The promise and challenge of virtual gaming technologies for chronic pain: the case of graded exposure for low back pain.

Virtual reality (VR) technologies have been successfully applied to acute pain interventions and recent reviews have suggested their potential utility in chronic pain. The current review highlights the specific relevance of VR interactive gaming technologies for pain-specific intervention, including their current use across a variety of physical conditions. Using the example of graded-exposure treatment for pain-related fear and disability in chronic low back pain, we discuss ways that VR gaming can be harnessed to optimize existing chronic pain therapies and examine the potential limitations of traditional VR interfaces in the context of chronic pain. We conclude by discussing directions for future research on VR-mediated applications in chronic pain.

Can a virtual patient trainer teach student nurses how to save lives--teaching nursing students about pediatric respiratory diseases.

INTRODUCTION: Virtual environments offer a variety of benefits and may be a powerful medium with which to provide nursing education. The objective of this study was to compare the achievement of learning outcomes of undergraduate nursing students when a virtual patient trainer or a traditional lecture was used to teach pediatric respiratory content. METHODS: This was a randomized, controlled, posttest design. A virtual pediatric hospital unit was populated with four virtual pediatric patients having different respiratory diseases that were designed to meet the same learning objectives as a traditional lecture. The study began in Spring 2010 with 93 Senior I, baccalaureate nursing students. Students were randomized to receive either a traditional lecture or an experience with a virtual patient trainer. Students' knowledge acquisition was evaluated using multiple-choice questions, and knowledge application was measured as timeliness of care in two simulated clinical scenarios using high-fidelity mannequins and standardized patients. RESULTS: Ninety-three students participated in the study, of which 46 were in the experimental group that received content using the virtual patient trainer. After the intervention, students in the experimental group had significantly higher knowledge acquisition (P = 0.004) and better knowledge application (P = 0.001) for each of the two scenarios than students in the control group. CONCLUSIONS: The purpose of this project was to compare a virtual patient trainer to a traditional lecture for the achievement of learning outcomes for pediatric respiratory content. Although the virtual patient trainer experience produced statistically better outcomes, the differences may not be clinically significant. The results suggest that a virtual patient trainer may be an effective substitute for the achievement of learning outcomes that are typically met using a traditional lecture format. Further research is needed to understand how best to integrate a virtual patient trainer into undergraduate nursing education.

Educating neonatal nurse practitioners in the 21st century.

The purpose of this education project is to prepare neonatal nurse practitioners using a nonlinear (random exposure to information delivered in context rather than abstracting information as is done in a traditional lecture), asynchronous approach. The Internet-based 3-dimensional virtual "living world" classroom will have a living textbook and a virtual neonatal intensive care unit (NICU). Deploying the program within a virtual living world will enhance program accessibility and overcome the challenges of nurses returning to school. Greater accessibility can help to alleviate the shortage of neonatal providers, which are needed to meet the needs of the growing population.A Neonatal Curriculum Consortium comprising expert neonatal nurse practitioners and faculty are developing multimedia learning modules for core content defined by national organizations and certifying bodies. Our Internet-based, multisite, nonlinear, asynchronous universal neonatal curriculum has at its core a 3-dimensional virtual "living text book" for didactic instruction and a "living world" NICU for "deliberate practice." The NICU will feature an interactive virtual infant patient. Our "Virtual NICU" will assist students to transition from the classroom, to the simulation laboratory, and ultimately to the clinical area. Providing clinical learning experiences in the virtual NICU will enhance the students' opportunities to learn to care for the culturally diverse populations they will serve as neonatal nurse practitioners.

Serious games for immersive cultural training: creating a living world.

Living worlds offer a nonlinear, unscripted process for experiencing and safely learning the cognitive complexity and nuance of culture through emergent high-fidelity simulation. The 3D Asymmetric Domain Analysis and Training model uses visual, auditory, behavioral, and cultural models for immersive cultural training using the living-world construct.