virtual reality fits in

Virtual reality simulations aide this process by immersing soon-to-be nurses in standardized clinical scenarios.

These scenarios can involve any type of nursing specialty, which can be difficult or impossible to reproduce by other methods.

Learners then have the opportunity to direct patient care, using all of their knowledge and applying that to the situation before them.

Single learner scenarios drive critical thinking and clinical judgment, as learners must make all their own decisions based on the information they gather in the room.

They must observe, analyze, formulate, and act in a timely manner to optimize patient outcomes – exactly what a bedside nurse is expected to do on a daily basis.

While each scenario at OMS is already competency-mapped, using an additional feature like Competency Mapping & Tracking can take learning to a new level. Students and educators receive pinpointed data and feedback linked to core competencies of the NGN, individualizing the learning experience.

Students can prepare for practice while gaining greater insight into their strengths and areas needing improvement before they sit for their exam.

To further personalize the learning experience, educators can use the authoring platform, OMS Create, to make small changes, like adjust learner feedback, or completely alter simulations, like tailoring scenarios to hone in on what students need to prepare for their exam.

All this together means an immersive experiential learning opportunity for nursing students to apply their knowledge, use clinical judgment, and ensure they’re on the right track come test time.

VR in nurse onboarding & residency

As nursing students become practicing nurses, an inevitable transition takes place.

It’s a shift in responsibility, and for many new nurses, it’s an added transition to learn the ropes at a new facility.

As student nurses, learners might manage one or two patient cases during a clinical rotation under the guidance and supervision of a clinical instructor or preceptor. However, when they hit the floor as a licensed RN, there’s a greater responsibility in needing to care for multiple people, managing several cases at every shift.

This can be a new experience for freshly-licensed nurses, and considering about 91% of new nurses fall outside the acceptable range of competency, it’s imperative that student nurses transitioning to practice get as much experience as possible to prepare.

Where VR fits in

Getting familiar with a new environment, policies and procedures, and managing patient care are all components of the onboarding process and transitioning to practice.

Virtual reality can facilitate all of those needs, on an individual level, creating a personalized onboarding and residency experience for new nurses.

Customizable scenarios offer the ability to make adjustments and upload facility-specific documents for new nurses to reference within a scenario. This can reduce variation in care and familiarize RNs with the facility’s specific procedures from the very beginning.

Realistic VR scenarios that reflect daily practice can help new nurses to apply critical thinking, building confidence in their clinical skills ahead of hitting the floor.

Multi-patient scenarios, for example, are a set of scaffolding simulations that go from one up to five patients. These scenarios mirror the responsibilities of an RN working a typical shift, caring for multiple patients all at different places in the healthcare journey.

As nursing students rarely have the opportunity to manage multiple patient cases before licensure, these nursing scenarios act as a bridge between education and practice for new nurses.

Critical thinking and clinical decision making skills are at the center of these scenarios, and additional skills, like delegation, prioritization, and time management are needed to effectively and efficiently deliver quality care.

As these types of VR nursing simulations are conducted on an individual basis, feedback and scoring promotes a personalized experience for learners.

Educators are able to use the robust data & analytics to identify areas of strength and improvements needed quickly and objectively.

They are then able to tailor the onboarding or residency experience to the learner’s specific needs.

New nurses can use feedback to reflect and gain insight into their personal clinical performance.

All of these factors together can promote nurse onboarding with individualized learning for new nurses, building confidence in their skills, demonstrating competency, and getting nurses familiar with the policies of their new environment.

VR for nursing competencies

As nurses become more confident and experienced in their practice, their needs shift from building skills to refreshing them – especially for high acuity situations that don’t occur frequently.

Maintaining clinical skills can mean reducing variation in care and staying prepared for emergent clinical situations that can arise at any time.

With the evolving landscape of clinical practice, it’s also imperative that nurses are afforded the opportunity to build new skills like utilizing advancing technology or implementing new clinical treatment methods.

However, it’s particularly difficult to arrange time for nurses on the floor to go into a sim lab and work in a physical simulation environment.

As it can be both time and resource-intensive to run physical simulations, they may not occur with the frequency needed for nurses to feel up-to-date and comfortable in handling low frequency, high stress events.

Where VR fits in

For competencies that occur once every one or two years, like ACLS, it’s important to provide nurses with regular opportunities to train in those situations.

Communication and procedural skills also require ongoing maintenance. While many of the day-to-day clinical encounters require continued application of those skills, it’s equally important to remain prepared for less frequent situations.

In VR scenarios, nurses can practice communication strategies in difficult situations like de-escalation or breaking bad news, and they can do that all in a safe space.

VR scenarios that can be accessed remotely can provide more frequent practice, which eliminates the difficulty in scheduling for physical simulation while providing more opportunities for refresher training.

This, in turn, creates more opportunities to support nurses in their continuing education. Nurses have more frequent training windows, so that they can run simulations independently and at their own pace.

In short, VR simulations provide more training, more often – improving patient outcomes, reducing variation in care, and supporting nurses in their lifelong learning.

The post VR: Supporting & Spanning the Nursing Career appeared first on Oxford Medical Simulation.

What to Know About Curriculum Mapping with OMS

Oxford Medical Simulation — Wed, 22 May 2024 16:47:17 +0000

At a time when learners are most vulnerable, learning brand new skills, in a whole new world, and likely overwhelmed, it’s the educators who are steering and guiding them along the path to being fully-fledged clinicians.

As educators pioneer new waves of teaching and learning, there’s been a lot of adoption of AI-powered tech like virtual reality. And even if you’re an educator at the helm of it all, implementing an entirely new form of simulation can feel daunting to say the least.

Building the roadmap for VR implementation

Mapping an entirely new form of simulation into your existing curriculum can feel like a mountainous task on top of the already-full plate many educators are working through. And while the excitement may be there, it still takes work to put it all together in a meaningful and intentional way for learners.

Maybe you’re starting from square one – you know VR exists, maybe you or someone you know enjoys playing games in VR, and maybe you know that VR is making significant impacts in both academia and healthcare.

But if you’re new to the world of virtual reality, it can be hard to think up all the ways it can work to benefit your learners and educators all on your own.

From using it in the classroom to complement didactic learning to remote accessibility for deliberate practice at home – even ways you may not have ever thought about like using VR for unbiased assessments or for specific needs like exam prep or the transition to practice.

So many options, it can feel like decision-overwhelm!

But that’s why experts are here – to help guide you along the way and get the heavy lifting done in the background, so you can narrow down your options and find the best ways to help your learners using this tech.

To help you visualize how VR can fit into your existing courses, Educational Specialists (ES) offer curriculum mapping as a complimentary service when you’re on the path to partnering with us.

Curriculum mapping with OMS

Why we do it in the first place

Many of us at OMS have been educators ourselves, so we know a thing or two about the work you all have going on at any given time. It’s no joke!

Our experience & expertise

OMS Educational Specialists have a wealth of experience in direct patient care, from areas like med-surg to women’s health to flight nursing (the list goes on!).

Because of their experiences in patient care, education, and now VR technology, our ESs have a unique understanding of the intersections of the needs for students, practitioners, & educators, and how VR is positioned to facilitate optimal outcomes.

It’s not only our Educational Specialists who come from clinical backgrounds. OMS Clinical Authors, the incredible minds who create our scenarios, also come from patient-centered backgrounds, with years of experience in patient care and healthcare education.

As part of the scenario-creation process, all OMS scenarios undergo a rigorous peer review process to ensure they’re aligned with standards of best practice.

Another key feature of OMS scenarios is that they are already competency-mapped and can be mapped to an existing framework, like to the AACN Essentials or the NMC.

And while you know your course(s) best, we also know our library has over 240 existing scenarios (…and counting!).

Tailoring the experience

OMS scenarios touch on so many aspects of care – just like in real life, any given scenario is nuanced and can involve lots of different points of care.

As part of a med-surg scenario, for instance, you might learn that your patient’s neighbors have reported hearing frequent falls.

One OMS scenario could touch on multiple clinical concepts, and with a bit of information about your goals, we can provide you with multiple avenues to meet learning objectives.

OMS VR scenarios also come in several modalities.

For example, you can choose to use Communication scenarios, which are AI-driven so you can have a real conversation with a virtual patient, family, or team member.

Or, you can use Multi-patient scenarios that allow you to lead a set of scaffolding scenarios (up to 5 patients at once), to work on bridging the gap in the transition to practice.

There are lots of options and directions you can go in mapping VR to your curriculum. We want to make sure you’re getting the right information up front, so you can make an informed decision about which way to go.

We could just toss you a list of all our scenarios, and let you do all of the reading, thinking, and mapping yourself, but that’s not our game.

When you work with OMS, we tailor the journey to you, so you don’t ever feel as though you’re lost in a sea of information with no direction or guidance.

Getting the most out of OMS

You’re the experts in education, and as the experts in VR, we’re here to collaborate with you – or let you take a much-needed brain break from all that mapping – and work asynchronously so you can visualize how VR can work within your program.

Our mentality is that it’s good for everyone if scenarios can be mapped specifically to learning objectives, concepts, or competencies.

We operate with the intent to benefit learners, educators, and ultimately, patients – we’re not here to force a scenario that doesn’t fit on anyone. That’s good for no one.

We’ll tell you if something isn’t the right fit, if it’s on the roadmap, or if it’s something you can easily adjust using our authoring platform, OMS Create.

Ultimately, we’re here for the betterment of patient care, and preparing the next wave of clinicians is a huge part of that process.

And if you’re going to put in all the work it takes to build out your VR simulation program, we want to ensure that we’re giving you everything you need to meaningfully integrate it into your curriculum, so students (and educators) get the most out of all that hard work.

How we do it

The basics of curriculum mapping with OMS

Here’s a quick step-by-step of how the process works:

Get on a call with an Educational Specialist
Discuss your curriculum, goals, and learning objectives
Provide your ES with relevant materials
Up to you – collaborate together on a call or let your ES work asynchronously
- ES reviews your materials, learning objectives, and competencies
- ES sources appropriate scenarios that match your criteria
- ES provides you with a document outlining curriculum map
You review the document provided by ES
Feedback with any edits or questions
ES takes feedback, makes edits, and provides updated versions
Repeat until you’re happy with the final curriculum map
You approve and finalize the curriculum map

A detailed look at OMS curriculum mapping

There’s lots of ways we can map VR scenarios to a curriculum, but a few of the major categories include:

By learning objectives

Have a specific learning objective in mind? Let us know! Chances are, you’re not the first to ask us, and we can point you in the right direction.

We can do this from your working syllabus or from your larger course objectives. Whether it’s one day of simulation or threaded throughout the entire course, we can help you figure out how it all fits together so your learners don’t miss a beat.

Each OMS scenario comes with its own reference material with learning objectives that align with the contents and skills in each simulation. We provide these notes alongside our recommendations, so you can be sure that your VR simulations will align with your learners’ needs.

By content

This is a good way to go if you’re looking at something higher-level or more broad in scope. It’s not necessarily aligned to a particular competency, but you know your learners need more experience with the topic.

Maybe you already know you’ll need content for topics like “patient communication”, “fundamentals”, or “nursing emergencies”, but you’d like multiple options to choose from – we can do that, too.

By competency framework

Are you gearing up to send out a report to an accrediting body? Let’s get specific, then!

We can get as detailed as you like, aligning OMS scenarios with specific core competencies of existing frameworks. Our Educational Specialists can map out exactly the path students will take to meet specific competencies using OMS so you can rest easy when you send out your plan.

All you need to do is review the work and let us know what you think!

Our team will tailor to your needs until you’re feeling the Goldilocks effect – it’s just right.

Next steps

Know that if you choose to start the journey with OMS, we’ll be right by your side throughout the entire process – from embedding to implementing to data collection and beyond.

Our team of experienced clinicians and educators have special insight into how VR can fit best into your curriculum while ensuring everyone involved is getting a value-add right from the start.

To get started in talking with your Educational Specialist, book a demo here – we look forward to speaking with you soon!

The post What to Know About Curriculum Mapping with OMS appeared first on Oxford Medical Simulation.

From Classroom to Clinic: Tackling the Academic Roots of the Nursing Shortage

Oxford Medical Simulation — Fri, 03 May 2024 18:52:39 +0000

The nursing workforce shortage continues to be a global problem. While initiatives are in place, and there is renewed attention on recruitment and retention, other factors need addressing to solve the shortage holistically.

There is a clear decline in the number of students entering or applying to nursing schools in the United States and the United Kingdom. Although the causes of these issues appear to differ, the US and the UK are both facing similar challenges.

Exploring contributing factors to nursing student shortages

Impacts on US nursing education

For example, US nursing schools are currently limited in student capacity, meaning schools are now turning away pools of interested students. According to the AACN, nursing schools across the US turned away nearly 92,000 qualified applicants in a 2021-2022 report.

One significant factor in this issue is the national nurse faculty vacancy rate of 8.8%.

There are several reasons why this might be the case.

Nearly one-third of the current nurse faculty workforce is expected to retire by 2025, as the average age of a doctorally prepared nursing professor is approximately 62.5. Per the AACN, this number continues to rise, potentially limiting the working time frame for highly qualified nurse educators.

Additionally, enrollment in master’s and PhD programs is down, and compensation in related career paths is higher.

According to The 2024 Nurse Salary and Work-Life Report, the average salary in the US for an advanced practice registered nurse was reported to be $120,000. However, the average salary for a master’s-prepared nursing professor is nearly $87,000, according to the AACN.

The demanding workload placed on an already stretched faculty, other avenues for professional development elsewhere, and a hefty barrier to entry for a career in academia makes it difficult for nursing schools to attract and retain faculty.

Impacts on UK nursing education

On the other hand, nursing schools in the UK are seeing their lowest numbers of applicants since they began tracking more data in 2019. The applicant pool for the 2024-2025 academic year is down by about 7% compared to the previous year.

Additionally, nurse educators in the UK are managing heavy workloads like their US counterparts.

These issues have become increasingly apparent, and as a result, an Educator Workforce Strategy is now in place to address the contributing factors, balance the workload for nurse educators, and promote a clear path for professional development.

Recommendations from a recent report by University Alliance echo the sentiments of the HEE Educator Workforce Strategy.

Collaborating and connecting the education sector alongside the healthcare systems as they plan for the future is one way to align and involve educators and practitioners in workforce planning.

Additionally, University Alliance recommends that educators embrace simulation, as outlined by the Nursing and Midwifery Council, to support students in a realistic yet safe learning environment as they prepare for the transition to practice.

Why physical simulation may not be enough

Manikin-based simulation or the use of standardized patients is one of many forms simulation can take in education.

Many institutions rely on this type of training in order to expose learners to all types of clinical situations – often for low frequency, high stress events.

While a valuable form of simulation-based education, physical simulation is not without its problems.

Conducting a day of simulation for learners is not only resource-intensive, but it relies heavily on educators to plan, set up, run, and break down – not to mention the need to supervise and provide meaningful feedback and debriefing opportunities to learners.

Additionally, not everyone has easy access to a simulation lab or can align so many people’s schedules to get learners and educators all in one place at the same time.

As these simulation days are often conducted in groups, some learners will get more opportunity than others to apply clinical knowledge.

Particularly when working with standardized patients, answers or experiences may differ between groups, raising questions about whether learners are all receiving a standardized experience.

Many educators need a reduced workload while also being able to provide more simulation to learners more frequently.

How AI and VR may be able to help

The rapid development of technology and how to best use it continues to be a looming question for the healthcare industry.

AI-driven technologies are increasingly being used to streamline work efficiencies, decrease administrative workloads, and, at the core of it, make people’s lives easier.

Of course, implementing new tech doesn’t mean a cure to the workforce crisis. Still, it may be able to help decrease workloads placed on faculty workloads while engaging students, many of whom expect schools and facilities to be on the frontlines of embracing technology.

Simulation-based education is now a cornerstone of healthcare education. While physical simulation has its place in education, conducting even one day’s worth of these scenarios remains resource and time-intensive.

Embracing innovative technology and opening up curricula to other simulation forms may result in a lessened workload for faculty and an engaged and excited student body.

For example, virtual reality has been widely used to facilitate simulations, providing similar learning outcomes to physical simulation at a reduced cost. Many students are already familiar with this technology and are eager to use it as a learning tool.

For educators, VR scenarios can mean a significantly lighter workload for simulations, with few constraints on time or space to conduct scenarios.

For example, the OMS platform can be accessed in a VR headset or on a desktop. Students can log in at any time and complete scenarios at their own pace—whether before, during, or after a didactic lesson.

As learners lead scenarios, the OMS platform logs and tags data throughout, meaning educators don’t need to worry about keeping track of every action a learner takes and when they hit or miss a required action.

Students can independently lead a case and repeat it as many times as they like, which differs from the typical group-based physical simulation.

Educators can rest assured that their students are receiving standardized simulations, and they can review data as it comes in to focus more on facilitating a meaningful debrief rather than spending so much time and energy in making sure that all the pieces of a simulation are in place.

For more information

The world needs nurses, which means people must be interested in the profession. This also means that the knowledgeable educators teaching the next generation of nurses need to be able to do just that without pressure to take on more work in other areas.

While not a panacea, embracing the wide world of technology can make a difference for both educators and students alike.

To learn more about implementing VR into your simulation program, read our comprehensive guide and grab the question checklist to find the right VR partner to fit your needs.

The post From Classroom to Clinic: Tackling the Academic Roots of the Nursing Shortage appeared first on Oxford Medical Simulation.

Choosing Your VR Partner: A Guide

Oxford Medical Simulation — Wed, 01 May 2024 17:54:41 +0000

Ready to step into the wide world of virtual reality simulation?

Need help kicking off your search to find the best VR healthcare company for you?

Starting to update or progress an educational or training program can feel daunting. But, with the right partner, it can feel like you’ve got a knowledgeable guide. They will help you find the best solution.

Suppose you know you’re searching for VR healthcare companies that can positively impact patients and reduce costs.

Even if you already have knowledge about the potential impact of using VR for education or training, there’s still a significant amount of information out there. You may not be sure what criteria will make a difference to your decision-making process.

From ensuring alignment with learning objectives to implementation and support to content fit to feasibility, finding what will work best for you and your learners can feel like a daunting task.

That’s why we’ve created this guide—to give you a sense of what to look for and how to select the right VR partner!

Alignment with objectives

What’s the first thing you want to know about your future VR partner? Whether their product fits your needs and learning objectives!

If you’re searching for a maternal health scenario, for example, but the VR vendor doesn’t offer that area of care, it’s fair to say that vendor probably won’t be best for you.

On the flip side, if you don’t have your learning objectives established yet, it can be hard to discern whether or not the vendor has what you need. So before you get started in speaking with potential candidates, make sure you know a bit about:

What your learners will be using VR for
What the learning objectives are for your course or program
Which modality fits best for your learners

Consider whether this will be used for first-year nursing students or practicing clinicians. The level of difficulty should be suitable for the people who will be engaging with the simulation.

What do you expect learners to get out of this simulation? Do they need to demonstrate clinical decision-making skills, conduct a procedure, or take a patient history? These needs may change which type of scenario you choose and can play a part in determining the suitable modality for your learners.

For example, a hand interaction scenario may be more appropriate if you expect learners to demonstrate a skill like PIVC insertion. Or, if you want learners to collaborate on a case, multi-participant may be right for you.

Do you want your learners to develop rapport and speak directly with patients? A voice-control scenario may make the most sense.

Allow your learning objectives to help guide you in narrowing down your options and determining which one or set of scenarios will be best for your learners.

This is an area that your VR vendor should have significant knowledge about, and they should be able to consult with you to determine which type of simulation will work best. Questions you can ask here include:

My learning objectives are XYZ. Which type of simulation would you recommend?

How can I determine how learners are meeting the objectives of this simulation?
Which scenarios will be better for newer students, and which will be better for advanced learners?

Questions like the above can provide a wealth of information about your potential partner’s expertise in the industry.

Do they deeply understand who your learners are and where they’re trying to go? Can they provide multiple opportunities for meaningful learning experiences tailored to your learners’ skill levels and goals?

When asking questions like these and working to determine the right fit, you must walk away feeling like you have a collaborative, responsive, and knowledgeable partner who will help guide you along the way.

Implementation and support

The next question in your mind likely revolves around the practicality of it all – how will it all work? Questions like:

Who will be responsible for the implementation process?

What support can you expect during the process?
How will you efficiently get VR into learners’ hands?

The best VR healthcare companies will clear a path to make it as easy as possible for you and your staff to successfully and efficiently onboard learners or other faculty.

A good VR partner will help you get everything set up, but a great VR partner will go beyond that. They will continuously check-in and provide ongoing support to you and your learners—not just at the beginning but throughout the entire process. This commitment to support will make you feel cared for and supported in your journey.

It may help you to know more about the following:

The number of learners you will onboard
The impact you want to have
When you want or need to have it all up and running
How you will receive notices of updates or new features

Here, you may also want to know more about the steps your VR partner will take – or recommend you take – to ensure the security of your learners’ information. How will it be maintained? How will you support protecting and securing your learners’ personal information?

These processes are likely already established, but it would be helpful for you to know before moving forward.

Additionally, you may already be thinking about how VR use can be expanded over time within your institution. If so, consider asking more about how scalable the system is. Can you quickly broaden its use to a larger cohort as your implementation of VR grows?

Asking VR healthcare companies about their support during and after implementation can help save you time (and technological headaches!).

Flexibility

One key reason for choosing VR is its flexibility! Your VR partner should be flexible in their product and in accommodating your specific needs.

Consider who you’ll want to supervise your learners (if anyone), where you’d like them to engage with VR, and the types of scenarios your learners can use to develop more targeted clinical skills.

Can learners engage solo and with supervision?

Do you want your learners to use VR only when a colleague or faculty member is present? Or do you want them to be able to access simulations anytime, remotely, and anywhere, with or without a supervisor?

If you’re looking to deliver VR simulation to a large number of learners or to use VR simulation remotely, finding a solution that provides automated scenarios and feedback is vital.

In addition to removing scheduling barriers, automated scenarios provide unlimited repeatability, allowing your learners to grow their skills through as much self-directed practice as they need.

It also allows them to practice alone before leading cases in front of their peers, ensuring psychological safety. So, it’s worth considering how important this is to you early in the process.

Does it work on screen and in VR?

Consider where and when your learners will be able to access these scenarios. If you’re looking for more flexibility, you may want to consider a VR healthcare company that caters to virtual reality and on-screen simulations.

Some people may not be able to use VR due to several factors. Providing on-screen simulations in addition to VR can serve as an alternative solution for those learners, ensuring accessibility for those who otherwise would not be able to participate.

The flexibility of both VR and on-screen scenarios also grants learners access to simulations at home – even if they don’t have a VR headset – to further increase your ability to scale simulation remotely.

How flexible is the team?

Finally, flexibility isn’t just about the product; it’s also about the team—a flexible team can accommodate your time, develop creative solutions, advise on the best ways to implement, and remain available for any questions.

Consider what support you might need throughout the decision-making and implementation process. Do you need curriculum or implementation advice? Do you want to hear who the company has partnered with before? Do you need a demo to ensure you’re happy with the product?

Asking yourself questions like these will give you a sense of the kind of experience you’re looking for, what impact you’re looking to create, and how flexible your VR partner should be.

Quality

One key feature you’ll likely be interested in to know more about across VR healthcare companies is the quality of their scenarios.

How realistic is it?

First, VR simulations should feel real – they should be dynamic, feature realistic characters, and have robust narratives.

Some virtual platforms have linear or branching scenarios – similar to a choose-your-own-adventure – but this simplicity isn’t how clinicians and patients operate in the real world, so always ask a potential VR partner about how their scenarios function.

Consider asking questions like:

Are there multiple paths through a scenario?

Can you multitask?

Can you see the effects of illness or treatment in a patient?
Is the patient’s conversation, behavior, and physiology adaptive?

All of these factors increase the realism of the experience, so it’s ideal that your VR partner considers these elements when creating their scenarios.

Real practice isn’t always step 1, then step 2, then step 3, so it shouldn’t be that way during a simulation. There isn’t only one path to complete a scenario correctly; if you want your scenarios to flow like real life, you are looking for a non-linear flow.

This means that mistakes beget consequences, and effective treatment visibly improves the patient’s state—the simulation won’t stop you just because you’ve made an error.

In fact, you may seek out scenarios that allow mistakes to play out so learners can safely experience what it looks like when things go wrong.

Patient states should ebb and flow, too – just as in real life. Pallor, respiratory rate, clamminess – these things change in patients and can fluctuate within hours, minutes, or even seconds. That’s exactly how a patient’s physiology should be in a VR scenario – dynamic.

Finally, patients don’t always say what you expect them to say. They’re people with emotions, and sometimes people have bad days. Do your VR scenarios reflect that? Can your virtual patients change emotions, and can those emotions shift based on how your learner interacts with them?

It’s crucial to reflect real life as much as possible in simulation, so getting a deep understanding of the components that go into creating a realistic scenario can help you ensure that your learners are practicing in a way that directly reflects the clinical setting.

This delivery of functional fidelity and narrative depth is what allows OMS scenarios to feel natural and remain non-linear, ensuring that experiences can play out in many ways. It’s all up to your learner to direct the situation and act accordingly!

Are scenarios aligned with best practices?

To simulate comprehensive, realistic clinical situations, scenarios must be grounded in current evidence and best practices. Beyond the scenarios themselves, peer-reviewed feedback can provide a meaningful basis for tracking progress and competency.

To determine the level of expertise involved in the scenarios, you may want to inquire about how VR healthcare companies create new scenarios.

Are they created in-house? By a team of experts with experience in the field?

Importantly, do scenarios undergo a peer review process before publication to ensure they’re accurate and aligned with best practice standards?

Fidelity in simulation isn’t necessarily enough, so make sure your VR partner explains how they create scenarios and whether those scenarios are based on the latest evidence.

Breadth of content

What specialties are covered?

You may need your learners to gain experience or increase their practice in different settings or conditions. Perhaps your learners plan to work in the inpatient or outpatient setting, or maybe you need them to have experience in both maternity and pediatric care.

Exposing learners to various areas of care can make all the difference, especially as many students simply cannot lead care during infrequent, emergent situations – many more may only experience these situations once they unfold during practice.

Providing opportunities for learners to refresh skills or recognize signs of an emergent condition can help build confidence and competence when these situations inevitably arise.

Consider asking your potential partner about their scenario libraries. Which areas of care do they cover? What do they not cover?

Think about the level of difficulty your learners need. Will you be using these scenarios with both beginners and advanced learners? If so, consider asking more about levels of difficulty that can be adjusted or which scenarios your partner recommends for particular skills.

The right VR healthcare company for you is likely to have existing scenarios that reflect the content you’re looking for.

If they don’t, you may want to know about the possibility of a partnership to create a custom plan with bespoke content that fits your needs.

Can you do individual and team training?

Think about how important it is for your learners to go into scenarios alone and with others.

Just like you would expect in the clinic, independently driven scenarios place the learner in the position of directing patient care. The learner works independently, focusing on clinical reasoning, critical thinking, and decision-making through deliberate practice.

If you’d also like your learners to be able to work together in simulations, consider whether your VR partner offers multiplayer scenarios.

In these scenarios, at least two learners – across disciplines – are working together to provide timely and effective patient care.

In simulations with multiple participants, you may want to know more about how the feedback will change between individual and interprofessional scenarios, as multidisciplinary scenarios require additional skills like teamwork and communication.

Can you see multiple patients at once?

Clinicians rarely care for one patient at a time, so consider if the VR healthcare company you’re speaking to provides multi-patient scenarios to help your learners prepare for practice more effectively.

These scenarios are typically for more advanced learners preparing for the transition to practice or onboarding as new graduates.

The ability to treat multiple patients at once provides an insightful, meaningful learning opportunity that most students in a healthcare program will not get the chance to do in their capacity as students.

As learners handle these dynamic simulations, they’ll have the chance to work on care prioritization and reprioritization, multitasking, delegating, and patient and interprofessional communication to effectively manage the complex nature of healthcare practice.

Consider whether you’ll want to scaffold skills in increasingly complex scenarios and ensure your VR partner provides this opportunity to your learners.

Can you teach procedures and communication skills?

Ask your potential VR partner if they can also build out other types of scenarios. This includes scenarios with hand and voice control, not just single-player vs. multiplayer or single-patient vs. multi-patient.

For instance, procedural scenarios use hand control to allow for repeated practice in technical skills. They enable the learner to develop much-needed muscle memory for a particular skill or procedure, with vibrotactile haptic feedback to simulate any level of interaction.

Scenarios using voice control require learners to speak with a patient and the team to gather information, convey empathy, educate, or de-escalate as needed.

As voice and hand control add layers of complexity and cognitive load to scenarios, the possibilities are seemingly endless (and even a bit overwhelming)! Your VR partner should help you understand the options available so you can make an informed decision about what types of scenarios will best serve your learners.

Having various options is important in tailoring the learning experience as much as possible, so be sure to ask about the breadth of content and the modalities offered.

Data & analytics

Providing meaningful feedback is an essential part of any simulation. You may be looking for VR healthcare companies with a platform that provides instant feedback to learners and delivers performance data in an objective and standardized way.

What feedback do learners get?

Ask yourself if you want the feedback your learners receive to provide evidence-based, unbiased advice to help them improve after every scenario.

What about the ability to use your VR platform to benchmark performance or even to be used for formative and summative assessments?

Automated feedback that provides supporting evidence to maintain alignment with standards of best practice can help your learners self-reflect immediately after the scenario.

With appropriate feedback, learners can easily identify mistakes or areas for improvement while better understanding their clinical performance overall. They can then immediately put that feedback into practice by running through the scenario again.

Staff can also use feedback to facilitate a meaningful debrief by identifying common mistakes amongst learners, recognizing trends, or discussing key takeaways from the scenario.

Consider asking about how feedback is generated for learners and if it aligns with current best evidence, so you rest assured your learners are getting quality feedback that they can use to improve their clinical practice.

What analytics are provided?

Another critical feature to discuss with your future VR partner is what types of insights you can expect to gain from partnering with them.

If you want to tease it out in more detail, ask:

Do they have an objective scoring system?

Can you track learner improvements over time?

Can analytics be linked with learning management systems?

How are learners scored in this system?

You may also want to ask how these VR companies recommend using data provided by the platform. An experienced team should be able to discuss how the analytics are being used to create a positive impact for learners and staff.

Depending on your chosen partner, you may have access to all sorts of information and insights. A clinical performance score, for example, may tell you more about the actions learners take in the scenario, what they prioritize, and the time between observations and the initiation of treatment.

Access to detailed analytics can provide you with a support network for making data-driven decisions about your curriculum or training program.

Your VR partner should be able to discuss the data you can expect to see, who can view it, and how it can be used most effectively to bolster your learners’ knowledge and track their progress over time.

Do scenarios link with competency frameworks?

Your scenarios must be evidence-based. While simulation itself can be a promising tool for promoting competencies, it can be challenging to implement virtual reality simulations that track progress in a way that aligns with current competency frameworks.

For example, if you wanted to see how your learners are progressing towards their preparation for the Next Gen NCLEX in the OMS platform, you would be able to see data about how often your learners are taking actions within a scenario that aligns with each core competency.

Health promotion and maintenance, physiological integrity, psychosocial integrity, and safe and effective care each have their own insights, meaning you can easily view where your learners are performing well and where there’s room for improvement.

The ability to use immersive scenarios and access meaningful feedback can be immensely valuable in ensuring your learners are on the right track. Your VR partner should be able to explain that data and how it can benefit your program.

Customization

What can I do with your authoring platform?

Is it essential for you to be able to customize scenarios to meet specific needs? If so, you may want to work with a VR healthcare company that houses an authoring platform.

Think about the level of control you’d like to have when you author. Are you looking to make small adjustments to existing scenarios by changing vital signs, lab results, or patient conversation? Or are you looking to build new scenarios from scratch?

Suppose you are creating VR nursing simulations for onboarding purposes, for instance. In that case, you may want to have a platform that allows you to upload your facility’s protocols so you can be sure your newly hired nurses are becoming familiar with exactly the right steps to take on the floor.

Perhaps you need a virtual patient to appear unwell more quickly, or you want to add documentation to your virtual patient’s medical record. If having the freedom to create is important to you, be sure to ask about the capabilities of any authoring platform you’ll have access to.

Do you offer bespoke partnerships?

In working with your VR partner, could you truly partner with them?

In addition to authoring platforms, if you’re looking to grow your VR capabilities as an institution, it’s worth asking if you can engage with your partner on custom content, quite literally designed to fit your needs.

Ask:

Have you partnered with other institutions?

What were the outcomes of those partnerships?

How does the process work?

You can even request to be introduced to existing clients and partners for reference checks – you need to make sure they’re right for you!

Budget

How does pricing work?

As with any new venture, cost is always a factor, and you’ll likely consider your price when talking to VR healthcare companies.

It may be helpful to have a range that you’re comfortable with. This can help you shop around to determine what solution will ultimately give you the most for your money.

A knowledgeable partner can provide you with more information on the pricing structure and the expected start-up costs for implementing VR into your sim program.

You may expect to reduce costs with VR, so ask what you should expect from initial setup and maintenance costs over time.

A VR partner should bring knowledge to the table and ease your mind by explaining all the steps you can expect to take throughout the process.

Finding your VR partner

All things considered, you’re probably looking for a VR partner that can:

Inform you about VR – in general, and how it relates to your curriculum
Provide flexibility in pricing or structuring
Produce quality content and meaningful data
Maintain open communication and support throughout the process

Experience & Expertise

Coming from the healthcare world, you want to work with a VR partner that has a team of people who understand healthcare and VR simulation. Look at who makes up the team—are there clinicians and simulationists? It may be necessary for you to have people who can understand both!

Take stock of how you feel in these initial conversations. Does their expert understand your specific needs and goals? Are they answering questions you didn’t even know you had? Is ongoing support included in your package?

Content Fit

Ensure that the scenarios meet your requirements and expectations. Consider the VR vendor’s current list of simulations, if they’re evidence-based, what their future scenarios look like, and if they can create custom content that meets your needs. Ask if you’ll be able to take advantage of any upcoming developments.

Data & analytics

When speaking with a VR partner, you should understand the data you can expect to see and how you can use it to assess learners’ progress and promote competency.

Support

A true partner walks the path with you; communication is vital to maintaining a good partnership. Your VR partner should be responsive and help you troubleshoot any issues along the way, virtually or onsite. Success and support teams should be ready to help you whenever you need it – not just when you’re starting but throughout your entire experience.

For more information

Conversations with the right VR healthcare company should feel like talking to a trusted confidante about your challenges and how you can work together to address them. The right VR partner should work with you to develop the right plan to fit your needs while keeping in mind your budget.

To get a sense of what you can expect when partnering with OMS, send us your questions or schedule a call with an experienced Educational Specialist.

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A resource just for you!

Phew, what a read! You’ve made it all the way through this guide—now what? Start by grabbing the checklist of relevant questions, which you can edit and take with you to your next meeting!

The post Choosing Your VR Partner: A Guide appeared first on Oxford Medical Simulation.

Maximizing Educational Impact with Extended Reality

Oxford Medical Simulation — Wed, 13 Mar 2024 13:50:41 +0000

Bringing realistic clinical simulations to life is no small task. Anyone who has been a part of a simulation day knows a thing or two about all the work that goes into it. So many decisions need to be made, schedules need to be aligned, and skills need to be developed – all in such a short time.

With simulation-based education, learners can practice skills through a range of modalities, whether it’s working on suturing skills with a task trainer, practicing history taking with a simulated patient, or leading a patient case in virtual reality.

As technology continues to rapidly evolve, it has become further embedded into training programs and curricula, providing immersive and experiential learning opportunities for current and future healthcare professionals.

These immersive experiences are often grouped under the umbrella term, extended reality (XR), which includes augmented reality (AR), virtual reality (VR), and mixed reality (MR).

AR, VR, MR - what’s the difference?

As immersive technologies like AR, VR, and MR have become more widely implemented across the healthcare continuum, there has been a call to the community for clarity of definitions.

While extended reality is the umbrella term, there are significant differences between modalities.

Broadly speaking, augmented reality blends the digital and the physical worlds, creating a learning experience with both real-world and virtual elements.

Mixed reality, however, involves elements of both the physical and digital worlds, and learners here can interact with both worlds. This is different from AR, as learners in AR can only interact with the physical elements of the environment, even with the digital component present.

Virtual reality recreates elements of the physical world in a virtual environment. With a head mounted display (HMD), learners can become completely immersed in a virtual world, wherever they are.

In short:

AR – uses the real world with the addition of digital overlay
MR – blends the physical and virtual, where learners can interact with elements of both worlds
VR – learners are fully immersed in a virtual environment, able to interact with elements of that environment

AR, VR, and MR in healthcare education & training

As selecting any simulation modality goes, it largely depends on the learning objectives.

Elements of surgical procedures can benefit from using augmented reality for skill transfer. For example, practicing suturing skills on a task trainer is a form of simulation, but if you were to add a digital layer displaying the steps of the procedure, that would be referred to as augmented reality. In AR, learners can physically perform the procedural skills with digital information contributing to and enhancing the learning experience.

One example of mixed reality in nursing education is a study in which participants performed a visual assessment of a holographic patient projected into a real-world environment. Here, learners had the opportunity to engage in observational analysis, or ‘noticing’, which has been linked to the development of clinical judgment.

Virtual reality, meanwhile, has been used in the development of a number of clinical skills, including clinical decision making and nontechnical skills. Often, learners immersed in these experiences must lead the simulation, emphasizing the importance of individual learning and critical thinking.

Benefits of XR technologies in curriculum

There are lots of reasons you might consider adding extended reality to complement or add onto learning experiences.

On the whole, XR technologies offer a standardization with training that can be difficult or impossible to achieve in physical simulations.

Head mounted displays or laptops increase accessibility and portability, meaning more simulations can be conducted, on a more individual basis, and in less time than other forms of simulation.

There’s also evidence demonstrating that the use of XR technologies can increase learner engagement and improve spatial representation, and have been shown to positively impact skills, knowledge, and attitudes of the learners engaging in these types of simulations.

From a pedagogical perspective, XR provides experiential learning, placing the learner at the center. Learners can engage in situations from differing viewpoints, collaborate with peers, and can transfer knowledge to practice independently.

These technologies can prove especially useful in situations where clinical placements are limited or more specialized areas of care are not easily accessible.

Learners can access simulations remotely and gain exposure to areas of care they might otherwise never experience as a student or rarely experience as a practitioner.

VR, AR, and MR can provide opportunities for individual learning, emphasizing the application or development of skills like clinical decision making and encouraging deliberate practice and reflective thinking.

Selecting the best XR technology

Again, this largely depends on the learning objectives and what learners are ultimately trying to achieve.

Once learning objectives are established, a next step may be considering the level of immersion that would most benefit the learner.

Both MR and AR provide advantages for simulations that require an interaction with the real world.

For example, AR or MR may be better suited for skills like surgical equipment management, as learners can physically interact with objects they will use in the operating room.

However, in both AR and MR, learners continue to be limited by their environment. For example, practicing skills in MR in the living room may inhibit a sense of presence or realism, as the learner remains aware that they are actually in a room of their home rather than a clinical setting.

Virtual reality, on the other hand, promotes immersion and presence by placing the learner directly in a 360 degree virtual environment.

In VR, learners can be anywhere – whether it’s a hospital room, outpatient clinic, or home health setting.

Not only can a higher level of immersion increase the realism a learner experiences during the simulation, it has also demonstrated significant increases in knowledge retention for learners.

Additionally, virtual reality provides a distraction-free environment by blocking out the real world and leaving the learner fully immersed in the virtual space. Once in the simulation, the learner can engage in and lead the session independently, receive and reflect on feedback, and repeat the simulation as much as needed to bolster clinical skills.

For scenarios that are dependent on the environment – home health, for example – VR is the only XR technology that can bring the learner completely into another space and allow them to interact with virtual equipment, patients, or caregivers.

Overall, XR technologies can provide a safe learning environment where learners are free to make mistakes, reflect, and learn from them, and authentic, evidence-based scenarios can provide more standardization with training and tracking progress in competencies.

As the authors of a study on XR in medical education concluded, “the research question these days is not whether XR is comparable or even superior to traditional media for medical education, but where and how it should be deployed for maximum impact.”

The post Maximizing Educational Impact with Extended Reality appeared first on Oxford Medical Simulation.

Virtual Reality: A New Wave for Simulation-Based Education

Oxford Medical Simulation — Fri, 01 Mar 2024 12:40:50 +0000

Whether in the classroom or the clinical setting, opportunities for learners to practice skills freely and in a safe environment are limited.

However, replicating real-world clinical scenarios is crucial in preparing students for practice and reinforcing knowledge and skills for clinicians.

This recreation of specific clinical situations is often referred to as ‘simulation-based education’, and has become a cornerstone of nursing education and training.

What makes for a simulation?

Recently, the Nursing and Midwifery Council (NMC) updated their terminology to provide clarity on what constitutes a simulation, now considered “an educational method which uses a variety of modalities to support students in developing their knowledge, behaviours and skills, with the opportunity for repetition, feedback, evaluation and reflection to achieve their programme outcomes and be confirmed as capable of safe and effective practice.”

Several key features are listed in the NMC’s revised definition of what’s required of a nursing simulation.

While simulation may be delivered through “a variety of modalities”, it must be used to facilitate skill development and reinforce knowledge for students. Additionally, there must be an “opportunity for repetition, feedback, evaluation, and reflection”.

With this idea in mind, the NMC announced earlier this year that the changes enacted during the Emergency Standard for Nursing Education (RN6D) are now permanent, meaning that qualified institutions may provide up to 600 hours of simulated practice learning, counting towards the total requirement of 2300 practice learning hours.

For clarity, the NMC defines simulated practice learning (SPL) as a means to “replicate, support, and complement practice learning scenarios through a wide variety of methodologies”.

This might include working with standardized patients, immersive rooms, or virtual reality. There are additional requirements for what counts as SPL, including meeting standards previously set for pre-registration nursing programmes and demonstrating the achievement of learning objectives, among other requirements.

Simulation in nursing education

A recent study by the Council of Deans of Health (CoDH) looked at the whole of ‘Simulation in Nursing Education’, with findings supporting the use of simulation-based education in nursing.

Notably, the study reported that, consistently, simulation-based education “is more effective than traditional clinical education in improving outcomes such as knowledge, clinical judgment, critical thinking, and measures of clinical competencies”.

Interestingly, this study found that academic staff reported low confidence levels in using cutting-edge technology like virtual reality or augmented reality. This study also demonstrated low use levels for VR, AR, and on-screen simulation, indicating a potential need for familiarity with these mediums amongst academic staff.

This may also factor into reported requirements for successful implementation and maintenance of simulation-based education, including:

Commitment from faculty leadership
Access to space
Funding and resources

Additionally, the “planning, delivery, and design” of simulations were seen as advanced skills for staff, potentially adding to the difficulty of implementing a comprehensive SPL into the curriculum.

Addressing challenges of implementing SBE

Common difficulties of physical simulation often include access to space or facilities, continuing cost of maintenance or equipment management, replenishment of consumable supplies, and scheduling conflicts.

Additionally, it’s often the responsibility of staff supervisors to observe students’ practice while running the simulation, track progress, and log relevant points that arise to facilitate meaningful debriefing discussions. On top of the cognitive load for staff, they may be responsible for the setup, reset, and breakdown of the simulation, which can become a months-long coordination effort for one to two days of simulation.

While manikin-based simulation or task trainers are ideal in certain circumstances, virtual reality is perfect for other outcomes.

For those seeking individualized training for a large cohort, an opportunity to safely assume a leadership role, or for the recreation of infrequent, high-stress situations that are difficult to replicate – these are just a few examples of the importance of using a variety of modalities when it comes to SBE.

Additionally, the CoDH study is one of many sources that find similar outcomes between virtual reality and physical simulation. A cost-utility analysis performed by Haerling also found “no significant differences in quantitative measures of learning or performance between participants in the mannequin-based and virtual simulation groups”. This study also reported a much lower cost-utility ratio favoring virtual simulation at $1.08 compared to manikin-based simulation at $3.62.

With VR, any space can be a learning environment. Quick setup, reset, breakdown times, and immersive, evidence-based clinical simulations make virtual reality a seamless adjunct to didactic learning and the transfer of knowledge to clinical practice.

As Brown et al. demonstrated in their paper on curriculum integration, virtual simulation can complement an existing program with positive student experiences.

Other benefits of virtual reality clinical simulations include ease of use, flexibility and accessibility, repeatability, and psychological safety.

Virtual reality has recently become a pivotal component of nursing education and training, and its use continues to rise, finding new avenues for adoption and use – for example, in Competency Mapping & Tracking or assessment.

With an easy setup, cost-effective maintenance, and the ability to recreate any situation, VR is an excellent addition to any simulation-based educational curriculum, allowing learners to direct patient care safely and providing immediate feedback and support for reflection and continued repetition of clinical skills practice.

For more information

For more on the benefits of virtual reality, see our research page, or to speak with an Educational Specialist about how best to integrate VR into your institution’s curriculum, set up a time to talk with us.

The post Virtual Reality: A New Wave for Simulation-Based Education appeared first on Oxford Medical Simulation.

Leveraging Virtual Reality to Improve Maternal Care

Oxford Medical Simulation — Thu, 15 Feb 2024 14:29:20 +0000

Preparing for the arrival of a new baby is often a time filled with joy, love, and anticipation as soon-to-be parents get ready both physically and mentally for a new chapter of life.

While pregnancy should be a time devoted solely to the excitement of bringing in new life, it sadly continues to be a cause for concern in healthcare with the CDC reporting a concerning rise in maternal death rate in the United States.

Rates of maternal mortality were dissected across a range of factors including age and race. For women aged 40 and older, the maternal mortality rate was 138.5 deaths per 100,000 live births, a rate 6.8 times higher when compared to a rate of 20.4 for women under 25 years old.

Significantly, racial disparities continue to be demonstrated in maternal mortality rates. According to the report entitled “Maternal Mortality Rates in the United States”, maternal mortality “rates for Black women were significantly higher than rates for White and Hispanic women.”

In a direct comparison, the maternal mortality rate in 2021 for White women was 26.6 deaths per 100,000 live births, while for Black women, the rate was at 69.9, 2.6 times higher than the rate for White women.

A recent study published by JAMA reviewed data between 1999-2019, While maternal mortality rates rose for all populations studied over 20 years, the median state maternal mortality rate was highest for Black women year over year.

In addition, disparities persisted in the median state maternal mortality rates for American Indian and Alaska Native women, as well, with rates more than tripling over the same time period.

While provisional data from the CDC demonstrates some promise in that maternal death rates appear to be decreasing, returning closer to rates seen pre-pandemic, this issue remains a significant part of maternal care.

Causes of maternal mortality

Taking in the above information, more questions surround why these disparities occur and what can be done to ameliorate them.

According to the World Health Organization, globally, major causes of maternal mortality can include infection, severe bleeding, or high blood pressure.

Infection or severe bleeding can occur following birth, however, cases with high blood pressure can impact or complicate delivery, making early detection and intervention highly important for patient safety.

Preparing for maternal healthcare

It’s well known that simulation-based education is a cornerstone of preparing for clinical situations that can arise at any time.

Between task trainers, manikins, or standardized patients, there’s a host of ways to practice delivering care in a safe space.

More recently, virtual simulation for maternal healthcare has become a pillar for healthcare education, providing another means to apply skills like clinical judgment and critical thinking to specific or infrequent situations related to specialized care.

Complications that arise during labor and delivery are difficult to recreate in physical simulation, often requiring specialized equipment and significant setup, reset, and takedown efforts.

Yet, it’s vitally important that learners – both students and practitioners – get repeated, frequent opportunities to grow accustomed to performing expertly in exactly these types of situations.

Particularly for onboarding nurses, recent graduates, or those coming from a generalist background – having the ability to lead in a high-intensity clinical situation before it plays out in real life can be invaluable to the preparation needed to feel competent, and confident, in delicate delivery situations.

Virtual reality and maternal care

Virtual reality provides an immersive landscape to practice anything from fundamental and foundational clinical skills development to rare conditions and complex case management.

Within the OMS scenario library are over 240 existing scenarios, covering a wide range of nursing and medical foundations and specialties. The maternal health scenarios are created by our in-house team of Clinical Authors and undergo rigorous peer review to ensure alignment with current standards of best practice.

These scenarios were developed to address the need to remain prepared for the assessment and management of obstetric emergencies like preeclampsia.

An opportunity to apply clinical knowledge and decision making skills within the context of a case can help learners cement concepts and bridge the gap between theory and practice.

Learners take the lead – they alone decide on what tests to order, how to interpret results, and they are responsible for implementing an appropriate and timely treatment plan. They also get the opportunity to observe changes in patient condition and respond accordingly, an imperative skill set that remains difficult to replicate in physical simulation.

For more information

Particularly in maternal health, early detection and intervention is key in affecting positive outcomes and safe patient care. If you’re interested in learning more about this specialized content, get in touch with us to set up a time to talk. For more information on upcoming scenarios, sign up for our newsletter to keep tabs on what we’re up to and what’s coming.

The post Leveraging Virtual Reality to Improve Maternal Care appeared first on Oxford Medical Simulation.

The True Cost of Nursing Turnover: Why Nurses are Resigning and What It Means for the Healthcare Industry

Oxford Medical Simulation — Wed, 17 Jan 2024 13:58:00 +0000

Nursing has seen a shift in recent years that has caused alarm – higher turnover rates, staff shortages, and an increased demand for healthcare professionals have impacted the remaining staff and patients.

It’s significantly financially costly for hospitals to replace lost staff, not to mention the time and resources cost of finding a suitable replacement. With reduced staff and increased workload for remaining clinicians, patient care may also be negatively impacted due to turnover.

According to the 2023 NSI National Health Care Retention & RN Staffing Report, the average turnover rate has decreased by about 4%, now at an average of 22.5%.

A significant finding from the report, as RN turnover rate increases or decreases, with each one percent fluctuation comes a savings or cost to the average hospital of $380,600 per year.

Considering the average turnover cost of one RN has increased over 13% from 2021 – now standing at $52,350 – it’s apparent that improving staff retention continues to be a primary focus of the healthcare industry.

Why are nurses resigning?

The role of an RN is demanding, with significant pressures to perform at each stop, as patient safety is of the utmost importance.

While the role has evolved, there hasn’t always been such an urgency and need to retain current staff – so where is the gap, and why are nurses resigning today?

Of course, that’s a question with multiple perspectives and no one answer, but some data can provide insight.

As Oracle reports, nurses report that factors contributing to their decisions to resign include burnout, salary, and career advancement.

A 2022 report from the U.S. Public Health Service noted that burnout had already reached “crisis levels” even before the onset of the pandemic, as nearly ⅓ to ½ of nurses and physicians were reporting symptoms of burnout.

Staff shortages and an increasing workload on remaining nurses are another set of potential factors for this continuing cycle.

When too many staff leave, the remaining staff and patient care can suffer.

The remaining staff are often called upon to take on the additional workload, and patient-to-nurse ratios may increase significantly. At the same time, recruitment progresses, and nurses may need more individual time with patients.

Turnover rates for new nurses are exceptionally high, reaching up to nearly 40% of new hires leaving within the first year. This may be due to increased or unexpected workloads or a need for more structured support following onboarding.

This may lead to the overworked staff seeking a new role, retiring early, or leaving the industry altogether.

What can be done to increase RN retention?

As this is a multifactorial issue, a host of contributing factors need to be put in place to begin addressing and improving staff retention.

According to a McKinsey report, top factors that increase the likelihood that a nurse will stay in their role include a sense of doing meaningful work, an ability to rely on team members, adequate technology, professional development opportunities, and being valued by the manager and organization.

A lack of being valued by the organization was the most reported reason for nurses who decided to leave their roles. Staff support is a significant contributing factor, particularly for new nurses and recent graduates, and education and training is a central support component for new nurses.

Training often occurs in a simulation lab and requires advanced notice for scheduling purposes. Usually done in groups and, in many cases, during working hours that may otherwise be used for documentation or breaks, a simulation may only be run once or twice, significantly limiting the hands-on training for many of the staff present.

Some hospital systems have leveraged immersive virtual reality scenarios to enhance onboarding experiences, investing in staff training and helping them prepare for complex or infrequent, emergent clinical situations. A host of contributing factors must be implemented to address and improve staff retention.

Virtual reality and healthcare training

Bringing advanced technology into the fold can demonstrate to staff that a hospital system is invested in their career development and is working to bring meaningful and impactful learning experiences to a structured training program.

As many academic institutions have embraced VR, new graduates may expect healthcare systems to follow suit in providing access to state-of-the-art training platforms that help in their readiness and transition to practice.

In hospitals, virtual reality has been utilized to help in the management of diabetic emergencies, increasing learner confidence and improving their daily practice following VR simulation.

Reducing scheduling conflicts and providing more readily available access to simulation can mean that nurses have more opportunities for directed, deliberate practice and reflective thinking, creating more meaningful learning experiences focused on skills like clinical decision-making or communication.

Investing in staff training to support professional development and patient care initiatives can significantly impact both staff and patient care.

One hospital system, Carle BroMenn Medical Center, has leveraged virtual reality training to assist in the detection and timely treatment of sepsis. Since implementing their program, staff self-perceived confidence and competence improved, and performance scores across the hospital jumped by nearly 40%.

Accommodating the demanding work schedule of nurses and staff and providing access to up-to-date technology and meaningful learning opportunities may be one step to improving retention and ensuring healthcare professionals get what they need to perform at their best.

The post The True Cost of Nursing Turnover: Why Nurses are Resigning and What It Means for the Healthcare Industry appeared first on Oxford Medical Simulation.