Prebrief Time for Immersive Virtual and Augmented Reality Simulation: An Integrative Review.

BACKGROUND: Virtual reality and augmented technology are rapidly advancing and hold the potential to transform nursing education by offering a convenient, efficient, learner-centered way to educate students. A comprehensive and time-oriented prebrief is essential to the process. PURPOSE: This review analyzes the status of scientific exploration regarding the prebrief and time allotments for virtual and augmented reality simulation. METHODS: Whittemore and Knafl's 5-stage method guided this integrative review. The authors searched 6 databases and selected 7 articles based on inclusion criteria. RESULTS: The findings from this review demonstrated objectives, a safe learning environment, orientation, preparation materials, and time in the prebrief; yet, inconsistencies persist in the virtual and augmented reality prebrief. CONCLUSIONS: Defining a comprehensive and consistent prebrief is essential for high-quality simulation. A more standardized process, including time allotments, must be established for virtual and augmented reality.

Innovative Learning: Implementing Virtual Reality in a Large Class of Prelicensure Students Using Limited Equipment, Time, and Resources.

ABSTRACT: The development of critical thinking and decision-making skills is essential to link knowledge to practice in prelicensure nursing education. Immersive virtual reality (VR) is a teaching modality that provides students with an interactive way to develop their knowledge and skills. Faculty at a large mid-Atlantic university developed an innovative strategy to deploy immersive VR in a senior-level advanced laboratory technologies course with 110 students. Implementation of this approach to VR was intended to augment clinical learning in a safe learning environment.

Telepresence: An Innovative Teaching Modality to Enrich Simulation and Remote Learning.

ABSTRACT: The COVID-19 pandemic magnified the need for simulation and necessitated a radical change in how educators execute simulation-based learning (SBL), highlighting new and emerging technologies. Student evaluations noted a lack of realism with screen-based and telesimulations, and faculty reported students' decreased engagement. This project enhanced SBL using robot telepresence to provide an immersive and interactive environment. Student comments supported the positive experience, expressing greater engagement and indicating that the experience closely mirrored clinical practice. Telepresence removes barriers to distance learning, augments the potential of SBL, and broadens the understanding of how to deliver engaging SBL experiences to remote learners.

Outcomes of an Innovative Best Practice Clinical Immersion Framework: A Pilot Study.

BACKGROUND: Academic nursing has a long history of partnering with practice-based settings to provide clinical learning experiences for nursing students; however, these placements are not easily obtained, especially in pediatrics. APPROACH: A freestanding academic pediatric hospital and 3 academic nursing programs collaborated to provide clinical practice to nursing students hired in a practice-based internship program. A second aim was to pilot a best practice clinical immersion framework to provide academic credit to bachelor of science in nursing (BSN) students using a shared clinical syllabus and e-learning platform. OUTCOMES: Sixteen nursing students successfully completed the program; 11 (68.7%) completed the pre- and postevaluation with significant ( P < .05) changes in scores for 7 of the 20 questions. CONCLUSION: This best practice clinical immersion framework provided a strategy for obtaining clinical practice and academic credit, demonstrating the potential of innovative practice-academic partnerships. Further, this framework can be easily adapted in other practice-academic partnerships in all clinical areas.

Simulation strategies to increase nursing student clinical competence in safe medication administration practices: A quasi-experimental study.

BACKGROUND: Nursing student medication errors often result from deficits in knowledge and application of fundamental safe administration practices. Factors such as high faculty-student ratios and legal restrictions have decreased clinical learning opportunities for nursing students to practice safe medication administration in the clinical setting. Evidence suggests that use of a structured medication safety enhancement (MSE) simulation program can significantly improve student knowledge and competency in safe medication administration. PURPOSE: To examine the effects of an educational strategy using a MSE simulation program with integrated technology on the medication administration knowledge, competency, and confidence levels of undergraduate nursing students. METHODS: This quasi-experimental replication study designed and implemented medication simulations enhanced by integrated information technologies in an undergraduate-nursing curriculum. Third-year BSN students (n = 83) were randomized into intervention or control groups. Control groups participated in standard training while the intervention group received additional clinical simulation experience and debriefing sessions focused on medication safety practices. Participant knowledge was measured using pre/post Medication Safety Knowledge Assessment (MSKA) and competency was evaluated using the Medication Safety Critical Element Checklist (MSCEC). RESULTS: The MSKA and MSCEC were analyzed using two-sided independent t-tests. Post-test knowledge scores increased in both groups but results were not statistically significant (α = 0. 05). Students who received the medication safetfy enhancement intervention performed significantly better in a subsequent simulation than students who did not have prior simulation experience (p < .001). CONCLUSION: Findings suggest that educators should consider high fidelity simulation as an evidence-based teaching strategy to engage students in understanding and implementing medication safety practices in the clinical setting.

Optimization of Nursing-Specific Flu Alerts.

Clinical decision support interventions, such as alerts and reminders, can improve clinician compliance with practice guidelines and patient outcomes. Alerts that trigger at inappropriate times are often dismissed by clinicians, reducing desired actions rather than increasing them. A set of nursing-specific alerts related to influenza screening and vaccination were optimized so that they would "trigger" less often but function adequately to maintain institutional flu vaccination compliance. We analyzed the current triggering criteria for six flu vaccine-related alerts and asked nurse end users for suggestions to increase specificity. Using the "five rights" (of clinical decision support) as a framework, alerts were redesigned to address user needs. New alerts were tested and implemented and their activity compared in two different flu seasons, preoptimization and postoptimization. The redesigned alerts resulted in fewer alerts per encounter (P < .0001), less dismissals of alerts (P < .0001), and a 2.8% point improvement in compliance rates for flu vaccine screening, documentation, and administration. A focus group confirmed that the redesign improved workflow, but some nurses thought they still triggered too often. The five rights model can support improvements in alert design and outcomes.